JOINT CIRCULAR NO. 27-TT/LB ON THE MANAGEMENT OF MEDICINE FUNDS IN HOSPITALS

 CIRCULAR
Regarding the management of medicine funds at hospitals 

Recently, many hospitals have complained about a lack of medicine due to insufficient funding or because the medicine standards are too low, thus failing to ensure adequate treatment.

The Joint Ministry has sent cadres to study at some facilities and found the specific situation as follows:

- Medicines needed for treatment are lacking, but at the same time, there are many other types of medicines stored in warehouses. Many items can replace each other, but hospitals do not actively utilize them despite guidance from the Ministry of Health. The desire to use special medicines is still quite common. Common items lie idle in warehouses for long periods, leading to some deteriorating in quality or becoming damaged.

- Advance funds at some places exceed the prescribed level in Circular No. 33-TCYT dated December 11, 1957, by two or three times, but some hospitals have not actively collected hospital fees, resulting in insufficient funds to purchase medicines, and then reporting financial shortages to the finance department.

- However, there are also places where the allocated budget is insufficient or rigidly fixed within the standard (VND60 or VND80 per bed per day) without considering the actual situation of the hospital, which has developed from a lower-level hospital with multiple specialized departments.

The management of medicine funds in many places has not been given sufficient attention, and the overall situation regarding the use of medicines on patient beds or in various departments, as well as the stock of medicines in warehouses, is generally not accurately grasped.

This situation has hindered patient service and may lead to waste and corruption, adversely affecting public funds.

To end this situation, the Joint Ministry proposes that provinces take the following actions:

1. REGARDING THE ISSUE OF ALLOCATION

Allocate advance funds to hospitals (or health stations) according to the provisions of Circular No. 33-TCYT mentioned above to purchase medicines for patient use and collect fees according to Circular No. 49-TTLB dated November 11, 1957, which established the hospital fee collection system.

- In addition to advance funds, if the hospital has departments such as radiology, surgery, dentistry, or rooms such as outpatient clinics dispensing medicine, laboratory testing, delivery, etc., then the finance department should allocate monthly funds for these departments' medicine expenses under operational expenses (item business fees).

For these departments, current standards for medicine expenses (except for outpatient clinics dispensing medicine) have not yet been defined, so when preparing budgets or final accounts, hospitals need to analyze the medicine expenses of each department, along with relevant data and plans or results of work (number of people examined, treated, etc.), and compare with previous months to explain increases or decreases. Additionally, the finance department should send auditors to review on-site to provide a basis for more accurate allocation.

2. REGARDING MANAGEMENT

Hospitals or health stations must:

- Actively improve the organization of hospital fee collection (study Circulars of the Ministry of Health No. 1328-BYT dated February 28, 1958, and No. 3465-BYT dated May 21, 1958, disseminating experiences in hospital fee collection).

- Improve pharmaceutical accounting - From the hospital's medicine warehouse to departments, rooms, and patient beds, there must be a system of accounting and statistics as outlined in Circular No. 3465-BYT of the Ministry of Health mentioned above.

- Actively use stored medicines, utilizing interchangeable medicines according to the guidance of the Ministry of Health.

3. DETERMINATION OF STANDARDS

Through a process of tracking expenditures on medicines in each department, combined with strengthened management, increased awareness of thrift, anti-corruption, and anti-waste, localities (Finance, Health, and hospitals, health stations) need to reassess and redefine the standards or expenditure limits for medicines in hospitals and health stations.

If changes are necessary, detailed reports should be submitted to the Joint Ministry for decision-making. However, while awaiting the Joint Ministry's opinion, if deemed urgent, the Provincial People's Committee, City People's Committee, or Autonomous Region Committee may decide on temporary measures.

Expenditures on medicines are a crucial component of the entire operational expenses of a medical facility.

The Joint Ministry requests that Provincial People's Committees, City People's Committees, and Autonomous Region Committees carefully study this circular and implement it effectively. If there are any difficulties, please report them immediately to the Joint Ministry for resolution.