The Ministry of Health is drafting a decree intended to allow public hospitals to offer higher pay to retain their best health workers.
The decree would allow the higher payments for efficiency and contribution to the hospital.
It would not limit the maximum earnings of health workers but stipulates that minimum income must be equal to or higher than their basic salary.
The ministry emphasises in a report accompanying the proposed decree that adequate salaries and benefits are essential to retaining staff, especially as health systems compete for workers in a globalised economy.
But it concedes that health-worker pay is so low it does not ensure their livelihood or sustain energy.
The report compares the cost of heart surgery in Viet Nam – from VND30 million (US$1,600) to VND40 million ($2,200) – with the about VND200 million ($11,000) in China and more than VND400 million ($20,000) in Singapore.
The figures show that health-worker pay does not compensate for the hard work and danger of the job, it says.
Extra payments
The report says payment for night shift, extra hours and permanent round-the-clock work should be added to daily examination and treatment fees.
A hardship allowance for work in toxic and other dangerous places; compensation for the extremely stressful work done by surgeons and higher pay for grassroots health workers should also be added in the price of health care, suggests the report.
Physician Nguyen Lan Hieu, at Ha Noi's Bach Mai General Hospital said the proposed changes would reduce "negatives" in health care.
"Standards of morality are usually assigned to health workers," he said.
"But how can they become dedicated without any motivation?"
Dr Hieu, like his colleagues, finds it difficult to fix free time to take his wife and child on vacation.
"It's honourable but very stressful work," he said.
The draft says patient costs will be based on all expenses including medicine, chemicals, materials, water, electricity, basic salary, training, scientific research, maintenance and the depreciation of fixed assets.
Health care cost would be readjusted each year based on commodity prices and changes to policy.
The report estimates the total hospital fees that patients and health insurance funds have to pay will increase by 20 per cent against the existing cost with the introduction of the new system.
The rise will be between 30 and 40 per cent if the costs of new technology and services are added.
About 53 million, or 62 per cent of Viet Nam's population, buy health insurance.
The ministry's report recommends hospitals in quickly developing cities and provinces be allowed to raise their fees.
This would allow priority in State funds for grassroots hospitals and clinics priority.
The report also discusses the support of hospitals and clinics that treat schizophrenia, tuberculosis and leprosy.
It has been posted on the Government web site to allow the public to have their say about the proposals.
Source: VNS