Circular No. 15/1999/TT-BYT guiding the implementation of the Private Medical Practice Ordinance and Resolution No. 06/CP dated January 29, 1994 of the Government on detailing certain provisions of the Private Medical Practice Ordinance in the field of medical practice.

CIRCULAR

Guidelines for implementing the Private Medical Practice Ordinance and Decree No. 06/CP dated January 29, 1994 of the Government on detailing certain provisions of the Private Medical Practice Ordinance in the field of medical practice.

Pursuant to the Private Medical Practice Ordinance dated September 30, 1993
Pursuant to Decree No. 06/CP dated January 29, 1994 of the Government detailing certain provisions of the Private Medical Practice Ordinance;

The Ministry of Health provides detailed guidelines for private medical practice as follows:

PART I
GENERAL PROVISIONS

Article 1: Forms of organization of private medical practice facilities:

1. Private hospitals:

- General

- Specialized

2. Multi-specialty clinics: Clinics with multiple specialties.

3. Specialized clinics:

- Internal medicine clinics: including the following types:

+ General internal medicine clinic

+ Internal medicine specialty clinics

+ Family medicine clinic

+ Telemedicine consultation clinic

- Surgery specialty clinic

- Obstetrics and family planning specialty clinic

- Dental specialty clinic

- Ophthalmology specialty clinic

- Otorhinolaryngology specialty clinic

- Plastic surgery specialty clinic

- Rehabilitation and functional recovery specialty clinic

- Diagnostic imaging specialty clinic

- Laboratory: Biochemistry, hematology, microbiology, histopathology.

4. Maternity homes

5. Healthcare services

- Denture clinic

- Injection and dressing change service

- Home healthcare service.

Article 2: Enterprises investing in building private healthcare facilities and individuals engaged in private medical practice are encouraged and enjoy incentives under the Law on Encouraging Domestic Investment dated May 20, 1998. The heads of private healthcare facilities must meet the qualifications and conditions for practicing according to the type of facility as stipulated in this Circular.

Article 3: Civil servants and officers on active duty in the People's Armed Forces are not allowed to participate in establishing or managing private hospitals or healthcare facilities established under the Law on Private Enterprise and the Law on Joint Stock Companies (when the Law on Enterprises takes effect). However, they may sign contracts with private hospitals and healthcare facilities to work overtime or register to practice outside their regular hours under other organizational forms if such individuals obtain written approval from their superiors.

Article 4: Healthcare facilities must have signs as prescribed, be transparent, and implement approved medical service fees and scope of practice. The scope of practice and medical service fees must be approved by the competent authority issuing the "Certificate of Qualification and Conditions for Establishing Private Medical Practice Facilities."

Article 5: Private healthcare facilities are only permitted to operate after obtaining a certificate of qualification and conditions for establishing private medical practice facilities from the competent health authority.

Article 6: All private medical practice facilities must register and pay the assessment fee for obtaining the certificate of qualification and conditions for establishing private medical practice facilities as stipulated in the joint Circular of the Ministry of Finance and the Ministry of Health.

PART II
QUALIFICATIONS, CONDITIONS AND SCOPE OF PRACTICE
FOR PRIVATE MEDICAL PRACTICE FACILITIES

Article 7: Hospitals: A hospital is a healthcare facility providing both inpatient and outpatient treatment. It can be either a general hospital or a specialized hospital.

1. Standards:

The director of a hospital must be a general practitioner or specialist who has practiced for five years at a hospital.

The head of a department must be a specialist who has practiced for five years at a legitimate healthcare facility, including three years in a specific specialty.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

- A hospital must have at least 21 beds.

- The organization and staff must be commensurate with the scale of the hospital.

- Infrastructure and medical equipment must comply with the regulations set forth in the hospital rules issued together with Decision No. 1895/1997-BYT-QĐ dated September 19, 1997.

The hospital must have the following:

+ Outpatient and emergency departments.

+ Treatment departments.

+ Ancillary departments.

+ Adequate electricity, water, fire-fighting equipment, and waste disposal systems.

+ Medical equipment for each department (at least equivalent to district level) as specified in the "List of Medical Equipment for Provincial, District, Regional Multi-Specialty Clinics, and Commune Health Stations" issued together with Decision No. 1419/BYT-QĐ dated August 23, 1996 by the Minister of Health.

Scope of practice:

Must comply with the technical procedures approved by the Ministry of Health. Hospitals must admit patients in critical condition and can only transfer them to another hospital after initial stabilization.

Article 8: Multi-specialty clinics: A multi-specialty clinic is a healthcare facility comprising several specialized clinics (at least two) under the supervision of a common director.

1. Standards:

The director of a multi-specialty clinic must be a general practitioner or specialist who has practiced for five years at a hospital; the head of a specialized clinic must be a specialist who has practiced for five years at a legitimate healthcare facility, including three years in a specific specialty.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

Infrastructure: Must ensure sufficient space. Equipment must meet the standards and conditions of specialized clinics. In addition to specialized clinics, multi-specialty clinics must have waiting rooms, emergency rooms, observation rooms (with a maximum of ten observation beds and no longer than 24 hours), adequate sanitary facilities, electricity, water, waste disposal systems, and environmental sanitation.

Scope of practice:

Practice according to the approved list of specialties.

Article 9: Internal clinics:

Internal medicine clinics include the following types:

- General internal medicine clinic

- Internal medicine specialty clinics

- Family medicine clinic

- Telemedicine consultation clinic

1. Standards:

The person registering to practice must be a general practitioner or specialist who has practiced for five years at a legitimate healthcare facility.

In highland areas, a medical officer who has practiced for five years at a legitimate healthcare facility or a doctor who has practiced for three years may register to practice. Medical officers are not allowed to provide telemedicine consultations.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

a. General internal medicine clinics and internal medicine specialty clinics must have basic medical equipment, a first aid kit, and anti-shock medications (Annexes 1 and 2). They must have at least one separate examination room of 10 square meters, with an examination bed and desk. The premises must be well-ventilated, neat, and equipped with lighting, water, sanitary facilities, and separated from residential areas.

b. Family medicine clinics must have basic medical equipment, a first aid kit, and anti-shock medications (Annexes 1 and 2).

Scope of practice:

a. General internal medicine clinics and family medicine clinics:

- Health counseling and family planning.

- Health management.

- Provide first aid, emergency care, diagnosis, prescription writing, and treatment of common illnesses without performing specialized procedures. Cases beyond their capacity should be referred to specialized clinics or higher-level facilities.

- Outpatient surgery: initial fracture care without casting, no minor surgeries.

- Obstetrics: prenatal care, pregnancy management, no delivery assistance.

- Conduct dental examinations but do not extract teeth.

- Examination of ear, nose, and throat: otoscopy, rhinoscopy, and pharyngoscopy; no incision or drainage for acute otitis media.

- Conduct simple tests using paper strips.

- Collect samples for testing; no biopsy or puncture.

- Electrocardiogram, ultrasound, etc., do not require separate certification, but must have a certificate of specialized training and practical experience in these fields from legitimate medical facilities authorized by competent authorities to practice within their scope of work. Inpatient departments shall conduct diagnosis and treatment of diseases within the approved specialties.

c. Telephone consultation room: doctors can only provide consultations in specialties they have registered and been trained in.

Article 10: Semi-public specialized surgical clinics:

1. Standards:

The practitioner must be a specialist surgeon who has practiced for five years at a legitimate medical facility, with at least three years of specialization in surgery.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

In addition to equipment and infrastructure as stipulated in Article 9 of this Circular, surgical clinics must have minor surgery tools and rooms, emergency rooms, and patient observation rooms, with particular attention paid to infection control techniques (Annex 3).

Scope of practice:

- Emergency care for surgical cases.

- Examination and treatment of common wounds.

- Casting of small bone fractures.

- Removal of plaster casts according to physician's instructions.

- Hemorrhoid banding, cyst excision, small subcutaneous tumor removal.

- No incision for large spreading abscesses.

Article 11: Obstetric and Gynecological Clinic - Family Planning Clinic:

1. Standards:

The practitioner must be a doctor who has practiced for five years at a legitimate medical facility, including at least three years specializing in obstetrics and gynecology.

In highland areas, midwives or nurse-midwives with a college degree who have practiced for five years in the specified specialty may register to practice.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

There must be examination tables, gynecological examination tools, and procedure rooms. In addition to general emergency medications, there must be specialized emergency medications (Annex 1, 4).

Scope of practice:

- Health education counseling, family planning counseling.

- Obstetric and gynecological emergencies.

- Prenatal examinations and pregnancy management.

- Routine gynecological examination and treatment.

- Inserting vaginal medication.

- Treating cervical erosion by cauterization.

- Performing cervical cytology tests.

- Inserting intrauterine devices.

- Inducing abortion up to 15 days post-conception.

- Performing male sterilization without using a knife.

- Not performing induced abortion, removal of intrauterine devices, or female sterilization.

- Not delivering babies at the clinic.

Article 12: Dental and Maxillofacial Clinic:

1. Standards:

The practitioner must be a dental and maxillofacial specialist who has practiced for five years at a legitimate facility.

In highland areas, dental and maxillofacial technicians with five years of practice or dentists with three years of specialization may register to practice.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

- Adequate dental and oral surgery equipment, including prosthodontic equipment if applicable.

- Must have sufficient minor surgery rooms and working spaces within the scope of practice (Annex 6, 7).

Scope of practice:

- General medical examinations and emergency care for facial injuries.

- Minor scar repair surgeries.

- Jaw realignment.

- Surface laser treatment.

- Treating periodontal diseases.

- Draining abscesses, removing tartar, and extracting teeth.

- Making dentures and false teeth.

Article 13: Otolaryngology Clinic:

1. Standards:

The practitioner must be an otolaryngologist who has practiced for five years at a hospital, including at least three years of specialization.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

- Must have sufficient examination and procedure equipment, including a minor surgery room (Annex 8).

Scope of practice:

- Emergency care for otolaryngological conditions.

- Routine examination and treatment.

+ Sinusitis, sinus puncture, and fluid aspiration from cysts.

+ Incision and drainage for acute otitis media.

+ Incision and drainage for peritonsillar abscess.

+ Simple polyp removal, benign cysts, lipomas in the ear, nose, and throat area.

+ Stopping nasal bleeding.

+ Removing foreign objects from the ear, nose, and throat. Not removing foreign objects from the trachea or esophagus.

+ Thermal ablation, laser ablation of the throat.

+ Suturing wounds in the head and neck region under 5cm.

+ Adenoidectomy.

Article 14: Eye Clinic:

1. Standards:

The practitioner must be an ophthalmologist who has practiced for five years at a hospital, including at least three years of specialization in ophthalmology.

In highland areas, ophthalmic technicians with five years of specialization may register to practice.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

- Must have sufficient examination and procedure equipment, including a minor surgery room (Annex 9).

- Adequate emergency eye medications.

- Minor surgery room.

Scope of practice:

- Emergency and routine eye care.

- Subconjunctival injections, periocular injections, and retrobulbar injections.

- Removal of foreign bodies from the conjunctiva, chalazion excision, pterygium excision, corneal ulcer excision.

- Lacrimal duct irrigation.

Article 15: Aesthetic Surgery Clinic: This is a facility that provides aesthetic services performed by physicians.

Beauty services such as skincare, makeup, and wedding makeup do not require health certificates for operation. These facilities are prohibited from performing tattooing, acne extraction, or other procedures causing bleeding.

1. Standards:

The practitioner must be a doctor who has practiced for five years at a hospital, including at least three years of specialization in plastic surgery or aesthetics.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

- Must have appropriate equipment and facilities for the scope of practice.

- The facility must ensure sterility, have sufficient operating rooms, recovery rooms, and waiting rooms.

Scope of practice:

- Tattooing lips and eyelids, acne extraction, and other blood-bleeding cosmetic services.

- Hair transplantation.

- Cheek augmentation and rhinoplasty.

- Facelift surgery.

- Treating upper and lower eyelid wrinkles, creating double eyelids from single eyelids.

Article 16: Rehabilitation and Functional Restoration Clinic:

1. Standards:

The practitioner must be a rehabilitation specialist who has practiced for five years at a legitimate medical facility, including at least three years of specialization in nursing and rehabilitation.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

In addition to the requirements set out in Point a, Clause 2, Article 9 of this Circular, rehabilitation clinics must have sufficient rooms and equipment suitable for the scope of practice.

Scope of practice:

- Care for central and peripheral nervous system paralysis syndromes.

- Caring for chronic musculoskeletal diseases.

- Postoperative care requiring continued functional rehabilitation.

- Implementing techniques:

+ Massage, acupressure, acupuncture.

+ Approved physical therapy methods.

+ Therapeutic exercises.

Article 17: Diagnostic Imaging Room: This facility assists in disease diagnosis and treatment monitoring through X-ray, ultrasound, endoscopy, etc.

1. Standards:

The practitioner for diagnostic imaging must be a radiologist who has practiced for five years in the specialty.

In highland areas, doctors who have practiced for five years at a legitimate medical facility, including at least three years of specialization in radiology, may register to practice.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

- Must have sufficient personal protective equipment and radiation-safe X-ray rooms. Equipment must meet county-level standards (Annex 10).

- Infrastructure must ensure absolute safety: must have waiting rooms, examination rooms, film processing rooms, printing rooms, result reading rooms, etc. The equipment room must be at least 3.5 meters high, with walls coated with barium and lead-lined doors, and a dry floor.

Scope of practice:

- Conducting X-rays, computed tomography, and magnetic resonance imaging.

- Doppler ultrasound diagnosis.

- Do not use contrast media for angiography.

- Not to perform ultrasound-guided biopsies, endoscopic surgery, bronchoscopy, or interventional radiology procedures involving bleeding.

Article 18: Laboratory: This facility aids in diagnosis and treatment monitoring, including hematology, biochemistry, microbiology, and histopathology.

1. Standards:

The practitioner for laboratories must be a doctor, pharmacist, or biological/biochemical science graduate who has practiced for five years in laboratory medicine at a legitimate medical facility.

In highland areas, practitioners must be doctors, pharmacists, or biological/biochemical science graduates who have practiced for five years at a legitimate medical facility, including at least two years of specialization.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

- Must have minimum specialized medical equipment (equivalent to a county-level laboratory) (Annex 11).

- Infrastructure must meet laboratory standards, architectural design and organization must comply with safety regulations for laboratory work. Attention should also be given to auxiliary parts such as electricity, water supply, and fire prevention.

Scope of practice:

Conduct hematological, biochemical, microbiological, parasitological, and histopathological (microscopic) tests.

Article 19: Maternity Home: This facility provides childbirth assistance, management, and postnatal care.

1. Standards:

The person registering to practice as an obstetrician-gynecologist or midwife with a secondary education must have practiced for five years at a maternity facility.

In highland areas: doctors and midwives with a secondary education who have practiced for three years at a maternity facility may register to operate a midwifery house.

The person registering to establish a midwifery house must be practicing full-time (not someone registered to practice outside regular working hours).

Conditions:

- Infrastructure: There must be delivery waiting rooms, delivery rooms, and post-delivery rooms that ensure sterile and well-ventilated conditions.

- Equipment: Must include a birthing table, delivery equipment, examination tools, general first aid kits, and obstetric emergency kits (Annex 5).

Scope of practice:

- Prenatal examinations and pregnancy management.

- Emergency and first aid obstetric care.

- Tetanus vaccination.

- Urine protein testing.

- Normal delivery assistance.

- Removal of retained placenta after delivery or miscarriage.

- Not to perform abortions.

- If there is an obstetrician-gynecologist capable of handling difficult deliveries, vacuum extraction, abortion under 15 days, intrauterine device insertion, and removal of intrauterine devices, they can perform first-class obstetric procedures.

Article 20: Medical services: The medical services referred to in this Circular are those performed based on prescriptions from physicians.

1. Standards:

The person registering to operate an injection and dressing change facility must be a nurse with a secondary education who has practiced for two years at a legally recognized healthcare facility.

The person registering to operate a dental prosthesis facility must be a dental technician who has been practicing since before 1980 and hold a certificate from local authorities.

The person registering to provide home health care services must have a relevant professional qualification corresponding to the service being registered.

Military service personnel falling under the categories specified in Article 1 of this Circular may extend their age for active service if they meet all of the following conditions:

- Injection and dressing change facility:

+ Must have a room with a minimum area of 8 square meters.².

+ Must have sufficient equipment and ensure sterility.

+ Must have a first aid kit and a shock treatment room.

- Dental prosthesis facility: The facility must meet the scale requirements, having either a separate dental room or a workshop equipped with dental prosthetic tools (Annex 7).

Scope of practice:

- Injection and dressing change services: Can only be performed based on prescriptions from physicians and cannot involve diagnosis or prescription writing.

- Dental prosthesis services: Can only involve making dentures and cannot include dental examinations or tooth extractions.

- Home health care services: Must be performed based on prescriptions from physicians.

CHAPTER III
AUTHORITY TO ISSUE CERTIFICATE OF MEETING STANDARDS AND CONDITIONS FOR ESTABLISHING PRIVATE HEALTHCARE PRACTICES

Article 21: Authority to issue certificates of meeting standards and conditions for establishing private healthcare practices (referred to as certificates of meeting standards and conditions for practice).

1. The Minister of Health shall issue "certificates of meeting standards and conditions for practice" for private hospitals and other healthcare facilities established under the Law on Private Enterprises and the Law on Companies (as amended by the Enterprise Law when it comes into effect).

2. The Director of the Department of Health of the province or centrally-administered city (collectively referred to as provinces) shall issue certificates for all other types of facilities, except those specified in Clause 1 of this Article.

3. The Ministry of Health shall establish an Advisory Council to assist the Minister in reviewing standards and conditions for issuing certificates. The Council shall be chaired by a Deputy Minister, with the Vice Chairman being the Director of the Treatment Department, and including a representative from the Vietnam Medical Association and other members.

4. The Department of Health of the province shall establish an Advisory Council to assist the Director of the Department in reviewing standards and conditions for issuing certificates. The Council shall be chaired by a provincial health department leader, with the Vice Chairman being the Head of the Professional Affairs Division or the Head of the Private Healthcare Management Division, and including a representative from the Provincial Medical Association and other members.

Article 22:

The application dossier for issuing "certificates of meeting standards and conditions for practice" shall be decided by the Minister of Health:

1. Application for hospital establishment.

2. Application for review to obtain "certificate of meeting standards and conditions for practice."

3. Hospital charter.

4. Economic and technical feasibility study: The content of the study must satisfy the following requirements:

- The necessity for investment.

- Project objectives.

- Name, location, form of investment, infrastructure construction plan.

- Specialized areas, rooms, number of beds.

- Supporting items (electricity, water, fire prevention and extinguishing, waste management, roads, landscaping).

- Construction costs.

- Implementation schedule.

- Certificates regarding waste management, radiation safety, fire prevention, and extinguishing.

- Medical equipment.

- Equipment name, quantity, price, total investment value for equipment.

- Management structure, personnel organization, staff.

- Investment capital and financial analysis.

- Economic and social benefits.

5. Detailed scope of practice.

6. List of Board of Directors and Executive Committee members (with brief biographies).

7. Copies of professional diplomas, certificates, practical experience, health check-up reports of the Director, heads of departments, doctors, pharmacists, and other university-level staff (with notarization by state notaries), related contracts, and certificates.

8. Introduction letter from the Medical Association.

Article 23: Procedures for reviewing applications for issuing "certificates of meeting standards and conditions for practice" for healthcare facilities shall be signed by the Minister of Health:

1. After completing all infrastructure construction, equipment installation, and personnel organization, the directors of private healthcare facilities (as stipulated in Clause 1, Article 21) submit the entire application dossier to the Department of Health. The Director of the Department of Health of the province shall establish a review team with necessary members (including representatives from the Medical Association) to conduct on-site reviews at the applying facility.

2. Review contents:

a. Legal basis.

b. Establishment application dossier (as stipulated in Article 22).

c. Infrastructure and environmental hygiene conditions.

d. Organization and personnel.

e. Medical equipment and tools.

f. Specific scope of practice.

3. The review record shall include the following main parts:

a. Time and place.

b. Participants:

- Review team

- Representatives of the reviewed facility.

c. Results of the review of six contents (specifically recorded).

d. Conclusions and recommendations.

4. After completing the review, the Department of Health shall send a recommendation letter along with the review record and the entire application dossier of the reviewed facility to the Ministry of Health.

All documents must be original copies, and all copies must bear the seal of a state notary.

Article 24:

1. The application dossier for issuing "certificates of meeting standards and conditions for practice" for private healthcare practices shall be decided by the Director of the Department of Health:

a. Application for registration of practice, specifying location and scope of practice.

b. Copies of professional diplomas and certificates (with notarization by state notaries).

c. Brief biography and health check-up report.

d. Permission to work outside regular hours if currently employed as a civil servant.

e. Description: location, facilities, equipment, personnel organization, and scope of practice.

If the practice facilities are simple, they may be described directly in the application form.

g. A letter of introduction from the Association of Traditional Medicine.

2. The procedures for reviewing the issuance of the Practice Permit signed by the Director of the Department of Health:

a. The practice facilities submit their applications to the Department of Health. The Department of Health will establish a review team to conduct on-site reviews at the requesting facilities.

b. The contents and minutes of the review shall be in accordance with Clause 2 and Clause 3 of Article 23.

Article 25: The validity period of the certificate of meeting the criteria and conditions for practice:

1. The Practice Permit issued by the Minister of Health is valid for five years.

The Practice Permit issued by the Director of the Department of Health is valid for three years.

2. Three months before the expiry date, the facilities must complete the procedures to renew the permit.

Article 26:

The Practice Permit shall be sent and kept as follows:

- The Practice Permit signed by the Minister of Health shall be made in four copies: one copy sent to the People's Committee of the province, one copy for the Department of Health, one copy for the applicant, and one copy retained by the Treatment Department.

- Other types of Practice Permits shall be made in three copies: one copy retained by the Department of Health, one copy sent to the applicant, and one copy sent to the District Health Office.

PART IV
 RIGHTS AND OBLIGATIONS OF THE
PRIVATE HEALTH PRACTITIONERS

In addition to the rights and obligations stipulated in Chapter III of the Private Medical Practice Ordinance and Article 16 of Decree No. 06/CP dated January 29, 1994 of the Government regarding the detailed implementation of certain provisions of the Private Medical Practice Ordinance, private health practitioners have the following rights and obligations:

Article 27:

1. Rights:

- Private hospitals are permitted to organize pharmacies, but the establishment procedures for pharmacies must comply with the relevant laws.

- Private health practitioners are entitled to long-term training according to state regulations on enrollment to improve their skills; participate regularly in professional activities and continuing education programs of the profession. Private health practitioners are eligible to attend training sessions to update their knowledge, particularly concerning dangerous diseases (malaria, cholera, typhoid, HIV/AIDS...). The provincial Department of Health has the responsibility to coordinate with the Provincial Association of Traditional Medicine to organize training and upgrading of skills, and updating of knowledge for private health practitioners.

- Individuals and units that achieve outstanding results in serving patients shall be commended and rewarded appropriately.

2. Responsibilities:

- They must reserve 3% of hospital beds for examining and treating poor patients; other forms of private health practice organizations must organize free medical examination and treatment sessions for poor patients.

- They must display the correct type of signboard, publicly post the fee schedule, and clearly specify the scope of practice; they must operate within the approved scope of practice and charge the approved fees.

+ Private hospitals and healthcare establishments established under the Law on Private Enterprises and the Company Law must develop a fee schedule and report it to the Ministry of Health for approval.

+ Other forms of private health practice organizations must develop a fee schedule and report it to the provincial Department of Health for approval.

- They must have an emergency medicine cabinet as prescribed, and must not sell drugs while prescribing them, nor prescribe the use of new types of drugs or apply new medical techniques that have not been approved for circulation.

- Private health practice organizations have the obligation to participate in disease prevention and control programs and national health programs. It is strictly prohibited to exploit medicines and equipment provided by the government (free of charge) for sale to make profits.

- Private health practice organizations must enter into contracts with public healthcare establishments to receive technical support and transfer patients when required.

CHAPTER V
 MANAGEMENT OF PRIVATE HEALTH PRACTICE

Article 28:

1. The provincial Department of Health is the agency assisting the provincial People's Committee in performing the state management functions over private health practice, having a dedicated department or staff responsible for overseeing and managing private health practice. For large cities such as Hanoi, Ho Chi Minh City, etc., the provincial Department of Health must report to the provincial People's Committee to request the Ministry of Health and the Civil Service Bureau of the Government's permission to retain the existing private health practice management departments of the provincial Department of Health to assist the Director in managing private health practice in the province.

2. District and county health centers may have dedicated or part-time staff to oversee and manage private health practice facilities in their respective areas depending on the situation.

3. Health stations help the district or commune People's Committees to monitor and create favorable conditions for private health practice facilities to effectively serve the health needs of the people, provide primary health care, and implement health programs.

Article 29:

1. The periodic reports submitted by the provincial Departments of Health to the Ministry of Health should include sections on the management of private health practice in the locality.

2. Each year, the provincial Departments of Health must submit separate reports on private health practice to the Ministry of Health.

3. Private hospitals and healthcare establishments established under the Law on Private Enterprises and the Company Law must submit periodic reports to the Ministry of Health.

Chapter VI
 INSPECTION, AUDITING, AND HANDLING OF VIOLATIONS

Article 30:

The Ministry of Health and the provincial Departments of Health shall organize regular or spot inspections and audits of the implementation of laws and regulations on private health practice. Organizations and individuals engaged in private health practice (including those with foreign investment) must comply and facilitate inspections and audits at their premises.

Article 31: Handling Violations

Organizations and individuals engaged in private health practice (including those with foreign investment) who violate the law, this Circular, and medical and technical regulations shall be subject to administrative penalties as specified in Decree No. 46/CP dated August 6, 1998 of the Government on the handling of administrative violations in the field of health administration, or criminal liability and compensation for damages as provided by law, depending on the severity of the violation.

Chapter VII
IMPLEMENTATION PROVISIONS

Article 32:

This Circular takes effect fifteen days after its date of issuance and replaces Circular No. 07/BYT-TT dated April 30, 1994 of the Minister of Health on guiding the implementation of the Private Medical Practice Ordinance and Decree No. 06/CP dated January 29, 1994 of the Government on detailing certain provisions of the Private Medical Practice Ordinance in the field of private health practice.