Law on Medical Examination and Treatment 2023, Law No. 15/2023/QH15

LAW

On Medical Examination and Treatment

Pursuant to the Constitution of the Socialist Republic of Vietnam;

The National Assembly promulgates the Law on Medical Examination and Treatment.

Chapter I

GENERAL PROVISIONS

             Article 1. Scope of regulation

This Law provides the rights and obligations of patients, medical practitioners and medical examination and treatment establishments; professional and technical requirements for medical examination and treatment; use of traditional medicine in medical examination and treatment, and combination of western medicine with traditional medicine in medical examination and treatment; humanitarian medical examination and treatment for non-profit purposes; technical transfer in medical examination and treatment; application of new techniques and methods and clinical trial; professional and technical mistakes; conditions to assure medical examination and treatment; mobilization of forces to serve medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations.

Article 2. Interpretation of terms

In this Law, the terms below shall be construed as follows:

1. Medical examination means the medical practitioners’ use of knowledges, methods, professional and techniques to assess patients’ health status, risks to patients’ health and healthcare needs.

2. Medical treatment means the medical practitioners’ use of knowledges, methods, professional and techniques to solve patients’ diseases, prevent the disease development or occurrence, or to meet the patients’ healthcare needs on the basis of the medical examination results.

3. Patient means a user of medical examination and treatment services.

4. Medical practitioner means a person possessing a medical practice license granted by a competent agency of Vietnam (below referred to as practitioner).

5. Medical practice license means a document granted by a Vietnamese competent agency to a person eligible for practicing medical examination and treatment under this Law (hereinafter referred to as practice license).

6. Medical examination and treatment establishment means an establishment granted with a license for medical examination and treatment to provide medical examination and treatment services by a competent agency of Vietnam.

7. License for medical examination and treatment means a document granted by a Vietnamese competent agency to an establishment eligible for conducting medical examination and treatment operations under this Law (hereinafter referred to as operation license).

8. Family herbal remedy or treatment method mean a remedy or treatment method passed from one generation to another of a family or family line, which effectively cures one or some diseases and is recognized by a health agency under the provincial-level People’s Committee.

9. Owner of a family herbal remedy or treatment method means a person holding the right to own the family herbal remedy or treatment method as prescribed in Clause 8 of this Article.

10. Patient without a relative means one of the following persons:

a) Patient in an emergency state without a personal paper, accompanied relative and information to contact his/her relatives;

b) Person who, at the time of visiting the examination and treatment establishment, is unable or has difficulties in cognition and behavior control, and has no personal paper, accompanied relative and information to contact his/her relatives;

c) Person who has been identified but at the time of visiting the examination and treatment establishment, is unable or has difficulties in cognition and behavior control, and has no accompanied relative and information to contact his/her relatives;

d) Infant under 6 months who is abandoned at the medical examination and treatment establishment.

11. Patient’s relative means one of the following persons:

a) Spouse; natural father, natural mother, adoptive father, adoptive mother, father-in-law, mother-in-law; natural son/daughter, adopted son/daughter, son-in-law, daughter-in-law of the patient, or another family member as prescribed by the Law on Marriage and Family;

b) Patient’s representative;

c) Person directly taking care of the patient during the medical examination and treatment at the medical examination and treatment establishment, other than the practitioner.

12. Patient's representative means a person who perform the patient's rights and obligations on behalf of the patient within the representative scope in accordance with this Law.

13. Person responsible for professional of the medical examination and treatment establishment means the at-law representative for all professional operations of that examination and treatment establishment.

14. Continued updating of medical knowledge means the improvement of medical knowledge and skills appropriate to the professional practice scope under the Health Minister’s regulations.

15. Emergency state means a health condition or behavior that appears suddenly of a person that, if not monitored and intervened in time, can lead to impaired bodily functions, serious and long-term damage to the organ or body part or death to that person or serious threat to the health or life of another person.

16. Consultation means a discussion among a group of practitioners on the disease status of a patient for diagnosis and introduction of appropriate and timely treatment methods.

17. Case history dossier means a set of data, including personal information, medical examination result, paraclinical result, functional exploration result, process of diagnosis, treatment, care and other relevant information during the medical treatment of the patient at the medical examination and treatment establishment.

18. Functional rehabilitation means a set of interventions, including medical methods, rehabilitation techniques, assistive technologies, educational, vocational, social and environmental measures, so that patients develop, achieve, maintain maximum functional activity, prevent and reduce disability appropriate to their environment.

19. Remote medical examination and treatment means a form of medical examination and treatment without direct contact between practitioners and patients, but medical examination and treatment is carried out through equipment and information technology.

20. Health examination means a medical examination to determine health status, classify health or detect and manage diseases.

21. Medical assessment means a medical examination to determine the health status, and extent of bodily harm caused by injury, disease, illness, deformity at the request or request of agencies, organizations or individuals.

22. Adverse event means any untoward or abnormal medical occurrence in a medical examination and treatment caused by objective or subjective factors.

23. Medical complication means an adverse event that causes harm to the health and life of a patient due to one of the following reasons:

a) Unintentional risks occur even though the practitioner has complied with professional and technical requirements for medical examination and treatment (hereinafter referred to as professional and techniques);

b) Professional and technical mistakes.

Article 3. Principles for medical examination and treatment

1. To respect, protect and ensure equality, fairness and non-discrimination for patients.

2. To prioritize medical examination and treatment for cases of emergency, under-6 children, pregnant women, people with extremely severe disabilities or severe disabilities, people aged full 75 or older; people with meritorious services to the revolution suitable to the characteristics of medical examination and treatment establishments.

3. To respect, cooperate with, and protect practitioners and others on duty at medical examination and treatment establishments.

4. To promptly and properly observe professional and technical regulations.

5. To comply with regulations professional ethics for practicing medical examination and treatment promulgated by the Minister of Health.

6. To ensure equality, fairness among medical examination and treatment establishments.

Article 4. State policies on medical examination and treatment

1. The State plays a leading role in the development of medical examination and treatment activities; mobilizes social resources for medical examination and treatment activities.

2. To prioritize state budget for the following activities:

a) Developing medical examination and treatment establishments under grassroots health care, and out-of-hospital emergency systems; focusing on investing in medical examination and treatment establishments in border areas, islands, ethnic minority and mountainous areas, areas with difficult socio-economic conditions and areas particularly difficult socio-economic conditions;

b) Providing medical examination and treatment for people with meritorious services to the revolution; children, the elderly, people with disabilities, people of poor and near-poor households; people currently living in border areas, islands, areas with difficult socio-economic conditions and areas particularly difficult socio-economic conditions; people suffering a mental disease or leprosy; people suffering group-A or group-B communicable diseases in the listed regulated by the Minister of Health;

c) Strengthening the development of human resources for healthcare, especially those in the fields of infectious diseases, psychiatry, anatomical pathology, forensic medicine, forensic psychiatry, emergency resuscitation and other specialized and fields that need to give priority to meet the needs and conditions of socio-economic development in each period according to the Government's regulations;

d) Studying and applying science, technology and digital transformation in medical examination and treatment.

3. To encourage the coordination between private and public sectors; to give investment incentives in medical examination and treatment. Medical examination and treatment establishments shall be eligible for credit incentives to invest and raise the medical examination and treatment quality; be exempted from enterprise income tax for the undivided income that is left to invest in the development of medical examination and treatment establishments.

4. To invest in medical examination and treatment establishments in areas with difficult socio-economic conditions or extremely difficult socio-economic conditions, and medical examination and treatment establishments for non-profit purposes determined sectors and trades eligible for special investment incentives in the List of sectors and trades eligible for investment incentives.

5. To rotate on a definite term for practitioners at state-owned medical examination and treatment establishments.

6. To have a special treatment policy for practitioners.

7. To have a policy to develop human resources in charge of management and administration of hospitals.

8. To promote the role of health socio-professional organizations in medical examination and treatment.

9. To inherit and promote traditional medicine; to combine traditional medicine with western medicine.

10. To combine army medical corps and civil medical forces in medical examination and treatment.

Article 5. State management in medical examination and treatment

1. The contents of the State management in medical examination and treatment include:

a) Formulating, promulgating and organizing the implementation of legal documents on medical examination and treatment; issuing a system of medical examination and treatment standards and technical regulations;

b) Formulating, promulgating and organizing the implementation of medical examination and treatment strategies, policies, programs, schemes and plans;

c) Formulating, promulgating and organizing the implementation of the master plan on the system of medical examination and treatment establishments in accordance with the planning law;

d) Prescribing the professional and technique, criteria, standards and regulations in medical examination and treatment;

dd) Organizing, developing and managing the system of medical examination and treatment establishments; evaluating the medical examination and treatment establishments’ quality;

e) Granting, suspending, revoking practitioners’ practice licenses and medical examination and treatment establishments’ operation licenses;

g) Training and fostering to develop human resources for medical examination and treatment; educating, propagandizing and disseminating knowledge and laws on medical examination and treatment; providing guidance on rotating on a definite term for practitioners;

h) Organizing the scientific and technological research and development, technology transfer and application in medical examination and treatment;

i) Developing, managing and operating the information system on medical examination and treatment management;

k) Conducting state management in terms of charges for medical examination and treatment services in accordance with this Law and the Law on Prices;

l) International cooperation in medical examination and treatment;

m) Inspecting, examining, settling complaints and denunciations and handling violations of the law on medical examination and treatment.

2. State management responsibilities for medical examination and treatment as follows:

a) The Government shall perform the unified state management of medical examination and treatment;

b) The Ministry of Health shall take responsibility before the Government for performing the state management of medical examination and treatment;

c) The Ministry of National Defence and the Ministry of Public Security shall, within the ambit of theirs tasks and powers, perform the state management in medical examination and treatment, and take responsibility for organizing the medical examination and treatment system and operation under the management in accordance with this Law;

d) Ministries and ministerial-level agencies shall, within the ambit of their tasks and powers, collaborate with the Ministry of Health in performing the state management of medical examination and treatment;

dd) People’s Committees at all levels shall perform the state management in medical examination and treatment within their localities.

Article 6. Health socio-professional organizations

A health socio-professional organization is established and operates in accordance with law provisions on association and has the following responsibilities:

1. Protecting its members’ legitimate rights and interests in accordance with law provisions;

2. Participating in the process of formulation of medical examination and treatment policies and law;

3. Participating in professional councils, compiling textbooks and documents for teaching documents, professional and technical documents, participating in testing and assessing practice capacity and monitoring the practice, continued updating of medical knowledge upon request of competent agencies and organizations;

4. Disseminating, educating and training professional knowledge, law and policies on medical examination and treatment for its members in accordance with law provisions;

5. Implementing programs, projects, research subjects, consulting, participating in the supervision and social counter-argument in terms of medical examination and treatment in accordance with law provisions;

6. Participating in formulating and organizing the implementation of the code of conduct; mobilizing members, organizations and individuals participating in medical examination and treatment activities to comply with the law;

7. Mobilizing social resources to carry out medical examination and treatment activities in accordance with law provisions;

8. Requesting competent state agencies to handle violations of law on medical examination and treatment.

Article 7. Prohibited acts in medical Examination and treatment

1. Infringing upon the rights of patients.

2. Refusing to provide or intentionally delaying first aid for patients, except for the cases specified in Article 40 of this Law.

3. Providing medical examination and treatment services without satisfying the conditions specified in Article 19 of this Law.

4. Providing medical examination and treatment services outside the practice or operation scope permitted by the competent agency, except cases of emergency or providing medical examination and treatment services according to the mobilization or assignment of the competent agencies upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations.

5. Failing to practicing medical examination and treatment within the time frame or at the location registered for medical examination and treatment operation (hereinafter referred to as practice registration), except for the cases specified in Clause 3 Article 36 of this Law.

6. Failing to comply with professional and technical regulations; applying methods, professional and techniques, or using medical equipment without the competent agency’s permission.

7. Prescribing or designating drugs not yet licensed for circulation in accordance with the law on pharmacy in medical examination and treatment.

8. Committing acts of harassment in medical examination and treatment.

9. Prescribing drugs or designating technical services and medical equipment, suggesting to transfer the patients to other medical examination and treatment establishments or committing other acts to seek profit.

10. Erasing and modifying case history dossiers to falsify information on medical examination and treatment, or compiling fake case history dossiers, or compiling false case history dossiers and other papers on medical examination and treatment results.

11. Practitioners selling drugs in any forms, except for the following cases:

a) Herb doctors, herb assistant doctors and herbalists and selling family remedies;

b) Owners of family herbal remedies selling family herbal remedies under their registered ownership.

12. Using liquor, beer and other alcoholic beverages, narcotics, tobacco at medical examination and treatment establishments or during the medical examination and treatment.

13. Using superstitions in medical examination and treatment.

14. Refusing to participate in medical examination and treatment activities upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations under mobilization decisions of competent agencies or persons, except for the cases specified at Points a and b Clause 3 Article 47 of this Law.

15. Medical examination and treatment establishments providing medical examination and treatment services when:

a) Failing to have an operation license; or

b) Being suspended from operation; or

c) Providing medical examination and treatment services outside the permitted operation scope, except cases of emergency or providing medical examination and treatment services under the mobilization or assignment decision of the competent agency or person upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations.

16. Hiring, borrowing, leasing or lending medical practice licenses or operation licenses.

17. Taking advantage of the practitioner's image and status to speak, propagate and encourage patients to use unrecognized medical examination and treatment methods.

18. Infringing upon the life, health, dignity or honor of the practitioners and others working at medical examination and treatment establishments, or destroying assets of medical examination and treatment establishments.

19. Obstructing patients in need of compulsory treatment in admitting to medical examination and treatment establishments or intentionally providing compulsory medical treatment for those not in need of compulsory treatment.

20. Advertising beyond the scope of practice or scope of professional operation approved by the competent agency; abusing medical knowledge to advertise medical examination and treatment untruthfully.

21. Posting attributable information about the responsibilities of practitioners and medical examination and treatment establishments when adverse events occur without conclusions of competent agencies.

Article 8. Patients’ representatives

1. One patient shall have only one representative at one time.

2. The patient’s representative must be the one with full civil act capacity, including:

a) The one selected by the adult patient;

b) The one selected by the patient's family member in case the adult patient fails to do so and fails authorize anyone before falling into a state of inability or difficulty in cognition and behavior control;

c) The authorized representative and at-law representative as prescribed by the Civil Code;

d) The at-law representative of a legal entity as prescribed by the Civil Code or a person assigned by the legal entity in charge of management, care and nurture of the patient as prescribed by the Civil Code;

dd) A person other than those specified at Points a, b, c and d of this Clause, but voluntarily to perform the patient's obligations as prescribed by the Civil Code.

3. The change of representative shall be conducted as follows:

a) The patient's confirmation is required, for the case of changing the representative specified at Point a Clause 2 of this Article;

b) The patient's confirmation or his/her family member’s confirmation is required, for the case of changing the representative specified at Point b Clause 2 of this Article;

c) The patient's confirmation is not required, for the case of changing the representative who is the minor patient's parent;

d) In case changing the representative who is the guardian, person designated by the Court, at-law representative of a legal entity, or a person assigned by the legal entity, a decision of the competent agency or organization is required;

dd) In case of changing the representative who is the authorized representative, a power of attorney is required according to regulations.

4. The representative’s rights and obligations, legal consequences of acts of representation, representation term and scope shall comply with the Civil Code and other relevant laws.

Chapter II

RIGHTS AND OBLIGATIONS OF PATIENTS

Section 1
RIGHTS OF PATIENTS

Article 9. Rights to medical examination and treatment

1. To be given information and explanations about their health status, treatment methods and medical examination and treatment services, charges for medical examination and treatment services; to be given instructions about self-monitoring, caring and prevention complications.

2. To receive medical examination and treatment with safe methods suitable to their health conditions and actual conditions of the medical examination and treatment establishments.

Article 10. Rights to respect for honor, protection of health, and respect for privacy in medical examination and treatment

1. To be respected in terms of age, gender, ethnics, religion, belief, health status, financial and social status.

2. To have information given in their case history dossiers and other private information provided to the practitioners during the process of medical examination and treatment kept confidential, unless otherwise agreed for sharing by the patients in accordance with law provisions, or except the cases specified in Clauses 3 and 4 Article 69 of this Law.

3. To be subject to no discrimination, mistreatment, physical or sexual abuse in medical examination and treatment.

4. To be subject to no forced medical examination and treatment, except the cases specified in Clause 1 Article 82 of this Law.

Article 11. Rights to choose in medical examination and treatment

1. To choose medical Examination and Treatment methods after receiving sufficient information, explanations and counsels about their disease status, results and risks that may occur, except for the cases specified in Clause 4 Article 40 of this Law.

2. To accept or refuse to participate in bio-medical research in medical examination and treatment.

Article 12. Rights to obtainment of information on case history dossiers and medical examination and treatment expenses

1. To read, view, copy and record their case history dossiers and receive brief information on their case history dossiers in accordance with Point d Clause 4 Article 69 of this Law.

2. To be provided detailed explanations about expenses for medical examination and treatment services at their requests.

Article 13. Rights to refusal of medical examination and treatment and discharge from medical examination and treatment establishments

1. To refuse medical examination and treatment, but to make written commitment on personal responsibility for such refusal after receiving the practitioners’ counsels, except the cases of compulsory medical treatment specified in Clause 1 Article 82 of this Law.

2. To leave medical examination and treatment establishments when treatment is not completed, but to make written commitment to take personal responsibility for such leaving, which is contrary to practitioners’ instruction, except the cases of compulsory medical treatment specified in Clause 1 Article 82 of this Law.

Article 14. Rights to petition and compensation

1. To make petitions about existence, inadequacies, difficulties, problems and other issues in the medical examination and treatment process.

2. To claim compensation in accordance with Article 102 of this Law.

Article 15. Performance of rights of patients losing civil act capacity, or having difficulties in cognition and behavior control or with restricted civil act capacity, or being minors, or without relatives

1. In case an adult patient losing his/her civil act capacity, having difficulties in cognition and behavior control, or with restricted civil act capacity has already had a document showing his/her lawful expectation in terms of medical examination and treatment, then such expectation shall be implemented.

2. In case an adult patient losing his/her civil act capacity, having difficulties in cognition and behavior control, or with restricted civil act capacity has no document showing his/her lawful expectation in terms of medical examination and treatment, the following provisions shall be complied with:

a) If he/she has a representative as specified at Points a, b, c and d Clause 2 Article 8 of this Law, such representative's decision shall be followed;

b) If he/she has no representative as prescribed at Points a, b, c and d Clause 2 Article 8 of this Law, the decision of the person responsible for professional or the leader on standby of the medical examination and treatment establishment shall be complied with.

3. For a minor patient, the following provisions shall be complied with:

a) If he/she has a representative as specified at Points c and d Clause 2 Article 8 of this Law, such representative's decision shall be followed;

b) If he/she has no representative as prescribed at Points c and d Clause 2 Article 8 of this Law, the decision of the person responsible for professional or the leader on standby of the medical examination and treatment establishment shall be complied with.

Section 2
OBLIGATIONS OF PATIENTS

Article 16. Respecting practitioners and others working at medical examination and treatment establishments

To respect practitioners; not to threaten or infringe the life, health, dignity or honor of practitioners and others working at medical examination and treatment establishments.

Article 17. Observing regulations on medical examination and treatment

1. To truthfully provide information related to their relatives, health status, take responsibility for the provided information, and fully cooperate with practitioners and others working at medical examination and treatment establishments.

2. To follow practitioners’ instructions on diagnosis and treatment methods.

3. To observe and request their relatives or visitors to observe rules of medical examination and treatment establishments and the law on medical examination and treatment.

Article 18. Paying medical examination and treatment expenses

1. Insured patients are obligated to pay medical examination and treatment expenses beyond the scope of benefit and benefit levels as prescribed by the law on health insurance.

2. Uninsured patients are obligated to pay medical examination and treatment expenses as prescribed by laws.

Chapter III

MEDICAL PRACTITIONERS

Section 1
PRACTICE CONDITIONS

Article 19. Conditions for persons to provide medical examination and treatment services

1. A person is allowed to practice medical examination and treatment in Vietnam when fully meeting the following conditions:

a) Having a valid practice license;

b) Having registered medical practice, except for the cases specified in Clause 3 Article 36 of this Law;

c) Meeting requirements on language skills in medical examination and treatment specified in Article 21 of this Law;

d) Being healthy enough to practice as prescribed by the Minister of Health;

dd) Not falling in to the cases specified in Article 20 of this Law.

2. A person may provide medical examination and treatment services without satisfying conditions specified at Points a, b and c Clause 1 of this Article if he/she falls into one of the following cases:

a) Learners, students and pupils of health training institutions, persons currently practicing medical examination and treatment pending the grant of practice licenses, persons who are awaiting the grant of practice licenses and may only provide medical examination and treatment under practitioners’ supervision;

b) Health workers of villages, village midwives or health workers working at health departments of agencies, units or organizations without establishing medical examination and treatment establishments may only provide medical examination and treatment services in the operation scope after completing the training program according to the professional operations prescribed by the Minister of Health;

c) Persons specified in Clause 1 Article 115 of this Law;

d) Other persons participating in the medical examination and treatment process as prescribed by the Government.

3. Foreigners and overseas Vietnamese who have had a practice license granted by a foreign competent agency or organization may provide humanitarian medical examination and treatment services in period, or each time of medical training coordination with medical examination and treatment practice, or professional and technical transfer in medical examination and treatment in this Law without satisfying conditions specified at Points a and b Clause 1 of this Article.

4. Persons participating in first aid in the community who are not out-of-hospital emergency care providers are not required to satisfy the conditions specified in Clause 1 of this Article.

Article 20. Cases banned from practicing medical examination and treatment

1. Being examined for penal liability for violating the law related to the technical professional.

2. During the execution of suspended sentence, or non-custodial reform for violating the law related to the technical professional.

3. Being under probation period, for persons sentenced to imprisonment related to technical professional but entitled to conditional early release.

4. Currently serving an imprisonment sentence or being subject to the administrative measure of confinement to a compulsory education institution, or compulsory drug rehabilitation center.

5. Being banned from practicing medical examination and treatment under a Court’s legally effective criminal judgment, or being restricted from providing medical examination and treatment services under a competent agency's decision.

 6. Losing civil act capacity, or having difficulties in cognition and behavior control, or having limited civil act capacity.

Article 21. Languages used in medical examination and treatment

1. Language used in medical examination and treatment must be Vietnamese, except for the cases specified in Clause 2 of this Article.

2. Practitioners who are foreigners or overseas Vietnamese (hereinafter referred to as foreign practitioners) may use languages other than Vietnamese to provide medical examination and treatment services for patients falling into one of the following cases:

a) Patients who have the same native languages with the practitioners; patients who are able to speak the same languages as those registered by the practitioners;

b) Foreign patients other than those specified at Point a of this Clause;

c) Provision of humanitarian medical examination and treatment in period; technical transfer in medical examination and treatment under a coordination agreement between Vietnamese medical examination and treatment establishment and foreign health establishment.

3. The use of languages specified in Clause 2 of this Article shall be implemented as follows:

a) An interpreter is required, for cases of medical examination and treatment specified at Points b and c Clause 2 of this Article;

b) Information about medical Examination and Treatment which is recorded in languages registered by foreign practitioners must be concurrently translated into Vietnamese.

4. The Government shall stipulate in details this Article; provide regulations on requirements for interpreters for cases specified at Point a Clause 3 of this Article; provide regulations on languages used in medical examination and treatment for ethnic minorities who are unable to speak Vietnamese, people with disabilities in terms of languages, and foreign patients.

Article 22. Continued updating of medical knowledge

1. Practitioners who are doctors, assistant doctors, nurses, midwives, medical technicians, clinical dietitians, out-of-hospital emergency providers and clinical psychologists shall be responsible for continued updating of medical knowledge suitable to their practice scope.

2. Forms of continued updating of medical knowledge:

a) Participating in short-term medical training courses, seminars or conferences suitable to the practice scope;

b) Participating in compiling textbooks, teaching or professional documents on medical examination and treatment;

c) Conducting scientific research, teaching in medical field within the practice scope;

d) Self-updating medical knowledges and other forms.

3. Medical examination and treatment establishments shall be responsible for creating favor conditions for practitioners to continuously update medical knowledge.

4. The Minister of Health shall detail this Article.

Section 2
ORGANIZATION OF TESTING FOR ASSESSMENT OF CAPACITY FOR PRACTICING MEDICAL EXAMINATION AND TREATMENT

             Article 23. Practicing medical examination and treatment

1. Persons applying the grant of medical practice licenses with one of the following titles: doctor, assistant doctor, nurse, midwife, medical technician, clinical dietitian, out-of-hospital emergency provider or clinical psychologist must practice medical examination and treatment on the principles specified in Clause 2 of this Article, except for the following persons:

a) Persons who have completed the specialized training program;

b) Persons who have obtained a practice license granted by a competent foreign agency or organization, and are recognized in accordance with provisions of Article 29 of this Law.

2. Medical examination and treatment practice must comply with the following principles:

a) Being suitable with the granted professional diplomas;

b) Being conducted at medical examination and treatment establishments with professional operation scope suitable to the practice contents;

c) The practice period is suitable to each title;

d) Establishments guiding the practice must appoint an instructor, registering the list of persons undergoing practice period at the establishment on the information system on medical examination and treatment management, and grant practice certificates to persons undergoing practice period;

dd) Instructors must be practitioners with the practice scope suitable to the instruction contents and shall take responsibility for professional operations of persons undergoing practice period during their practice period, except for the case the persons undergoing practice period intentionally violate the law;

e) Persons undergoing practice period must observe the assignment and instruction of the instructors and must respect patients’ rights and obligations.

3. The Government shall detail this Article.

Article 24. Testing for assessment of capacity for practicing medical examination and treatment

1. Testing for assessment of capacity for practicing medical examination and treatment before applying the grant of practice licenses applies to the following titles: doctor, assistant doctor, nurse, midwife, medical technician, clinical dietitian, out-of-hospital emergency provider and clinical psychologist.

2. Participants of the test for assessment of capacity for practicing medical examination and treatment must meet the following conditions:

a) Possessing diplomas suitable to each title specified in Clause 1 of this Article;

b) Having completed the practice of medical examination and treatment expenses under Article 23 of this Law.

3. The test for assessment of capacity for practicing medical examination and treatment shall be presided and organized by the National Medical Council.

4. Participants of the test for assessment of capacity for practicing medical examination and treatment must pay expenses for the test.

5. The Government shall detail this Article.

Article 25. National Medical Council

1. National Medical Council is an organization that is established by the Prime Minister with its own seal and headquarter, and has a function to independently assess the capacity for practicing medical examination and treatment.

2. National Medical Council has the following tasks:

a) Assuming the prime responsibility for, and coordinating with medical socio-professional organizations and concerned agencies and organizations in, developing the set of tools for assessing capacity for practicing medical examination and treatment;

b) Issuing a set of tools for assessing capacity for practicing medical examination and treatment;

c) Assume the prime responsibility for organizing the test for assessment of capacity for practicing medical examination and treatment;

d) Receiving and settling petitions and complaints, or coordinating with state management agencies in settling complaints and denunciations about results of the test for assessment of capacity for practicing medical examination and treatment;

dd) Performing other tasks as prescribed by the Prime Minister.

3. The Prime Minister shall prescribe the organization and operation of the National Medical Council.

Section 3
PRACTICE LICENSES

Article 26. Professional titles requiring practice licenses

1. Professional titles requiring practice licenses include:

a) Doctor;

b) Assistant doctor;

c) Nurse;

d) Midwife;

dd) Medical technician;

e) Clinical dietitian;

g) Out-of-hospital emergency provider;

h) Clinical psychologist;

i) Herbalist;

k) Owner of family herbal remedies or treatment methods.

2. The Government shall prescribe the professional titles and conditions for grant, re-grant, renewal, modification or suspension from professional practice, revocation of practice licenses of professional titles in addition to the titles specified in Clause 1 of this Article, according to the socio-economic development of the country in each period, after reporting to the National Assembly Standing Committee.

3. The Minister of Health shall prescribe the practice scope for each title.

Article 27. Practice licenses

1. Every practitioner shall only be granted one practice license which can be used nationwide.

2. A practice license’s validity duration is 05 years.

3. A practice license must have the following principal information:

a) Full name; date of birth; ID number (for Vietnamese practitioners), or passport number and citizenship (for foreign practitioners);

b) Professional title;

c) Practice scope;

d) Validity duration of the license.

4. Persons applying for grant, re-grant, renewal or modification of practice licenses must pay charges in accordance with the law on charges and fees, unless the grant, re-grant, renewal or modification is at faults of the agency competence to grant licenses.

5. The Minister of Health shall detail this Article and practice license form.

Article 28. Competence to grant, re-grant, renewal, modification of practice licenses, suspension from professional practice, and revocation of practice licenses

1. Competence to grant, re-grant, renewal, and modification of practice licenses as follows:

a) The Ministry of Health shall grant, re-grant, renew and modify practice licenses for doctors, assistant doctors, nurses, midwives, medical technicians, clinical dietitians, out-of-hospital emergency providers and clinical psychologists working at medical examination and treatment establishments under the management;

b) The Ministry of National Defence shall grant, re-grant, renew and modify practice licenses for doctors, assistant doctors, nurses, midwives, medical technicians, clinical dietitians, out-of-hospital emergency providers and clinical psychologists working at medical examination and treatment establishments under the management;

c) The Ministry of Public Security shall grant, re-grant, renew and modify practice licenses for doctors, assistant doctors, nurses, midwives, medical technicians, clinical dietitians, out-of-hospital emergency providers and clinical psychologists working at medical examination and treatment establishments under the management;

d) Health agencies under the provincial-level People’s Committees shall grant, re-grant, renew and modify practice licenses for professional titles specified in Clause 1 Article 26 of this Law, except for the cases specified at Points a, b and c of this Clause.

2. Competence to suspend professional operations, and revoke practice licenses as follows:

a) The Ministry of Health shall suspend professional operations of practitioners working at medical examination and treatment establishments nationwide; revoke practice licenses of practitioners working at medical examination and treatment establishments under the management;

b) The Ministry of National Defense shall suspend professional operations and revoke practice licensee of practitioners working at medical examination and treatment establishments under the management;

c) The Ministry of Public Security shall suspend professional operations and revoke practice licensee of practitioners working at medical examination and treatment establishments under the management;

d) Health agencies under the provincial-level People’s Committees shall suspend professional practice for practitioners working at medical examination and treatment establishments within the localities; revoke practice licenses of practitioners under the management.

Article 29. Recognition of practice licenses granted by competent foreign agencies or organizations

1. A practice license granted by competent foreign agency or organization shall be considered and recognized if it fully meets the following conditions:

a) Being recognized under the treaties to which the Socialist Republic of Vietnam is a contracting party, or international agreements to which Vietnam is a party; a practice license is granted by a competent foreign agency or organization that is assessed for recognition by the Ministry of Health in accordance with Clause 3 of this Article;

b) Remaining valid at the time of application for recognition;

c) Showing information about the professional title and such title must be equivalent to one of the titles specified at Points a, b, c, d, dd, e, g and h Clause 1 Article 26 of this Law.

2. The practice license renewal procedures are as follows:

a) The practice license holder shall submit an application dossier for recognition of practice license to the Ministry of Health. Such dossier must comprise a written application for recognition of practice license and a valid copy of the granted practice license;

b) Within 30 days after receiving the application dossier, the Ministry of Health shall issue a written reply to recognize or refuse to recognize the practice license;

c) In case where the verification of the practitioner’s training period in foreign countries is required, the time limit for recognizing is 30 days after the verification result is available.

3. Assessment contents for recognition of the foreign agencies or organizations granting practice licenses include:

a) Assessing the training system;

b) Assessing the system, process and procedures for grant of practice licenses and regulations on titles and practice scope.

4. Holder of a practice license granted by a competent foreign agency or organization recognized in Vietnam is not required to practice medical examination and treatment in accordance with Article 23 of this Law and is not required to participate in the test for assessment of capacity for practicing medical examination and treatment as prescribed in Article 24 of this Law.

5. The Government shall detail this Article.

Article 30. Grant of practice licenses

1. Practice licenses shall be granted for the following persons:

a) Persons applying the grant of practice licenses for the first time;

b) Practitioners changing their professional titles stated on the practice licenses;

c) Persons who have their practice licenses revoked are subject to the grant of practice licenses under the Government's regulations;

d) Other cases as prescribed by the Government.

2. Conditions for grant of practice licenses for a doctor, assistant doctor, nurse, midwife, medical technician, clinical dietitian, out-of-hospital emergency provider or clinical psychologist:

a) Having his/her medical practice capability assessed through the test and assessment of the capacity to practice medical examination and treatment prescribed in Article 24 of this Law or having a recognized practice license as prescribed in Article 29 of this Law;

b) Being physically fit for medical practice;

c) Satisfying the Vietnamese language ability for foreigners according to the Government's regulations;

d) Not falling into one of the cases specified in Article 20 of this Law, or being administratively sanctioned for the act of providing medical Examination and Treatment services without a practice license while the time limit upon the expiration of which he/she/it is regarded as having never been administratively sanctioned has not expired.

3. Conditions for grant of a practice license for an herbalist, owner of a family herbal remedy or treatment method:

a) Possessing an herbalist certificate or certificate of owner of a family herbal remedy or certificate of owner of a treatment method;

b) Satisfying conditions specified at Points b, c, and d Clause 2 of this Article.

4. A dossier of application for the grant of a practice license must comprise:

a) An application for a practice license;

b) Documents proving the applicant satisfying the conditions specified in Clause 2 or Clause 3 of this Article, for each corresponding title.

5. Procedures for grant of a practice license as follows:

a) An applicant shall submit a dossier as prescribed in Clause 4 of this Article to the agency competent to grant practice licenses;

b) The agency competence to grant practice licenses shall grant a new practice license within 30 days after receiving a complete dossier. In case of refusal, a written reply clearly stating the reason is required;

c) In case where the verification of documents with foreign factors included in the application dossier is required, the time limit for grant is 30 days after the verification result is available.

6. The Government shall detail this Article.

Article 31. Re-grant of practice licenses

1. A practice license shall be re-granted in the following cases:

a) The practice license is lost or damaged;

b) There is a change to the information specified at Point a Clause 3 Article 27 of this Law, or error in the information specified in Clause 3 Article 27 of this Law;

c) Persons who have their practice licenses revoked are subject to the re-grant of practice licenses under the Government's regulations;

d) The practice certificate is granted ultra vires;

dd) Other cases as prescribed by the Government.

2. Conditions for re-grant of practice licenses:

a) A person has already been granted a practice license;

b) Conditions suitable to the contents of re-grant are fully satisfied;

c) Not falling into one of the cases specified in Article 20 of this Law.

3. A dossier of application for the re-grant of a practice license must comprise:

a) An application for re-grant of a practice license;

b) Documents proving the satisfaction of the conditions prescribed in Clause 2 of this Article.

4. Procedures for re-grant of a practice license as follows:

a) An applicant shall submit a dossier as prescribed in Clause 3 of this Article to the agency competent to grant practice licenses;

b) The agency competence to grant practice licenses shall re-grant a practice license within 15 days after receiving a complete dossier. In case of refusal, a written reply clearly stating the reason is required;

c) In case where the verification of documents with foreign factors included in the dossier is required, the time limit for grant is 15 days after the verification result is available.

5. The Government shall detail this Article.

Article 32. Renewal of practice licenses

1. An expired practice license shall be renewed.

2. Conditions for renewal of practice licenses for a doctor, assistant doctor, nurse, midwife, medical technician, clinical dietitian, out-of-hospital emergency provider, clinical psychologist or herbalist:

a) Meeting requirements on continued updating of medical knowledge under Article 22 of this Law;

b) Being physically fit for medical practice;

c) Carrying out the renewal procedures at least 60 days before the expiration of the practice license, unless otherwise prescribed by the Government;

d) Not falling into one of the cases specified in Article 20 of this Law.

3. Conditions for renewal of a practice license for an owner of a family herbal remedy or treatment method include the conditions specified at Points a, c and d Clause 2 of this Article.

4. An application dossier for renewal of a practice license must comprise documents proving the satisfaction of the conditions specified in Clause 2 or 3 of this Article.

5. Procedures for renewal of a practice license as follows:

a) An applicant shall submit a dossier as prescribed in Clause 4 of this Article to the agency competent to grant practice licenses;

b) During the period between the time of receiving a complete dossier and the expiry date stated on the practice license, the agency competence to grant practice licenses shall be responsible for renewal, or issue a written reply clearly stating the reason of refusing the renewal. If the agency fails to issue a written reply on the expiry date as stated on the practice license, such practice license shall remain valid in accordance with Clause 2 Article 27 of this Law;

c) In case where the verification of the practitioner's continued updating of medical knowledge under the program implemented by a foreign agency or organization is required, the time limit for renewal is 15 days after the verification result is available.

6. The Government shall detail this Article.

Article 33. Modification of practice licenses

1. The practice license of a doctor, assistant doctor, nurse, midwife, medical technician, clinical dietitian, out-of-hospital emergency provider, clinical psychologist or herbalist shall be modified upon adding or changing the scope of medical practice.

2. Conditions for modification of practice licenses:

a) Having completed the training course about technical professional suitable to the medical practice scope to be modified that is granted by an education institution or hospital;

b) Satisfying the requirements on medical practices in a number of specialized fields;

c) Not falling into one of the cases specified in Article 20 of this Law.

3. A dossier of application for the modification of a practice license must comprise:

a) An application for modification of a practice license;

b) Documents proving the satisfaction of the conditions prescribed in Clause 2 of this Article.

4. Procedures for modification of a practice license as follows:

a) An applicant shall submit a dossier as prescribed in Clause 3 of this Article to the agency competent to grant practice licenses;

b) The agency competence to grant practice licenses shall modify a practice license within 15 days after receiving a complete dossier. In case of refusal, a written reply clearly stating the reason is required;

c) In case where the verification of documents with foreign factors included in the dossier is required, the time limit for modification is 15 days after the verification result is available.

5. The Government shall detail this Article.

Article 34. Suspension of professional practice

1. Practitioners shall be suspended from professional practice in the following cases:

a) Being confirmed (by the Professional Council specified in Article 101 of this Law) to have committed professional and technical mistakes subject to suspension of professional practice but not serious enough for revocation of practice license;

b) Being concluded (by the competent agency) to violate professional ethics but not serious enough for revocation of practice license;

b) Failing to meet health requirements for professional practice.

2. Depending on the nature and extent of professional and technical mistakes and health status, the practitioner shall be suspended from professional practice from 01 month to 24 months.

3. After being suspended from professional practice, depending on the nature and extent of the professional and technical mistakes, the practitioner must update his/her medical knowledge under the Professional Council's conclusion as prescribed in Article 101 of this Law.

4. The Government shall detail this Article.

Article 35. Revocation of practice licenses

1. A practice license shall be revoked when:

a) A dossier of application for practice license fails to meet requirements;

b) Forging documents included in the application dossier;

c) Recording a wrong professional title or medical practice scope in the practice license compared to that in the application dossier;

d) The practitioner fails to practice for 24 consecutive months, unless he/she participates in the specialized training programs;

dd) The practitioner is prohibited from medical practice as prescribed in Clauses 1, 2, 3, 4 and 6 Article 20 of this Law;

e) The practitioner is confirmed (by the Professional Council specified in Article 101 of this Law) to have committed professional and technical mistakes to the extent that his/her practice license is revoked;

g) The practitioner is confirmed (by the Professional Council specified in Article 101 of this Law) to have committed professional and technical mistakes to the extent that he/she is suspended from professional practice during the practice license validity for the second time;

h) The practitioner is concluded (by the competent agency) to violate professional ethics to the extent that he/she is suspended from professional practice during the practice license validity for the second time;

i) The practitioner requests the revocation of his/her practice license;

k) Other cases specified by the Government, after reporting to the National Assembly Standing Committee.

2. After having a practice license revoked, if a practitioner wishes to continue to practice, he/she must apply the grant of a new practice license under Point c Clause 1 Article 30 of this Law, or request the re-grant of practice license under Point c Clause 1 Article 31 of this Law.

3. The Government shall detail this Article.

Section 4
MEDICAL PRACTICE REGISTRATION

Article 36. Principles of medical practice registration

1. A practitioner may register to practice medical examination and treatment for different medical examination and treatment establishments, provided that the working times at those establishment are different.

2. A practitioner may register to work at one or more professional positions for one medical Examination and Treatment establishment, provided that he/she must ensure the work quality at the assigned positions, including:

a) Providing medical examination and treatment services according to the practice license;

b) Being in charge of a specialized department;

c) Taking professional responsibility for a medical examination and treatment establishment.

3. A practitioner may provide medical examination and treatment services without registering the medical practice in the following cases:

a) Giving first aid outside the medical examination and treatment establishment, except for the out-of-hospital emergency providers;

b) Being mobilized or assigned to participate in the medical examination and treatment activities upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations by the competent agency or person;

c) Providing humanitarian medical examination and treatment in period;

d) Providing medical examination and treatment during the process of technical and professional transfer, or support of technical professional at medical examination and treatment establishments for a short term;

dd) Other cases under the Minister of Health’s regulations.

Article 37. Contents of medical practice registration

1. Full name, serial number of the practitioner’s practice license.

2. Title, professional position of the practitioner.

3. Place of medical practice, including name, address of the medical examination and treatment establishment where the practitioner registers his/her medical practice.

4. Practice duration.

5. Language used by the foreign practitioner when providing medical examination and treatment services, for the cases specified at Points a and b Clause 2 Article 21 of this Law.

Article 38. Responsibility in medical practice registration

1. The medical examination and treatment establishment shall register the medical practice for its practitioners as follows:

a) Submitting the list of medical practice registration and an application for grant of an operation license to the agency competent to grant operation licenses;

b) In case there is any change to the practitioners while awaiting the grant of operation license or during the establishment’s operation, it shall submit a written registration to the agency competence to grant operation licenses.

2. The agency competent to grant operation licenses shall be responsible for publicizing the list of practitioners on the information system on medical examination and treatment management as follows:

a) Such list shall be publicized at the same time as the time the operation license is granted, for the cases specified at Point a Clause 1 of this Article, and the case of changing the practitioners while awaiting the grant of operation license as prescribed at Point b Clause 1 of this Article;

b) Such list shall be publicized within 05 working days after receiving the written registration for medical practices, for the case of changing the practitioners during the establishment's operations as prescribed at Point b Clause 1 of this Article.

3. The Government shall provide detailed provisions on medical practice registration in Section 4 Chapter III of this Law.

Section 5
RIGHTS OF PRACTITIONERS

Article 39. Rights to professional practice

1. To professionally practice within the permitted professional operation scope.

2. To decide on diagnosis and treatment methods within the permitted professional operation scope.

3. To practice medical examination and treatment at different medical examination and treatment establishments, but to follow regulations on practice registration of this Law.

4. To join health socio-professional organizations.

Article 40. Rights to refusal of medical examination and treatment

Practitioners are allowed to refuse to provide medical examination and treatment in the following cases:

1. Anticipating that treatment of a disease goes beyond their capacity or is outside the scope of their professional operation, but to introduce patients to appropriate practitioners or medical examination and treatment establishments for examination and treatment. In this case, practitioners shall still provide first aid, supervision, care and treatment for the patients until they are transferred to medical examination and treatment establishments or received by other practitioners;

2. The examination and treatment is contrary to law or professional ethics;

3. Patients or their relatives commit acts of infringing upon the practitioners’ body, health or life when they are performing tasks, except for the cases where such patients or relatives are suffering mental disease or other diseases and unable to cognize or control behavior;

4. Patients request a medical examination and treatment method inappropriate to the professional and technical requirements;

5. Patients or their relatives specified at Point a Clause 2 and Point a Clause 3 Article 15 of this Law fail to follow practitioners’ instructions on diagnosis and treatment methods after being counseled or persuaded by the practitioners, and such non-compliance may harm to the patients’ health or life.

Article 41. Rights to improvement of professional capacity

1. To receive training and improve professional capacity.

2. To receive continued updating of medical knowledge relevant to their professional practice scope.

3. To participate in refresher training and sharing information on professional operation and the health law.

Article 42. Rights to protection upon occurrence of adverse events

1. To be protected by law and take no responsibility when properly observing regulations adverse events still occur.

2. To request agencies, organizations and health socio-professional organizations to protect the lawful rights and interests upon occurrence of adverse events.

Article 43. Rights to assurance of safety during medical practice

1. To be ensured with occupational safety and hygiene while working in accordance with the law on occupational safety and hygiene.

2. To have their health, life, honor and dignity protected.

3. To temporarily leave workplaces when having their life or health threatened by others, but then to report such to persons in charge of professional, or on-standby leaders of medical examination and treatment establishments and police stations or administrations of nearest localities.

Section 6
OBLIGATIONS OF PRACTITIONERS

Article 44. Obligations toward patients

1. To provide timely first aid, emergency aid and medical examination and treatment for patients, except the cases specified in Clauses 2, 3, 4 and 5 Article 40 of this Law.

2. To respect rights of patients, to be considerate and polite to patients.

3. To give counseling and provide information under Clause 1 Article 9 of this Law.

4. To equally treat patients, not to let personal interests or discrimination affect their professional decisions.

5. To request patients to pay only expenses for medical examination and treatment as prescribed by law.

Article 45. Professional obligations

1. To observe professional and technical regulations.

2. To take responsibility for their medical examination and treatment.

3. To regularly study and continuously update medical knowledge.

4. To be devoted in medical examination and treatment.

5. To keep confidential the health status of patients, information provided by patients and case history dossiers, unless otherwise agreed for sharing by patients, or the cases specified in Clauses 3 and 4 Article 69 of this Law.

6. To report on practitioners deceiving patients or violating this Law to competent persons.

Article 46. Obligations toward colleagues

1. To cooperate with colleagues in medical examination and treatment.

2. To respect the honor and prestige of colleagues.

Article 47. Obligations toward the society

1. To participate in emergency provision, community health protection and education.

2. To participate in supervising the professional capacity and ethics of other practitioners.

3. To observe definite-term rotation assignment decisions of their managing agencies; mobilization decisions of competent state agencies or competent persons on participating in providing medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations; except for the following cases:

a) The practitioner is pregnant or is raising an under-24-month-old child, except for the case of voluntary;

b) The practitioner falls into the high-risk group for epidemics and other cases as prescribed by the Minister of Health.

Chapter IV
MEDICAL EXAMINATION AND TREATMENT ESTABLISHMENTS

Section 1

LICENSES FOR MEDICAL EXAMINATION AND TREATMENT

             Article 48. Organizational forms of medical examination and treatment establishments

1. Organizational forms of medical examination and treatment establishments include:

a) Hospital;

b) Infirmary of People's Armed Force;

c) Obstetrics clinic;

d) Clinic;

dd) Traditional medicine diagnosis and treatment clinic;

e) Paraclinical service establishment;

g) Health center;

h) Out-of-hospital emergency establishment;

i) Family medicine center;

k) Other organizational forms as prescribed by the Government.

2. In case a medical assessment establishment, forensic or mental forensic examination establishment, health center, hospital equipped with hospital beds, health department of an agency, unit, organization, or other establishment provides medical examination and treatment services, the operation license shall be granted according to one of the organizational forms specified in Clause 1 of this Article.

3. The Government shall detail this Article.

Article 49. Conditions for operation of medical examination and treatment establishments

1. To possess an operation license granted by an agency competent to grant operation licenses.

2. To maintain principal quality standards specified at Point a Clause 1 Article 57 of this Law during its operation.

Article 50. Operation licenses of medical examination and treatment establishments

1. Every medical examination and treatment establishment shall be granted an indefinite-term operation license. In case a medical examination and treatment establishment organizes more medical examination and treatment establishments at different places, each establishment shall be granted a separate operation license.

2. An operation license must have the following principal information:

a) Name of the medical examination and treatment establishment;

b) Organizational form;

c) Place of operation;

d) Scope of professional operations;

dd) Daily working hours.

3. An establishment applying for grant, re-grant or modification of an operation license must pay charges in accordance with the law on charges and fees, unless the grant, re-grant or modification is at faults of the agency competence to grant operation licenses.

4. Within 05 working days from the date on which the operation license is granted, re-granted or modified, the agency competent to grant operation licenses must update information related to the grant, re-grant or modification of the license on the Information system on medical examination and treatment management.

5. The Government shall provide detailed provisions on cases, conditions, dossiers and procedures for grant, re-grant or modification of operation licenses for each organizational form as prescribed in Article 48 of this Law; provide operation license form and specific conditions for medical examination and treatment establishments of the People's Armed Force.

Article 51. Competence to grant, re-grant, modify operation licenses, suspend operations and revoke operation licenses for medical examination and treatment establishments

1. The Ministry of Health shall grant, re-grant or modify operation licenses, suspend operations and revoke operation licenses of medical examination and treatment establishments affiliated to the Ministry of Health; suspend operations of other medical examination and treatment establishments nationwide.

2. The Ministry of National Defence shall grant, re-grant, modify operation licenses, suspend operations and revoke operation licenses of medical examination and treatment establishments under the management.

3. The Ministry of Public Security shall grant, re-grant, modify operation licenses, suspend operations and revoke operation licenses of medical examination and treatment establishments under the management.

4. Health agencies under the provincial-level People’s Committee shall grant, re-grant, modify and revoke operation licenses of medical examination and treatment establishments within the localities, except for the cases specified in Clauses 1, 2 and 3 of this Article; suspend operations of medical examination and treatment establishments within the localities.

Article 52. Grant of operation licenses

1. Operation licenses shall be granted for the following establishments:

a) Medical examination and treatment establishments apply the grant of operation licenses for the first time;

b) Medical examination and treatment establishments have their operation licenses revoked, except for the cases specified at Point d Clause 1 Article 56 of this Law;

c) Medical examination and treatment establishments change their organizational forms or operation places after being granted an operation license;

d) Medical examination and treatment establishments are separated, merged or consolidated after being granted an operation license;

dd) Other cases as prescribed by the Government.

2. An establishment shall be granted an operation license if satisfying the following conditions:

a) Being lawfully established in accordance with law;

b) Having an organizational structure suitable to each organizational form of medical examination and treatment establishments;

c) Having a place of operation;

d) Having physical foundations in accordance with the professional operation scope and size of the medical examination and treatment establishment, in which the information technology infrastructure must ensure the connection with the information system on medical examination and treatment management under Clause 1 Article 112 of this Law;

dd) Being equipped with adequate medical equipment and means in accordance with its professional operation scope and size;

e) Employing sufficient practitioners in accordance with its professional operation scope and size; and one establishment must only have one person in charge of professional.

3. A dossier of application for grant of an operation license comprises:

a) An application for grant of operation license;

b) Documents proving the medical examination and treatment establishment’s satisfaction of the conditions specified in Clause 2 of this Article.

4. Procedures for grant of an operation license as follows:

a) An application dossier shall be submitted to the agency competent to grant operation licenses;

b) The agency competent to grant operation licenses shall appraise the dossier. The appraisal duration must not exceed 60 days from the date of receipt of a complete dossier. The appraisal result must be shown on an appraisal record, which clearly states contents to be modified or added (if any), and must bear signatures of parties participating in the appraisal and the appraised establishment;

c) Within 10 working days from the date of making the appraisal record, the agency competent to grant operation licenses must grant an operation license. In case an establishment is required to make any modification or addition as stated on the appraisal record, within 10 working days from the date of completing the modification or addition, the agency competent to grant operation licenses shall grant an operation license.

5. The Government shall detail this Article; and provide regulations on grant of operation licenses for medical examination and treatment establishment of the People's Armed Force.

            Article 53. Re-grant of operation licenses

1. Operation licenses shall be re-granted in the following cases:

a) An operation license is lost;

b) An operation license is damaged;

c) An operation license contains false information.

2. A dossier of application for a re-granted operation license comprises:

a) An application for a re-granted operation license;

b) An original copy of an operation license, except for the cases specified at Point a Clause 1 of this Article;

c) Proof documents, for the cases specified at Point c Clause 1 of this Article.

3. Procedures for re-grant of an operation license as follows:

a) An application dossier shall be submitted to the agency competent to grant operation licenses;

b) Within 20 days after receiving a complete dossier, the agency competent to grant operation licenses shall re-grant the operation license. In case the on-site appraisal is required, it shall be carried out according to the procedures specified at Points b and c Clause 4 Article 52 of this Law.

4. The Government shall detail this Article; and provide regulations on re-grant of operation licenses for medical examination and treatment establishment of the People's Armed Force.

Article 54. Modification of operation licenses

1. An operation license shall be modified in the following cases:

a) Changing the scope of professional operations;

b) Changing the operation scale;

c) Changing the working time;

d) The medical examination and treatment establishment changes its name, address but does not change its operation place;

dd) The medical examination and treatment establishment’s partially-suspended duration expires but it fails to complete contents required in the suspension document.

2. An establishment shall have its operation license modified if satisfying the following conditions:

a) Having a valid operation license;

b) Satisfying conditions appropriate to the contents of request for modification as prescribed by law.

3. A dossier for a modified operation license comprises;

a) An application for a modified operation license;

b) Original copies of an operation license and documents proving the changes specified at Point b Clause 2 of this Article.

4. Procedures for modification of an operation license as follows:

a) An application dossier shall be submitted to the agency competent to grant operation licenses;

b) Within 20 days after receiving a complete dossier, the agency competent to grant operation licenses shall modify the operation license. In case the on-site appraisal is required, it shall be carried out according to the procedures specified at Points b and c Clause 4 Article 52 of this Law.

5. The Government shall detail this Article; and provide regulations on modification of operation licenses for medical examination and treatment establishment of the People's Armed Force.

Article 55. Suspension from operations of medical examination and treatment establishments

1. A medical examination and treatment establishment shall be suspended a part or entire operation in the following cases:

a) Occurring an adverse event at the medical examination and treatment establishment, which leads to the suspension of operation;

b) Failing to meet one of the requirements specified in Article 49 of this Law;

c) Failing to meet one of the requirements specified in Clause 2 Article 52 of this Law.

2. The suspension duration ranges from 01 month to 24 months.

3. The suspension of a part or entire operation of a medical examination and treatment establishment and the suspension duration shall be determined based on the cause, nature, extent and consequence of the adverse event or the operation condition which fails to be satisfied.

4. During the suspension duration, if the medical examination and treatment establishment completes all contents required in the suspension document, the agency competent to suspend operation of such establishment shall decide to permit it to resume operations.

5. The Government shall detail this Article.

             Article 56. Revocation of operation licenses of medical examination and treatment establishments

1. An operation license shall be revoked when:

a) A dossier of application for operation license fails to meet requirements;

b) Forging documents included in the application dossier;

c) The operation license is granted ultra vires;

d) An operation license contains false information;

dd) The operation license is granted with wrong organizational form or professional operation scope;

e) The medical examination and treatment establishment fails to operate after 24 months from the date of obtaining an operation license;

g) The medical examination and treatment establishment suspends its operation for 24 consecutive months or more, or terminates its operation;

h) The medical examination and treatment establishment’s wholly-suspended duration expires but it fails to complete contents required in the suspension document;

i) The medical examination and treatment establishment fails to fully maintain the conditions specified in Article 49 or Clause 2 Article 52 of this Law;

k) The medical examination and treatment establishment requests the revocation of its operation license.

2. The Government shall detail this Article. In case of necessity to add cases of revocation of operation licenses, the Government shall report the National Assembly Standing Committee before issuance.

Section 2
EVALUATION OF THE QUALITY OF MEDICAL EXAMINATION AND TREATMENT ESTABLISHMENTS

             Article 57. Quality standards for medical examination and treatment establishments

1. Quality standards mean standards and requirements for management and technical professional which are used as a basis for evaluating the quality of technical services of each specialty or the entire medical examination and treatment establishment already granted with an operation license, including:

a) Basic quality standards applicable to medical examination and treatment establishments, issued by the Ministry of Health;

b) Advanced quality standards applicable to medical examination and treatment establishments, issued by the Ministry of Health;

c) Quality standards applicable to each specialty or technical service, issued by the Ministry of Health;

d) Quality standards applicable to medical examination and treatment establishments, or each specialty or technical service, issued by foreign or domestic organizations and recognized by the Ministry of Health.

2. Medical examination and treatment establishments are encouraged to apply quality standards specified at Points b, c and d Clause 1 of this Article.

3. Quality standards specified at Point d Clause 1 of this Article must be consistent to the conditions of Vietnam, not lower than quality standards specified at Point a Clause 1 of this Article, and must at least satisfy the following requirements:

a) Ensuring science and efficiency;

b) Ensuring to generally evaluate quality characteristics and components;

 c) Being recognized by international organizations involved in to medical examination and treatment quality; being globally applied.

4. The Minister of Health shall provide regulations on recognition of quality standards specified at Point d Clause 1 of this Article.

Article 58. Evaluation and certification of the quality of medical examination and treatment establishments

1. The evaluation and certification of the quality aim to:

a) Maintain and improve the operation quality of medical examination and treatment establishments;

b) Provide information so as patients and payers can select an appropriate medical examination and treatment establishment;

c) Serve as a basis for proposing the handling of violations and commendation for evaluation results made according to the basic quality standards.

2. Principles of evaluating the quality of medical examination and treatment establishments:

a) Independence, objectiveness, truthfulness, publicity, transparency and lawfulness;

d) Consistent to the medical examination and treatment quality standards issued or recognized by the Ministry of Health;

c) The quality shall only be evaluated after the medical examination and treatment establishment has been granted an operation license for at least 12 months;

d) The agency or organization evaluating and certifying the quality shall take responsibility before the law for its evaluation results.

3. On an annual basis, the medical examination and treatment establishment shall self-evaluate its quality in accordance with Point a Clause 1 Article 57 of this Law.

4. An organization evaluating and certifying the medical examination and treatment establishment’s quality that has been granted a certificate of registration for conformity evaluation as prescribed by law shall evaluate the quality at requests of the state management agencies in charge of medical examination and treatment, or the medical examination and treatment establishments.

5. Quality evaluation results shall be publicized at the medical examination and treatment establishments, and on the information system on medical examination and treatment management.

6. State management agencies in charge of medical examination and treatment shall, based on the evaluation results specified in Clauses 3 and 4 of this Article, check the quality evaluation results of medical examination and treatment establishments under the management on the principle of risk management.

7. The Government shall detail this Article.

Section 3
RIGHTS AND RESPONSIBILITIES OF MEDICAL EXAMINATION AND TREATMENT ESTABLISHMENTS

              Article 59. Rights of a medical examination and treatment establishment

1. To provide medical examination and treatment under this Law.

2. To refuse to provide medical examination and treatment in the following cases:

a) Beyond the professional ability or contrary to the scope of professional operations, except for the case of first aid specified in Article 61 of this Law.

b) Falling into one of the cases specified in Clauses 3, 4 and 5 Article 40 of this Law.

3. To collect charges related to the medical examination and treatment under law.

4. To enjoy incentives when providing medical examination and treatment under law.

5. To enter into contracts on health insurance-covered medical examination and treatment with social insurance agencies in accordance with the law on health insurance; to enter into contracts with other insurance organizations in accordance with the law on insurance business for providing medical examination and treatment.

6. To coordinate with domestic and foreign organizations and individuals in medical examination and treatment.

7. To organize to provide healthcare and support services at requests of patients and their representatives.

8. Private medical examination and treatment establishments may participate in a bid or be ordered by the State to provide a number of medical Examination and Treatment services on the list of public non-business services funded or partially funded by the state budget.

Article 60. Responsibilities of a medical examination and treatment establishment

1. To promptly give first aid to and provide medical examination and treatment for patients.

2. To observe professional and technical regulations and other relevant laws; to take responsibility for the medical examination and treatment result of the practitioners under the management.

3. To publicize the working time and the list of practitioners and their working time at the establishment.

4. To list the charges for medical examination and treatment services, charges for provision of healthcare and support services at requests at the establishment, and on the information system on medical examination and treatment management.

5. To guarantee the rights and obligations of patients and practitioners under this Law.

6. To ensure necessary conditions for practitioners to provide medical examination and treatment.

7. To conduct self-evaluation of the quality, and publicize the quality valuation results in accordance with Clauses 3 and 5 Article 58 of this Law.

8. To observe mobilization decisions of competent agencies and persons upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations.

9. To organize forces to protect and maintain conditions for physical foundations to ensure security and order according to the organizational form and scale of the establishment; to coordinate with competent police offices in organizing the implementation of measures for assurance of security and order at the establishment; to notify competent police offices in the locality to coordinate in taking measures to protect abused patients.

10. To introduce and transfer the patient to another medical examination and treatment establishment suitable to his/her disease and requirements in the following cases:

a) His/her disease goes beyond its capacity or is contrary to the scope of professional operations of the establishment;

b) At request of the patient or his/her representatives and under the permission of the practitioner directly providing treatment to the patient or clinical standby;

c) Temporary suspension or suspension of operation, revocation of operation licenses;

d) The establishment has a force majeure incident and cannot continue to receive patients and provide treatment.

11. To participate in preventive medicine as prescribed by law.

12. To participate in professional liability insurance in medical examination and treatment as prescribed by the Government.

Chapter V

PROFESSIONAL AND TECHNIQUES

             Article 61. First aid

1. First aid activities include:

a) First aid at medical examination and treatment establishments;

b) First aid for out-of-hospital emergency.

2. First aid must be performed on the basis of assessment, classification and application of professional and technical measures appropriate to the patient's condition. In case it is necessary to apply urgent emergency measures without the consent of the patient's representative, person responsible for professional of the medical examination and treatment establishment or leader on standby of the medical examination and treatment establishment shall decide.

3. When giving first aid requires professional and technical assistance, depending on specific cases, the establishment shall carry out one or some of the following activities:

a) Holding a consultation under Article 64 of this Law;

b) Requesting another medical examination and treatment establishment to support first aid;

c) Providing remote medical examination and treatment;

d) Transferring the patient to an appropriate medical examination and treatment establishment.

4. Medical examination and treatment establishments shall take responsibility for prioritizing the best conditions in terms of human resources, medical equipment and drugs for giving the first aid to patients and transferring emergency patients to appropriate medical examination and treatment establishments.

5. Out-of-hospital first aid activities include:

a) First aid activities performed by persons with knowledge or training in out-of-hospital first aid;

b) First aid activities performed by out-of-hospital emergency providers or practitioners.

6. Out-of-hospital emergency systems shall be organized based on the following basic criteria:

a) Being suitable to the population size;

b) Being suitable to the geographical characteristics of each locality;

c) Ensuring the ability to receive and transport patients to medical examination and treatment establishments in the shortest time.

7. Expenses for out-of-hospital first aid activities include:

a) The state budget shall ensure funding for investment in setting up out-of-hospital emergency systems of the State; system for receiving information and coordinating emergency; expenses for transportation and use of medical examination and treatment services in the course of emergency transportation for cases of accidents, natural disasters, disasters, especially dangerous infectious diseases that can be transmitted rapidly, wide spread with high mortality rate or unknown causative agent; expenses for management and operation of the State's out-of-hospital emergency establishments;

b) Users of the out-of-hospital emergency service shall pay the cost of using the service as prescribed in Articles 18 and 110 of this Law, except for the case specified at Point a of this Clause.

8. Provincial-level People's Committees shall take responsibility for organizing the State's out-of-hospital emergency systems in the localities.

9. The Government shall detail the guarantee of funding for first aid activities specified at Point a Clause 7 of this Article.

Article 62. Medical examination, instruction on treatment methods and prescription

1. The medical examination, instruction on treatment methods and prescription must comply with professional and technical regulations promulgated or recognized by the Minister of Health.

2. A practitioner assigned to provide medical examination and treatment shall:

a) Give medical examination, instruct treatment methods and make prescription promptly and accurately and take responsibility for his/her decisions;

b) Based on the patient's medical condition, decide on day treatment, inpatient or outpatient treatment. Introduce patients in need of inpatient treatment to appropriate medical examination and treatment establishments when his/her medical examination and treatment establishment has no patient beds.

             Article 63. Use of drugs in treatment

1. The use of drugs in medical examination and treatment must adhere to the following principles:

a) To use drugs only when actually necessary and properly, safely, reasonably and effectively;

b) To prescribe drugs properly according to diagnosis and illness of patients;

c) To use drugs in compliance with regulations on drug storage, distribution and use.

2. When making a prescription, a practitioner shall fully and clearly write in the prescription or case history dossier names of drugs, their contents, dosage, methods of administration and use times; not indicate functional foods in the prescription.

3. When distributing drugs to patients, practitioners assigned to distribute shall:

a) Check the prescription, drug receipt slip, names, concentrations, contents, dosage, methods of administration;

b) Check and compare the prescription with information on names, concentrations, contents, expiry dates of drugs and quantities when receiving drugs;

c) Check and compare the patient’s full name and the names, forms, contents, dosage, methods of administration and use times of drugs before distributing drugs to the patient;

d) For inpatients, fully record times of distributing drugs to the patient, monitor and promptly detect and report complications to the practitioner directly providing treatment.

4. A patient shall use drugs in strict accordance with the practitioner’s instructions. The patient or the patient's representative shall promptly report to the practitioner or medical examination and treatment establishment on abnormal signs after using drugs.

Article 64. Consultation

1. A consultation shall be held when treatment of a disease goes beyond the diagnosis and treatment capacity of practitioners or a medical examination and treatment establishment or treatment of a disease experiences worse developments or no progress. The results of the consultation must be in writing and archived in the case history dossier.

2. Consultation includes:

a) Consultation within a ward, consultation involving different wards and within the medical examination and treatment establishment;

b) Consultation involving different domestic medical examination and treatment establishments; consultation involving different domestic and foreign medical examination and treatment establishments;

c) Other consultations.

3. Consultation methods includes:

a) Direct consultation;

b) Distance consultation.

4. Based on the results of consultation, practitioners directly providing medical examination and treatment shall make decisions on diagnosis and appropriate treatment for patients.

Article 65. Surgery, surgical interference

1. All surgeries and surgical interference are subject to consent of patients or their representatives as prescribed at Points a, b, c and d Clause 2 Article 8 of this Law.

2. Surgeries and surgical interference for patients who have lost their civil act capacity, have difficulties in cognition, behavior control, limited civil act capacity or who are minors or patients without relatives shall comply with the provisions of Article 15 of this Law.

Article 66. Care for patients

1. Patient care means the implementation of professional and supportive intervention techniques to care for patients during medical examination and treatment as prescribed by practitioners.

2. Patient care includes:

a) Determining care needs, making nursing diagnoses, designating patient care interventions;

b) Decentralizing patient care levels;

c) Implementing professional and supportive intervention techniques for patient care, guiding patients or their relatives to perform care activities;

d) Monitoring patient's condition and evaluating the results of care interventions.

Article 67. Nutrition in medical examination and treatment

1. Nutrition in medical examination and treatment means clinical nutrition activities and the counseling and guidance on nutrition regimes in medical examination and treatment.

2. Nutrition in medical examination and treatment includes:

a) Examining, assessing and classifying levels of malnutrition, providing professional advice and guidance on pathological nutrition and monitoring nutritional status of patients;

b) Conducting education and communication on nutrition.

            Article 68. Functional rehabilitation

1. Principles of implementation of functional rehabilitation include:

a) Preventing and lowering the effects of disability; examining and detecting for early functional rehabilitation;

b) Assessing the need of intervention measures for functional rehabilitation during examination and treatment for patients;

c) Intervention measures must be implemented continuously and comprehensively according to the disease progression stages;

d) Coordinating between the rehabilitation specialty and other specialties; between medical examination and treatment establishments and individuals, families, communities and other agencies and organizations; implementing the community-based rehabilitation.

2. Functional rehabilitation includes:

a) Examining, diagnosing and determining the functional rehabilitation needs of patients;

b) Using techniques of movement therapy, physical therapy, occupational therapy, speech therapy, psychotherapy, orthopedics, medical equipment, functional rehabilitation tools and other intervention measures;

c) Counseling patients and their families on functional rehabilitation, psychology, education, career guidance and community integration;

d) Adjusting and improving conditions to access to living environment suitable to health status;

dd) Propagating prevention of disabilities and diseases.

Article 69. Case history dossiers

1. Case history dossiers shall be made and updated for all patients receiving inpatient treatment, day treatment and outpatient treatment in medical examination and treatment establishments.

Case history dossiers made in hard or soft copies have the same legal validity. The form of case history dossiers and the summary form of case history dossiers shall be issued by the Minister of Health.

2. Case history dossiers shall be confidentially preserved in accordance with the law; if case history dossiers fall within the scope of state secrets, the provisions of the law on protection of state secrets shall be applied. The archive of dossiers of case history dossiers must comply with the law on archives.

3. The use of case history dossiers under treatment shall be carried out as follows:

a) Pupils, students, trainees, researchers of research institutions, training institutions, practitioners, persons directly involved in the treatment of patients in medical examination and treatment establishments may read but copy case history dossiers only with the consent of medical examination and treatment establishments;

b) Practitioners of other establishments may read and copy case history dossiers with the consent of the medical examination and treatment establishments.

4. The use of case history dossiers of a completed treatment that has been transferred to archives shall be carried out as follows:

a) Representatives of health state management agencies, investigative agencies, procuracies, courts, health inspectors, forensic and mental forensic examination organizations and lawyers of the patients may access and provide case history dossiers to perform their duties in accordance with relevant laws;

b) Pupils, students, trainees, researchers of research institutions, training institutions, practitioners of medical examination and treatment establishments are allowed to borrow case history dossiers for on-the-spot reading or for copying for research or professional purposes with the consent of medical examination and treatment establishments;

c) Representatives of social insurance agencies or state compensation agencies may borrow case history dossiers for on-the-spot reading or taking notes or requesting a copy for assigned tasks with the consent of medical examination and treatment establishments;

d) Patients or their representatives specified at Points c and d Clause 2 Article 8 of this Law may read, copy and record the case history dossiers and receive brief summaries of case history dossiers upon request in writing;

dd) The patient's representative specified at Points a and d Clause 2 Article 8 of this Law may receive brief summaries of case history dossiers upon request in writing.

5. When using information of case history dossiers, the users specified in Clause 4 of this Article shall keep it confidential and use it only for the purposes reported to the medical examination and treatment establishments.

Article 70. On-standby medical examination and treatment

1. Medical examination and treatment establishments with inpatient treatment, hospital beds for patient monitoring and treatment, and out-of-hospital emergency establishments shall provide on-standby medical examination and treatment according to the operation time stated in the operation license, including holidays, New Year's Day, weekends, in order to promptly give first aid and maintain other medical examination and treatment.

2. On-standby medical examination and treatment includes:

a) Leaders on standby;

b) Clinical standby;

c) Paraclinical standby;

d) Logistic standby and administration on standby.

3. On-standby medical examination and treatment at hospitals must ensure full members as prescribed in Clause 2 of this Article; on-standby medical examination and treatment at medical examination and treatment establishments specified in Clause 1 of this Article, other than hospitals, shall comply with the regulations of the Minister of Health.

4. The head of a medical examination and treatment establishment specified in Clause 1 of this Article shall:

a) Assign persons on standby;

b) Ensure sufficient means of transport for first-aid suited to the form of medical examination and treatment; medical equipment and essential drugs for emergencies;

c) Ensure reporting by each on-standby shift.

Article 71. Prevention of adverse events at medical examination and treatment establishments

1. The prevention of adverse events shall be conducted on the basis of identifying, reporting, analyzing to find the causes, giving recommendations and solutions to prevent and avoid the recurrence of adverse events to improve the quality of medical examination and treatment services and safety for patients.

Recommendations and solutions to prevent adverse events shall be publicly announced on the Information System on medical examination and treatment management.

2. The head of a medical examination and treatment establishment shall take responsibility for the prevention of adverse events at the medical examination and treatment establishment.

Article 72. Receiving and handling patients without relatives

1. When receiving and providing medical examination and treatment for a patient without relative, medical the examination and treatment establishment shall take responsibility for inventorying, making records and keeping the patient’s assets.

2. If the patient's relative cannot be identified within 48 hours after receiving the patient, the medical examination and treatment establishment shall:

a) To notify such to the commune-level People’s Committee of the locality where the medical examination and treatment establishment is located, which shall issue a notice of search for relatives of the patient in the mass media;

b) To make a dossier of request for admission of social protection subjects with extremely difficult circumstances into social assistance establishments according to the provisions of the law on social protection for children under 6 months of age who are abandoned at medical examination and treatment establishments.

3. In case the patient has been treated and the condition is stable but his/her relatives are unidentifiable, and he/she falls into the case of loss of civil act capacity, difficulties in perception, behavior control, limitation of civil act capacity, the medical examination and treatment establishment shall compile dossiers of request for admission of social protection subjects with extremely difficult circumstances into a social assistance establishment in accordance with the law on social protection.

4. For a deceased patient, the medical examination and treatment establishment shall handle it in accordance with Article 73 of this Law.

5. Medical examination and treatment establishments shall provide care, nursing, medical examination, and treatment for patients from the time of receipt until completion of procedures for transferring patients to social assistance establishments or until the patient passes away.

6. The Government shall stipulate the payment of expenses for care, nursing, medical examination and treatment for the subjects specified in this Article and the handling of foreign patients without relatives.

Article 73. Handling of deceased patients

1. For a patient who dies before being admitted to a medical examination and treatment establishment, the medical examination and treatment establishment shall:

a) In case a patient has personal identification papers and it is able to contact his/her relatives, the medical examination and treatment establishment shall notify the patient’s relatives to receive his/her body;

b) In case a patient does not have personal identification papers or he/she has personal identification papers but it is unable to contact his/her relatives, the medical examination and treatment establishment shall notify the commune-level People’s Committee of the locality where it is located within 24 hours of receiving the body.

The commune-level People’s Committee of the locality where the medical examination and treatment establishment is located shall receive the body and organize the burial within 48 hours from the date of receipt of the notice.

2. For a patient who dies at a medical examination and treatment establishment, the medical examination and treatment establishment shall:

a) Issue death certificate, hold a critical discussion, complete and archive the patient's case history dossier; take and store samples of the body to serve the identification of the patient's identity, for the cased specified at Point b Clause 1 of this Article; notify the patient's relatives to organize the burial;

b) Notify the commune-level People’s Committee of the locality where the medical examination and treatment establishment is located within 24 hours since the patient's death for the case nobody receives the dead or refusal to accept.

The commune-level People’s Committee of the locality where the medical examination and treatment establishment is located shall receive the body and organize the burial within 48 hours from the date of receipt of the notice from the medical examination and treatment establishment as prescribed at Point b of this Clause.

3. The Government shall stipulate regulations on handling of deceased foreigners without relatives and payment of funeral expenses for the cases specified at Point b Clause 1 and Point b Clause 2 of this Article.

Article 74. Control of bacterial contamination at medical examination and treatment establishments

1. Measures to control bacterial contamination at medical examination and treatment establishments include:

a) Supervision of bacterial contamination at medical examination and treatment establishments and diseases at risk of causing epidemics;

b) Supervision of compliance with practices of bacterial contamination control;

c) Standard precautions, transmission-based precautions;

d) Control of bacterial contamination of medical instruments and equipment;

dd) Hand hygiene;

e) Environmental hygiene;

g) Prevention and treatment of bacterial contamination related to microorganisms;

h) Food safety;

i) Other measures to control bacterial contamination.

2. A medical examination and treatment establishment shall:

a) Take measures to control bacterial contamination at its establishment specified in Clause 1 of this Article;

b) Guarantee physical foundations, equipment, protective clothing, personal hygiene conditions for those working at its establishment, patients and visitors of the establishment in conformity with requirements on bacterial contamination control at medical examination and treatment establishments;

c) Counsel patients and their relatives on measures to control bacterial contamination;

d) Organize systems to control bacterial contamination at medical examination and treatment establishments.

            Article 75. Management of medical waste and environmental protection in medical examination and treatment establishments

Medical examination and treatment establishments shall manage medical waste and protect the environment in medical examination and treatment establishments in accordance with the law on environmental protection.

Article 76. Outpatient treatment

Patients that do not require inpatient treatment at medical examination and treatment establishments shall be treated as outpatients.

Article 77. Inpatient treatment

1. Patients that require inpatient treatment at medical examination and treatment establishments as prescribed by practitioners shall be treated as inpatients.

2. Depending on the specialty and operating conditions, a medical examination and treatment establishment may provide inpatient treatment. Private polyclinics in areas with difficult socio-economic conditions, areas with extremely difficult socio-economic conditions, border areas, islands, state-owned regional polyclinics, obstetrics clinics and commune-level health centers shall be arranged with hospital beds to monitor and treat patients, but not more than 72 hours, except in case of force majeure due to natural disasters, catastrophes or epidemics.

3. The transfer of patients shall be conducted when:

a) Detecting the medical examination and treatment at other specialties is more suitable to the patient's disease;

b) The specialty that transfers the patient shall complete the case history dossier, transfer the patient and the case history dossier to the new department.

4. In case of patient transfer, the medical examination and treatment establishment transferring the patient must complete the patient's case history dossier and refer him/her to the new medical examination and treatment establishment.

In case of patient transfer at the request of the patient or the patient's representative, for the cases specified in Article 15 of this Law, the patient or the patient's representative must make a written commitment to take responsibility for such transfer.

5. A patient may discharge from the medical examination and treatment establishment if:

a) He/she has recovered or his/her condition is stable; or

b) The patient requests the discharge from the medical examination and treatment establishment and makes a written commitment; in case the patient has lost his/her civil act capacity, has difficulties in cognition, behavior control, or limited civil act capacity, or is a minor, such commitment shall be made by his/her representative.

6. When the patient discharges from a medical examination and treatment establishment, the medical examination and treatment establishment shall:

a) Complete the patient’s case history dossier;

b) Provide healthcare guidance for the patient;

c) Decide on outpatient treatment, when necessary;

d) Settle medical examination and treatment expenses;

dd) Issue a notice of discharge from the medical examination and treatment establishment for the patient.

Article 78. Day treatment

1. Patients that require inpatient treatment as prescribed by practitioners but do not have to stay overnight at the medical examination and treatment establishments shall be undergone day treatment.

2. The day treatment must comply with Article 77 of this Law.

Article 79. Mobile medical examination and treatment

1. Mobile medical examination and treatment includes:

a) Mobile medical examination and treatment provided by a medical examination and treatment establishment outside the location stated on license for medical examination and treatment;

b) Medical examination and treatment at home, health examination at agencies, organizations and units;

c) Providing humanitarian medical examination and treatment in period.

2. Conditions for providing mobile medical examination and treatment shall be prescribed as follows:

a) For the cases specified at Points a and b Clause 1 of this Article, mobile medical examination and treatment shall be provided by a medical examination and treatment establishment with sufficient practitioners, medical equipment, physical foundations and other conditions suitable to the scale and scope of providing mobile medical examination and treatment services, except for home medical examination and treatment performed by health workers of villages, village midwives;

b) For the case specified at Point c Clause 1 of this Article, the conditions specified in Clause 2 Article 88 of this Law must be satisfied;

c) Mobile medical examination and treatment must be approved by a health agency under the provincial-level People's Committee where the mobile medical examination and treatment is expected to be organized, for the cases specified at Points a and c Clause 1 of this Article, except for medical examination and treatment establishments of the armed forces that organize mobile medical examination and treatment for subjects under their management.

3. The Government shall detail this Article.

             Article 80. Remote medical examination and treatment and support for remote medical examination and treatment

1. Remote medical examination and treatment between practitioners and patients shall be carried out as follows:

a) Remote medical examination and treatment between a practitioner and a patient must be provided according to the practitioner's scope of practice; diseases to be remotely treated must be in accordance with the list of diseases and conditions promulgated by the Minister of Health;

b) Practitioners must take responsibility for the results of diagnosis, instruction on treatment methods and prescription.

2. Support for remote medical examination and treatment between practitioners and patients shall be carried out as follows:

a) Practitioner who directly provides medical examination and treatment at the supported medical examination and treatment establishment shall take responsibility for this/her medical examination and treatment results;

b) The supported medical examination and treatment establishment must pay expenses for the supporting medical examination and treatment establishment according to the expenses agreed upon between the two establishments.

3. The Government shall provide detailed provisions on remote medical examination and treatment and support for remote medical examination and treatment.

Article 81. Family medical examination and treatment

1. Family medical examination and treatment shall be provided by family medicine centers or other medical examination and treatment establishments with the family medicine professional.

2. Centers and medical examination and treatment establishments specified in Clause 1 of this Article shall perform the following tasks:

a) Managing and providing primary health care in the areas where they operate;

b) Counseling, disease prevention, disability prevention and health improvement;

c) First aid, medical examination and initial treatment;

d) Providing medical examination, treatment, functional rehabilitation, palliative care, end-of-life care at home;

dd) Deciding on the transfer of patients under the management to other medical examination and treatment establishments; receiving and managing the health of patients transferred by other medical examination and treatment establishments;

e) Performing other tasks assigned by competent agencies.

             Article 82. Compulsory medical treatment

1. Cases subject to compulsory medical treatment under this Law include:

a) Persons suffering a group-A infectious disease under the law on prevention and control of infectious diseases;

b) Persons suffering depression which gives rise to the idea or act of committing suicide or suffering a mental disease in a state of loss of self-control that may harm themselves or engage in acts that cause harm to others or damage property;

c) Other cases as prescribed by law.

2. The Government shall prescribe measures for compulsory medical treatment for the cases specified in Clause 1 of this Article.

Article 83. Health examination

1. Health examination includes:

a) Regular health examination;

b) Health examination to classify health for study and working purposes;

c) Health examination for pupils and students;

d) Health examination for requirements of specific occupations and jobs;

dd) Health examination to detect occupational diseases;

e) Health examination upon request;

g) Other types of medical examination.

2. The Minister of Health shall prescribe the standards and health examination specified in Clause 1 of this Article, except for the cases specified in Clause 3 of this Article.

3. The Minister of National Defence and the Minister of Public Security shall prescribe specific health standards and health examination for subjects under their management.

Article 84. Medical assessment

1. Medical assessment includes initial assessment, reassessment, special reassessment and final assessment.

2. Assessment conclusions must comply with the contents solicited by the agency, organization or individual. The agency or person making assessment conclusions shall take responsibility before the law for such conclusion.

Chapter VI

USE OF TRADITIONAL MEDICINE IN MEDICAL EXAMINATION AND TREATMENT; AND COMBINATION OF TRADITIONAL MEDICINE WITH WESTERN MEDICINE IN MEDICAL EXAMINATION AND TREATMENT

              Article 85. Development of traditional medicine in medical examination and treatment

1. State-owned general hospitals must organize medical examination and treatment by using traditional medicine; traditional medicine establishments are encouraged to organize general medical examination and treatment if they fully satisfy all required conditions.

2. Inherit and promote the development of herbal remedies, medical examination and treatment methods of use of traditional medicine; encourage to use of drugs from medicinal materials, traditional drugs made from domestic sources clinically effective in disease prevention and treatment. Encourage and support the development of use of traditional medicine in yangsheng (nourishing life) in the community.

3. The following activities of scientific and technological research on traditional medicine are encouraged:

a) Discover and research drugs from medicinal materials, traditional drugs;

b) Research the taste and effects of traditional herbal medicaments, folk drugs, herbal remedies in traditional medicine that are effective in disease prevention and treatment according to traditional medicine and western medicine;

c) Research the safety and effectiveness of traditional medicine diagnosis and treatment methods, and treatment with traditional medicine methods without drugs in disease prevention and treatment;

d) Research, select and develop safe drugs from medicinal materials, traditional drugs with high treatment effectiveness;

dd) Research the safety and effectiveness of combination of drugs from medicinal materials or traditional drugs and pharmacochemical drugs in each period of disease;

e) Research the combination of traditional medicine with western medicine in disease diagnosis to develop a set of criteria for diagnosis of diseases and disease types according to traditional medicine;

g) Research the application of advanced technology for preparation of drugs from medicinal materials, traditional drugs in modern forms.

4. The registration of intellectual property for family herbal remedies or treatment methods is encouraged.

Article 86. Development of resources for use of traditional medicine in medical examination and treatment

1. Integrate the traditional medicine in training programs of training institutions in the health sector; diversify forms and types of training of human resources using traditional medicine for medical examination and treatment with different qualifications.

2. Herbalists, owners of family herbal remedies or treatment methods may participate in training courses to update, foster and improve their knowledge about traditional medicine and western medicine.

3. Owners of family herbal remedies or treatment methods are encouraged to register the provision of training of family herbal remedies or treatment methods with the health agency under the provincial-level People's Committee where they carry out the professional practice.

4. The Minister of Health shall define the grant of certificates of herbalists, certificates of owners of family herbal remedies, certificates of owners of family treatment methods.

Article 87. Combination of traditional medicine with western medicine in medical examination and treatment establishments

1. Combination of traditional medicine with western medicine must be carried out in medical examination and treatment establishments and comply with the following provisions:

a) Combine professional methods and techniques of traditional medicine with professional methods and techniques of western medicine for medical examination and treatment, and monitoring and evaluation of treatment results;

b) Only practitioners fully satisfying requirements may combine traditional medicine with western medicine in instructions on treatment methods and prescriptions.

2. The Minister of Health shall detail this Article.

Chapter VII

HUMANITARIAN MEDICAL EXAMINATION AND TREATMENT, MEDICAL EXAMINATION AND TREATMENT FOR NON-PROFIT PURPOSES; TECHNICAL TRANSFER IN MEDICAL EXAMINATION AND TREATMENT

Section 1

HUMANITARIAN MEDICAL EXAMINATION AND TREATMENT, MEDICAL EXAMINATION AND TREATMENT FOR NON-PROFIT PURPOSES

            Article 88. Activities of humanitarian medical examination and treatment, medical examination and treatment for non-profit purposes

1. Domestic and foreign organizations and individuals have the right to request humanitarian medical examination and treatment, and medical examination and treatment for non-profit purposes in Vietnam.

2. Conditions for humanitarian medical examination and treatment in period shall be as follows:

a) Be performed by practitioners or persons specified in Clause 3 Article 19 of this Law;

b) Be performed by a medical examination and treatment establishment or an organization that is licensed to operate in Vietnam;

c) Financial resources for organization of humanitarian medical examination and treatment are available; all medical examination and treatment expenses for patients receiving humanitarian medical examination and treatment are waived;

d) Obtain the competent agency’s consent in accordance with the Government’s regulations.

3. Conditions for grant of operation licenses for humanitarian medical examination and treatment establishments, establishments of medical examination and treatment for non-profit purposes shall be as follows:

a) Satisfy the requirements for grant of an operation license under this Law;

b) Humanitarian medical examination and treatment establishments must have financial resources for organization of humanitarian medical examination and treatment and waive all medical examination and treatment expenses for their patients receiving such humanitarian medical examination and treatment;

c) Establishments of medical examination and treatment for non-profit purposes must make commitment to operate for non-profit purposes, not withdraw capital; their annual incomes will belong to indivisible common ownership by integration and be used for further investment in the development of such establishments. The commitment must be recorded in the decisions on establishment or transformation of medical examination and treatment establishments.

4. The Government shall detail this Article.

Article 89. Incentives for humanitarian medical examination and treatment establishments, establishments of medical examination and treatment for non-profit purposes

1. Humanitarian medical examination and treatment establishments, establishments of medical examination and treatment for non-profit purposes shall enjoy incentives as specified by law regulations upon foundation.

2. Regimes of finance, accounting, auditing, taxation, property valuation and financial disclosure of humanitarian medical examination and treatment establishments, establishments of medical examination and treatment for non-profit purposes shall comply with relevant law regulations; their undistributed incomes of establishments of medical examination and treatment for non-profit purposes are not subject to taxation.

Section 2
TECHNICAL TRANSFER IN MEDICAL EXAMINATION AND TREATMENT

             Article 90. Technical transfer in medical examination and treatment

1. Medical examination and treatment establishments may cooperate with domestic and foreign organizations and individuals on technical transfer in medical examination and treatment in Vietnam.

2. The training in technical transfer in medical examination and treatment must be performed by lawful practitioners and medical examination and treatment establishments.

3. The Government shall detail this Article.

Article 91. Incentives for technical transfer in medical examination and treatment

The technical transfer in medical examination and treatment shall be entitled to preferential regimes in accordance with law provisions on technology transfer, intellectual property, science and technology.

Chapter VIII
APPLICATION OF NEW TECHNIQUES AND METHODS IN MEDICAL EXAMINATION AND TREATMENT, AND CLINICAL TRIAL IN MEDICAL EXAMINATION AND TREATMENT

Section 1
APPLICATION OF NEW TECHNIQUES AND METHODS IN MEDICAL EXAMINATION AND TREATMENT

             Article 92. New techniques and methods in medical examination and treatment

1. New techniques and methods are techniques and methods that are applied in Vietnam for the first time.

2. New techniques and methods include:

a) New techniques and methods which are studied in Vietnam or overseas;

b) New techniques and methods which have been licensed for application by overseas competent agencies.

Article 93. Conditions for application of new techniques and methods in medical examination and treatment

1. A medical examination and treatment establishment requesting for application of a new technique or method in medical examination and treatment must meet the following conditions:

a) Possess a license for medical examination and treatment with the scope of professional operation in conformity with such requested new technique or method;

b) Satisfy requirements for physical foundations, medical equipment, human resources and other conditions to apply the new technique or method.

2. The application of the new technique or method shall be performed as follows:

a) The medical examination and treatment establishment shall submit a scheme to request pilot application of the new technique or method;

b) The Ministry of Health shall appraise or decentralize the appraisal to allow the pilot application of the new technique or method;

c) After the pilot application duration, the medical examination and treatment establishment shall synthesize the pilot application results and request the Ministry of Health to organize the acceptance tests;

d) If the acceptance test results meet requirements, the Ministry of Health shall issue a document allowing the application of the new technique or method.

3. The Government shall detail this Article.

Section 2

CLINICAL TRIAL IN MEDICAL EXAMINATION AND TREATMENT

             Article 94. Cases subject to clinical trial in medical examination and treatment

1. New techniques and methods in medical examination and treatment.

2. Medical equipment before being registered in Vietnam that is at moderate-high level of risks or high level of risks according to the Government’s regulations.

Article 95. Conditions of participants in clinical trial in medical examination and treatment

1. Meet the professional requirements of the clinical trial of new technique, new method, or medical equipment in medical examination and treatment (hereinafter referred to as the clinical trial) and voluntarily participate in the clinical trial.

2. The participation in clinical trial of persons having lost their civil act capacity, having difficulty in perceiving or controlling their acts, or having their civil act capacity limited or being minors must be agreed by their representatives or their guardians in accordance with civil law provisions.

3. In case clinical trial participants are subjects specified in Clause 2 of this Article, pregnant or breastfeeding women, the research dossier must clearly state the reasons for selection and appropriate measures to protect the clinical trial participants, fetuses or infants breastfed by women participating in the clinical trial.

            Article 96. Rights and obligations of clinical trial participants

1. Clinical trial participants have the following rights:

a) To be provided with sufficient and truthful information about the clinical trial and possible risks before participating in the clinical trial;

b) To receive compensation for any damage (if any) caused by the clinical trial;

c) To have his/her personal information related to the clinical trial kept confidential;

d) To bear no responsibility when unilaterally withdrawing from the clinical trial;

dd) To lodge a complaint, denunciation or lawsuit about illegal acts of the organizations or individuals having new techniques, new methods, or medical equipment subject to clinical trial.

2. Clinical trial participants are obliged to comply with the guidelines stated in the approved dossier of the clinical trial.

Article 97. Rights and responsibilities of organizations or individuals having new techniques, new methods, or medical equipment subject to clinical trial

1. Organizations or individuals having new techniques, new methods, or medical equipment subject to clinical trial have the following rights:

a) To select an establishment that satisfies requirements for physical foundations and human resources to conduct the clinical trial;

b) To own all results of the clinical trial.

2. Organizations or individuals having new techniques, new methods, or medical equipment subject to clinical trial have the following responsibilities:

a) To pay compensation in accordance with law provisions to the clinical trial participants if a risk occurs as a result of the clinical trial;

b) To conclude a written contract on the clinical trial with an establishment conducting clinical trial;

c) To take responsibility before law for the quality and safety of new techniques, new methods or medical equipment they provide.

Article 98. Rights and responsibilities of establishments conducting clinical trial

1. Establishments conducting clinical trial have the following rights:

a) To conduct the clinical trial according to regulations;

b) To import and purchase chemicals, standard substances, drug samples and medical equipment in service of clinical trial;

c) To use clinical trial results according to the agreement with organizations or individuals having new techniques, new methods, or medical equipment subject to clinical trial.

2. Establishments conducting clinical trial have the following responsibilities:

a) To take responsibility for the completeness, accuracy and reliability of the clinical trial results;

b) To take responsibility for the safety of clinical trial participants and pay compensation in accordance with law provisions to them if any risk occurs due to the establishments’ fault;

c) To ensure truthfulness and objectivity in the clinical trial.

Article 99. Principles and competence of approval of clinical trial

1. A clinical trial shall be conducted before the approval of application of a new technique, new method, or registration of a medical equipment, except for cases eligible for exemption from clinical trial or exemption from some stages of clinical trial.

2. The clinical trial shall be conducted only after the dossier of the clinical trial has been assessed in terms of scientific and ethical issues by the council of ethics in biomedical research specified in Clause 3 of this Article and the clinical trial is approved in writing by the competent agency.

3. The council of ethics in biomedical research is an independent body that is established for the purpose of protecting the rights, safety and health of clinical trial participants.

4. The clinical trial, scientific and ethical assessment of the clinical trial dossier, and approval of the clinical trial must adhere to the following principles:

a) Respect, protect and assure the right to self-determination of clinical trial participants;

b) Ensure that the research benefits outweigh possible risks arising during the clinical trial;

c) Ensure equality in benefits and responsibilities and fair distribution of risks among clinical trial participants;

d) Strictly follow the stages of clinical trial and applying good practices in clinical trial of new techniques, new methods, medical equipment defined by the Minister of Health.

5. The Government details the following contents:

a) Stages of clinical trial;

b) Cases eligible for exemption from clinical trial or exemption from some stages of clinical trial;

c) Requirements for new techniques, new methods, medical equipment subject to clinical trial;

d) Requirements for establishments conducting clinical trial;

dd) Dossier, process and procedures for allowance of clinical trial;

e) The establishment of councils of ethics in biomedical research.

Chapter IX
PROFESSIONAL AND TECHNICAL MISTAKES

Article 100. Determination of practitioners with professional and technical mistakes

1. A practitioner makes professional and technical mistakes when he/she is determined by a professional council under Article 101 of this Law to commit any of the following acts:

a) Violate regulations on responsibilities for care for and treatment of patients;

b) Violate professional and technical regulations.

2. A practitioner makes no professional and technical mistakes when he/she is determined by a professional council under Article 101 of this Law to fall into either of the following cases:

a) Have complied with regulations on responsibilities for care for and treatment of patients and observed professional and technical regulations in medical examination and treatment but medical complications still occur to patients;

b) Cases of emergency in which medical complications occur to patients due to an unsolvable lack of medical means and equipment, drugs and practitioners or the unavailability of professional and technical guidance on a disease, resulting in such medical complications;

c) Force majeure events, objective hindrances or other objective reasons resulting in such medical complications to patients;

d) Cases of medical complications caused by patients.

Article 101. Professional councils

1. Upon occurrence of a medical complication, if there is a request for dispute settlement by a patient, representative of the patient or the practitioner, the medical examination and treatment establishment must set up a professional council to determine whether or not professional and technical mistakes are made by the practitioner.

2. A professional council includes:

a) Experts in relevant specialties;

b) Experts in other specialties related to medical complications.

3. The solicitation of experts to join a professional council must ensure objectivity and avoid conflicts of interests in accordance with law provisions.

4. A professional council shall be set up in the following cases:

a) A professional council is set up by a medical examination and treatment establishment under Clause 1 of this Article. In case a medical examination and treatment establishment cannot set up a professional council, it shall propose the competent health state agency directly managing that establishment to set up a professional council.

b) A professional council shall be set up by the competent health state agency directly managing a medical examination and treatment establishment at the proposal of such medical examination and treatment establishment under Point a of this Clause or in case involved parties disagree with conclusions by the professional council set up by the medical examination and treatment establishment and submit a written proposal;

c) A professional council is set up by the Ministry of Health in case involved parties disagree with conclusions by the professional council set up by the competent health state agency directly managing the medical examination and treatment establishment and submit a written proposal.

5. A professional council operates on the following principles:

a) The professional council operates on the principle of collective discussion, decision making by votes of majority and taking responsibility before law for its conclusions.

b) Conclusions of the professional council serve as a basis for dispute settlement upon occurrence of a medical complication and serve as a basis for the competent health state management agency, the head of the medical examination and treatment establishment to handle practitioners according to the competence;

c) Conclusions of a professional council set up by the Ministry of Health are final conclusions on whether or not professional and technical mistakes are made.

6. The Minister of Health shall define the regulations on organization and operation of professional councils and the order and procedures for dispute settlement upon occurrence of a medical complication.

Article 102. Compensation upon occurrence of medical complications

Upon occurrence of a medical complication to a patient, the medical examination and treatment establishment must pay compensation to the patient in accordance with law provisions, except for the cases specified in Clause 2 Article 100 of this Law.

Article 103. Professional liability insurance in medical examination and treatment

1. Professional liability insurance in medical examination and treatment means a type of insurance used to pay compensation for damage caused by medical complications during the medical examination and treatment that occur within the insurance period and costs of lawsuits related to such medical complications, except for the cases specified at Point d Clause 2 Article 100 of this Law.

2. Insurance enterprises shall pay the compensation specified in Clause 1 of this Article to the medical examination and treatment establishments under the concluded insurance contracts.

3. Professional liability insurance in medical examination and treatment shall comply with laws on insurance business.

4. The Government shall detail this Article.

Chapter X
CONDITIONS FOR ASSURANCE OF MEDICAL EXAMINATION AND TREATMENT

Section 1

CONDITIONS FOR PROFESSIONAL AND TECHNICAL ASSURANCE

             Article 104. Professional and technical levels in medical examination and treatment

1. State-owned and private medical examination and treatment establishments are classified into 03 professional and technical levels as follows:

a) Those at the level of initial medical examination and treatment that perform the tasks of medical examination, outpatient treatment, and primary healthcare; disease management, functional rehabilitation in the community;

b) Those at the level of basic medical examination and treatment that perform the tasks of general medical examination and inpatient and outpatient treatment; general practice training, organizing continued updating of medical knowledge for practitioners;

c) Those at the level of intensive medical examination and treatment that perform the tasks of advanced medical examination and outpatient and inpatient treatment; advanced practice training; advanced research and continued training; technology transfer in medical examination and treatment.

2. The organization of professional and technical levels in medical examination and treatment must ensure the continuity and connection in provision of medical examination and treatment services according to disease status and severity, and comply with the following principles:

a) A medical examination and treatment establishment is only classified into one professional and technical level; in case a medical examination and treatment establishment can perform the tasks of all 03 professional and technical levels, it shall be classified into the advanced level; in case the medical examination and treatment establishment can perform the tasks of the initial level and the basic level, it shall be classified into the basic level;

b) A medical examination and treatment establishment must concentrate on performing the tasks of its classified professional and technical level and may perform professional techniques of other levels if it fully satisfies the conditions prescribed by the Minister of Health; perform tasks of other professional and technical levels in conformity with the characteristics of the sector or field according to the Government's provisions.

3. Professional and technical levels of medical examination and treatment establishments shall be classified according to the following criteria:

a) Capacity in terms of provision of medical examination and treatment services and the scope of professional operation;

b) Capacity in terms of medical practice training;

c) Capability in terms of provision of technical support for other medical examination and treatment establishments;

d) Capability in terms of scientific research in medicine.

4. The Government shall detail this Article.

Article 105. Practitioner training and retraining

1. The medical examination and treatment establishments shall be responsible for providing practitioners with, create favorable conditions for practitioners to participate in, training and continued updating of medical knowledge, professional, technical and ethic refresher training.

2. The State adopts the policy on grant of scholarships as follows:

a) Encouragement scholarships shall be granted to learners majoring in psychiatry, anatomic pathology, forensic medicine, psychiatrically forensic medicine, infectious diseases and intensive care in the State-owned training institutions in the health sector whose learning and practice results are eligible for scholarships;

b) Policy scholarships shall be granted to learners majoring in psychiatry, anatomic pathology, forensic medicine, psychiatrically forensic medicine, infectious diseases and intensive care who are working in medical examination and treatment establishments located in areas with difficult socio-economic conditions and areas with extremely difficult socio-economic conditions.

3. Learners majoring in psychiatry, anatomic pathology, forensic medicine, psychiatrically forensic medicine, infectious diseases and intensive care shall be supported by the State as follows:

a) They shall receive tuition fees and support for cost-of-living expenses for their entire courses in case they learn in the State-owned training institutions in the health sector;

b) They shall receive support for tuition fees and support for cost-of-living expenses for their entire courses that are corresponding to the support rates specified at Point a of this Clause in case they learn in the private training institutions in the health sector.

4. The State encourages organizations and individuals to grant scholarships or allowances to learners.

5. The Government shall detail this Article.

Section 2

CONDITIONS FOR FINANCIAL ASSURANCE

             Article 106. Financial sources for medical examination and treatment

1. Financial sources for medical examination and treatment include:

a) State budget;

b) Health insurance fund;

c) Charges collected from patients;

d) Financial aid and supports from domestic and foreign organizations under law provisions;

dd) Other lawful financial sources in accordance with law provisions.

2. Regimes of finance, accounting, auditing, taxation, property valuation and financial disclosure of medical examination and treatment establishments shall comply with law regulations.

Article 107. State budget for medical examination and treatment

1. Spending for medical examination and treatment establishments in provision of medical examination and treatment services in the list of medical examination and treatment services using the state budget in accordance with law provisions and performance of tasks ordered and assigned by competent state agencies.

2. Spending for supporting State-owned medical examination and treatment establishments in accordance with law on State budget, law on financial autonomy regime for public non-business units, including ensuring of current expenditure for State-owned medical examination and treatment establishments in case such establishments cannot balance their current expenditure.

3. Spending for development investment of medical examination and treatment establishments in accordance with law regulations.

4. Spending for payment for or assistance with payment for health insurance premiums for beneficiaries of them under law provisions on health insurance.

Article 108. Regulations on autonomy applicable to State-owned medical examination and treatment establishments

1. State-owned medical examination and treatment establishments shall be allocated funds by the State to perform their functions and tasks assigned by the State agency; take the responsibility for effectively using financial resources in accordance with law provisions, promoting their potentials and strengths, and improving their quality of medical examination and treatment.

2. State-owned medical examination and treatment establishments applied to autonomy regime are autonomous in deciding on organization and personnel, performing tasks, developing professional activities and other activities in service of their medical examination and treatment under this Law and other relevant laws.

3. Medical examination and treatment establishments shall apply the financial autonomy in accordance with law provisions and the following contents:

a) Deciding the contents of collection, the rates of charges of services and goods related to medical examination and treatment, serving of patients and the patient’s relatives in accordance with law provisions, except for services and goods priced by the State;

b) Deciding the use of lawful revenues to invest in projects to conduct medical examination and treatment in accordance with law provisions;

c) Deciding the contents and rates of spending from revenues from medical examination and treatment services and non-business revenues, funding sources for ordering goods under their internal spending regulations in conformity with law regulations and their financial capacity;

d) Deciding the use of public properties in accordance with law provisions for the purpose of developing medical examination and treatment on the principles of maintaining and development; receipt, management, exploitation and use of properties donated by organizations and individuals on the principles of publicity, transparency and non-binding of interests between the parties for medical examination and treatment;

dd) Medical examination and treatment establishments covering their investment and current expenditures by themselves may decide on the charges of medical examination and treatment services but must ensure that such charges do not exceed the corresponding medical examination and treatment service charges defined by the Minister of Health, except for the charges of at-request medical examination and treatment services and charges of medical examination and treatment services formed from the cooperation in the form of public-private partnership that shall comply with Clauses 7 and 9 of Article 110 of this Law.

4. The Government shall detail this Article.

Article 109. Socialization of medical examination and treatment

1. All organizations, families and citizens shall take care of themselves, early detect diseases for members of their organizations and families and themselves; participate in first aid, support the remedy of accidents and injuries occurred in the community and participate in medical examination and treatment activities when being mobilized by competent authorities or persons.

2. The State shall diversify forms of medical examination and treatment services; organizations and individuals participating in the construction of medical examination and treatment establishments are entitled to preferential policies in accordance with laws on socialization, ensuring the principles of publicity, transparency, equality, sustainability, efficiency and harmony of the interests of the State, investors, patients and the community; the State encourages private medical examination and treatment establishments to provide humanitarian medical examination and treatment, for non-profit purposes; and encourages the establishment of funds for medical examination and treatment support.

3. Forms of attracting social resources in medical examination and treatment include:

a) Investment in establishment of private medical examination and treatment establishments;

b) Investment in the form of public-private partnership to establish medical examination and treatment establishments;

c) Borrowing of capital for investment in infrastructure works and medical equipment;

d) Renting, leasing of property, clinical services, para-clinical services, non-medical services, pharmacy services, management and operation of medical examination and treatment establishments;

dd) Purchase of medical equipment on deferred or installment payment; renting, borrowing of medical equipment;

e) Financial aid from domestic and foreign organizations and individuals;

g) Other forms under laws on management and use of public property and other relevant law provisions.

4. The attraction of social resources in medical examination and treatment for State-owned medical examination and treatment establishments shall comply with law provisions.

5. The Government shall detail this Article.

Article 110. Charges for medical examination and treatment services

1. Charges for medical examination and treatment services include:

a) The total costs of medical examination and treatment services specified in Clause 2 of this Article;

b) Accumulation or expected profits (if any);

c) Financial obligations prescribed by laws.

2. The total costs of medical examination and treatment services include:

a) Labor expenses, including salaries and wages suitable to the type of provided services, salary-based contributions and allowances as prescribed;

b) Direct expenses include expenses for drugs, chemicals, blood, blood products and expenses for raw materials, materials, tools, fuel, energy used in medical examination and treatment and other direct expenses;

c) Depreciation costs for medical equipment and fixed assets;

d) Administration expenses include maintenance expenses for medical equipment, fixed assets, expenses for environmental protection, control of bacterial contamination, expenses for training, scientific research, and information technology, expenses of purchase of professional liability insurance, expenses of quality control, loan interests (if any) and other expenses related to medical examination and treatment activities.

3. The determination of charges of medical examination and treatment services must be consistent with the types of provided medical examination and treatment services and the following principles:

a) Covering costs of medical examination and treatment performance in conformity with Points b and c Clause 4 of this Article;

b) Ensuring the harmony of interests of the State, lawful rights and interests of medical examination and treatment establishments, and patients;

c) Reviewing components of charges for medical examination and treatment services for the adjustment in case of necessity. The adjustment of charges for medical examination and treatment services must be consistent with the bases specified in Clause 4 of this Article.

4. Determination of charges for medical examination and treatment services shall be based on the following elements:

a) Factors forming charges for medical examination and treatment services specified in Clause 1 of this Article at the time of charge determination;

b) The supply-demand relationship between medical examination and treatment services and patients’ payment ability;

c) Policies and laws on autonomy applicable to public non-business units in each period, the State’s policies for socio-economic development in each period according to the roadmap of correct and adequate calculation of charges of medical examination and treatment services prescribed by the Government.

5. The Minister of Health shall

a) Assume the prime responsibility for, and coordinate with the Minister of Finance in, prescribing methods of determination of charges for medical examination and treatment services;

b) Define in detail charges for medical examination and treatment services in the list of medical examination and treatment services covered by the health insurance fund, charges of medical examination and treatment services covered by the State budget, charges of medical examination and treatment services other than those in the list of medical examination and treatment services covered by the health insurance fund and not being at-request medical examination and treatment services, for medical examination and treatment establishments under the Ministry of Health and other ministries.

6. Provincial-level People's Councils shall define in detail charges for medical examination and treatment services specified at Point b Clause 5 of this Article for State-owned medical examination and treatment establishments in the localities within the scope of assignment but must ensure that such charges do not exceed the corresponding medical examination and treatment service charges prescribed by the Minister of Health.

7. State-owned medical examination and treatment establishments shall apply specific charges for medical examination and treatment services to patients without health insurance cards that use services on the list of medical examination and treatment services covered by the health insurance fund and not being at-request medical examination and treatment services; decide on charges of at-request medical examination and treatment services and must declare and post the charges of at-request medical examination and treatment services.

8. Private medical examination and treatment establishments are entitled to decide charges for medical examination and treatment services and must declare and post them.

9. Medical examination and treatment establishments invested in the form of public-private partnership shall decide the charges of medical examination and treatment services in accordance with laws on investment in the form of public-private partnership.

10. The Government shall detail this Article.

Article 111. Funds for medical examination and treatment support

1. A fund for medical examination and treatment support is established to support those meeting with difficulties or unable to pay medical examination and treatment expenses in paying such expenses; cases of occupational accidents in medical examination and treatment; and for other activities serving medical examination and treatment.

2. Funds for medical examination and treatment support include:

a) Funds for medical examination and treatment support that are established by organizations or individuals, operating and managed in accordance with law provisions on social funds and charity funds;

b) Funds for medical examination and treatment support that are established by medical examination and treatment establishments, funded by financial aid of organizations, individuals, funding sources of medical examination and treatment establishments (if any) and other sources prescribed by laws, organized, managed and operating in accordance with their internal spending regulations in conformity with laws.

Section 3
OTHER CONDITIONS

Article 112. The information system on medical examination and treatment management

1. The information system on medical examination and treatment management includes the following information:

a) Patients and their health information;

b) Practitioners;

c) Medical examination and treatment establishments;

 d) Professional and technical contents;

dd) Charges for medical examination and treatment services, charges for at-request care and support services;

e) Charges for medical examination and treatment, including those covered by the health insurance fund.

2. The information system on medical examination and treatment management is uniformly and centrally managed by the Ministry of Health, and must meet the requirements for ensuring information safety and confidentiality as prescribed by laws and ensure the connection to national databases.

3. Medical examination and treatment establishments shall be responsible for providing the information in an adequate, accurate and prompt manner to the information system on medical examination and treatment management.

4. Social insurance agencies shall be responsible for fully, accurately and promptly providing the information about payment of medical examination and treatment costs covered by health insurance to the information system on medical examination and treatment management.

5. The Minister of Health shall define the following contents:

a) Standard data output format applicable to the information system on medical examination and treatment management specified in Clause 1 of this Article;

b) Building, management, exploitation and use of the information system on medical examination and treatment management.

Article 113. Medical equipment

1. Medical equipment used in medical examination and treatment establishments must be licensed for circulation in Vietnam.

2. The use, inspection, maintenance, repair, replacement of supplies and components, verification and calibration of medical equipment must comply with their manufacturers’ regulations, unless otherwise required by law provisions on verification and calibration.

3. Medical examination and treatment establishments must make, manage and store in an adequate manner medical equipment monitoring records.

4. The Government shall detail this Article.

Article 114. Assurance of security and order at medical examination and treatment establishments

1. Measures to ensure security and order for medical examination and treatment establishments and safety for practitioners and other people working at medical examination and treatment establishments include:

a) Set up a system of monitoring and warning about the risks causing insecurity and disorder;

b) Limit the entering and leaving of medical examination and treatment establishments by hour and area;

c) Apply hi-tech solutions to manage patients, patients' relatives and practitioners to enhance security and order at medical examination and treatment establishments;

d) Take appropriate measures to preserve properties of patients and their relatives during medical examination and treatment at medical examination and treatment establishments;

dd) Substances, means, tools and items that cause insecurity and disorder are banned from the medical examination and treatment establishments;

e) Other security and order assurance measures as prescribed by laws.

2. In case patients, patients’ relatives or other people commit any act of disturbing public order, harming the patients’ life, health and safety of patients, practitioners, other people working at medical examination and treatment establishments, and people entering and leaving medical examination and treatment establishments, the medical examination and treatment establishments may take the following measures:

a) Apply deterrent measures in accordance with laws and notify the police offices, except for cases where the violators are patients in an emergency state;

b) Restrict the entering or leaving of areas under insecurity and disorder or at risk of insecurity and disorder at the medical examination and treatment establishments.

3. Heads of medical examination and treatment establishments shall, based on this Law and other relevant laws, prescribe and organize the implementation of measures to ensure security and order for the medical examination and treatment establishments, and safety for practitioners, other people working at medical examination and treatment establishments, people entering and leaving the medical examination and treatment establishments.

4. Depending on the nature and severity of their violation, persons committing any act of harming the human body, health and life or hurting the honor or dignity of practitioners and other people working at medical examination and treatment establishments shall be administratively handled or examined for penal liability in accordance with law provisions.

Chapter XI

MOBILIZATION OF FORCES TO SERVE MEDICAL EXAMINATION AND TREATMENT UPON OCCURRENCE OF NATURAL DISASTERS, CATASTROPHES, GROUP-A COMMUNICABLE DISEASES OR EMERGENCY SITUATIONS

Article 115. Mobilization of persons participating in medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations

1. Competent agencies and persons may mobilize the following persons to participate in medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations without modification or grant of practice licenses:

a) Medical practitioners, including foreigners practicing in Vietnam;

b) Foreigners and overseas Vietnamese that have been granted a practice license by a competent foreign agency or organization;

c) Students and learners studying at training institutions in the health sector; persons eligible for practice licenses but without possessing a practice license.

2. The tasks assigned to the subjects specified in Clause 1 of this Article must be as consistent as possible with the mobilized persons’ professional qualifications and ensure patients’ safety.

3. In the course of task performance, the mobilized persons specified in Clause 1 of this Article shall not be held responsible for medical complications when falling into one of the cases specified in Clause 2 Article 100 of this Law.

 4. The Minister of Health shall define the mobilization and assignment of tasks for the subjects specified in Clauses 1 and 2 of this Article.

Article 116. Mobilization of medical examination and treatment establishments to participate in medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations

1. State-owned medical examination and treatment establishments in one of the forms specified in Clause 1 Article 48 of this Law may be established for medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations without satisfaction of all conditions specified in this Law and operation license.

2. Medical examination and treatment establishments mobilized to participate in medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations must not modify their operation licenses, including cases where their medical examination and treatment is different from their scope of professional operations.

3. The Government shall detail this Article.

Article 117. Financial mechanism applicable to medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations

1. The state budget shall allocate the following expenses under the assignment:

a) Salaries, wages, allowances, contributions specified by laws and other regimes (if any), for people working at medical examination and treatment establishments defined in Clause 1 Article 116 of this Law that are receiving salaries and wages under the laws and are mobilized to support medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations;

b) Allowances and other regimes (if any), for persons that are mobilized to support medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations but do not receive salaries and wages under the laws.

2. Funds for current expenditures of mobilized medical examination and treatment establishments prescribed in Clause 1 Article 116 of this Law, including the State budget, the health insurance fund, payment of service users and other lawful revenue sources as prescribed by laws, in which:

a) The central budget shall allocate funds for medical examination and treatment establishments founded by central agencies. In case the local budget allocates part of funds for activities of medical examination and treatment establishments founded by central agencies that located in the localities, the central budget must not pay such part of funds;

b) The local budget shall allocate funds for medical examination and treatment establishments founded by the localities. In case a locality fails to ensure the funds allocation after using up all their resources as prescribed, the central budget shall consider providing support.

3. The State budget shall allocate the funds for activities in service of prevention, control and remediation of consequences of natural disasters, catastrophes, group-A communicable diseases or emergency situations by mobilized medical examination and treatment establishments.

4. The Government shall detail this Article.

Article 118. Competence of mobilization of forces to participate in medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations

1. The Minister of Health shall mobilize human resources and medical examination and treatment establishments to participate in medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations nationwide at the request of agencies, organizations and localities, except for human resources and medical examination and treatment establishments in the people’s armed forces.

2. Heads of other ministries and sectors and chairpersons of provincial-level People's Committees shall mobilize human resources under their management to participate in medical examination and treatment upon occurrence of natural disasters, catastrophes, group-A communicable diseases or emergency situations.

Chapter XII
IMPLEMENTATION PROVISIONS

Article 119. Amending and supplementing a number of articles of laws related to medical examination and treatment

1. To amend and supplement Clause 10 Article 4 of the Law No. 14/2008/QH12 on Enterprise Income Tax, which is amended and supplemented by the Law No. 32/2013/QH13, Law No. 71/2014/QH13 and Law No. 61/2020/QH14 as follows:

“10. Undistributed incomes of medical examination and treatment establishments, which are retained for the development of these establishments; undistributed incomes of health establishments under the socialization policy not being medical examination and treatment establishments and undistributed incomes of establishments engaged in education and training, and other sectors under the socialization policy, which are retained for the development of these establishments in accordance with specialized laws; incomes forming undistributed assets of cooperatives that are established and operating under the Law on Cooperatives.”

2. To replace the phrase “Law No. 40/2009/QH12 on Medical Examination and Treatment” with “Law No. 15/2023/QH15 on Medical Examination and Treatment” at Point 26 of Appendix II on List of technical and specialized master plans to the Law No. 21/2017/QH14 on Planning.

Article 120. Effect

1. This Law takes effect on January 01, 2024, except for the cases specified in Clauses 3, 4, 5, 6, 7, 8 and 9 of this Article.

2. Law No. 40/2009/QH12 on Medical Examination and Treatment, which was amended and supplemented by the Law No. 21/2017/QH14 shall cease to be effective from the effective date of this Law.

3. The National Medical Council shall carry out testing for assessment of capacity for practicing medical examination and treatment as follows:

a) From January 01, 2027, for doctors;

b) From January 01, 2028, for assistant doctors, nurses, midwives;

c) From January 01, 2029, for medical technicians, clinical dietitians, out-of-hospital emergency providers and clinical psychologists.

4. The conditions for Vietnamese language ability applicable to foreigners specified at Point c Clause 1 Article 19 and Point c Clause 2 Article 30 of this Law shall apply from January 01, 2032.

5. The provisions on information technology infrastructure specified at Point d Clause 2 Article 52 of this Law shall apply:

a) From January 01, 2027, for cases where the dossiers of application for operation licenses are submitted from January 01, 2027;

b) No later than January 01, 2029, for medical examination and treatment establishments that have been granted operation licenses before January 01, 2027.

6. The quality standards defined at Point a Clause 1 Article 57 of this Law shall apply:

a) From January 01, 2025, for hospitals;

b) From January 01, 2027, for medical examination and treatment establishments in other forms.

7. Provisions on professional and technical levels in medical examination and treatment specified in Article 104 of this Law shall apply from January 01, 2025.

8. The establishment and operation of the information system on medical examination and treatment management must be completed before January 01, 2027.

9. Specialized health agencies under provincial-level People's Committees shall grant, re-grant, modification and revocation of operation licenses for private hospitals from January 01, 2027.

Article 121. Transitional provisions

1. Practice certificates granted before January 01, 2024 shall be converted to practice licenses according to the roadmap set by the Government and renewed every five years from the date of conversion in accordance with this Law.

2. The grant of practice certificates for application dossiers submitted before January 01, 2024 shall comply with Law No. 40/2009/QH12 on Medical Examination and Treatment, which was amended and supplemented under the Law No. 21/2017/QH14.

3. Practice certificates granted under Clause 2 of this Article must be converted to practice licenses and renewed under Clause 1 of this Article.

4. The provisions on languages used in licensing and medical examination and treatment practice in Vietnam applicable to foreigners and overseas Vietnamese defined by the Law No. 40/2009/QH12 on Medical Examination and Treatment, which was amended and supplemented under the Law No. 21/2017/QH14 shall apply until the end of December 31, 2031.

5. Suspension from professional practice or revocation of practice certificates granted under Law No. 40/2009/QH12 on Medical Examination and Treatment, which was amended and supplemented under the Law No. 21/2017/QH14 shall comply with provisions on suspension from professional practice or revocation of practice licenses defined in this Law.

6. The testing for assessment of practice capacity under this Law is not required for persons applying for the grant of medical practice licenses with the title of doctor from January 01, 2024 to the end of December 31, 2026.

7. The testing for assessment of practice capacity under this Law is not required for persons applying for the grant of medical practice licenses with the title of assistant doctor, nurse or midwife from January 01, 2024 to the end of December 31, 2027.

8. The testing for assessment of practice capacity under this Law is not required for persons applying for the grant of medical practice licenses with the title of medical technician, clinical dietitian, out-of-hospital emergency provider or clinical psychologist from January 01, 2024 to the end of December 31, 2028.

9. Persons granted practice licenses under Clauses 1, 2, 6, 7 and 8 of this Article must comply with provisions related to the practice specified in this Law.

10. Persons who are granted an assistant doctor diploma at intermediate level after December 31, 2026 may not be granted a practice license with the title of assistant doctor.

11. Medical examination and treatment establishments that have operation licenses granted under Law No. 40/2009/QH12 on Medical Examination and Treatment, which was amended and supplemented under the Law No. 21/2017/QH14 may continue operating without request for re-grant of operation licenses.

12. Dossiers of application for operation licenses that are submitted before January 01, 2024 shall continue to be handled in accordance with Law No. 40/2009/QH12 on Medical Examination and Treatment, which was amended and supplemented under the Law No. 21/2017/QH14.

13. The grant of operation licenses for the application dossiers that are submitted from January 01, 2024 to the end of December 31, 2026 shall comply with provisions on organizational form, conditions, procedures and competence defined in this Law, except for those on conditions at Point d Clause 2 Article 52 and those on competence in Clause 9 Article 120 of this Law. From January 01, 2024 to the end of December 31, 2026, the grant, re-grant, modification and revocation of operation licenses for private hospitals shall be performed by the Minister of Health.

14. Suspension from operation or revocation of operation licenses granted under Law No. 40/2009/QH12 on Medical Examination and Treatment, which was amended and supplemented under the Law No. 21/2017/QH14 shall comply with provisions on suspension from operation or revocation of operation licenses of this Law.

15. The Government shall detail this Article; and the conditions for grant of practice licenses specified in Clauses 6, 7 and 8 of this Article.

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This Law was adopted on January 09, 2023, by the XV^th National Assembly of the Socialist Republic of Vietnam at its 2^th extraordinary session.

CHAIRMAN OF THE NATIONAL ASSEMBLY

Vuong Dinh Hue