Resolution No. 139/NQ-CP dated December 31, 2017 of the Government on the Government’s Action Program for implementation of the Resolution No. 20-NQ/TW dated October 25, 2017 from the 6th Meeting of the 12th Central Committee on enhancement of people’s health protection, care and improvement in new circumstances

THE GOVERNMENT

Resolution No.139/NQ-CP dated December 31, 2017 of the Government on the Government’s Action Program for implementation of the Resolution No. 20-NQ/TW dated October 25, 2017 from the 6^thMeeting of the 12^thCentral Committee on enhancement of people’s health protection, care and improvement in new circumstances

Pursuant to the Law on Government Organization dated June 19, 2015;

Pursuant to the Resolution No. 20-NQ/TW dated October 25, 2017 of the 6^thMeeting of the 12^thCentral Committee on enhancement of people s health protection, care and improvement in new circumstances;

At the request of the Minister of Health,

RESOLVES:

Article 1.Issue together with this Resolution the Government’s Program of Action for implementation of the Resolution No. 20-NQ/TW dated October 25, 2017 from the 6^thMeeting of the 12^thCentral Committee on enhancement of people s health protection, care and improvement in new circumstances.

Article 2.This Resolution takes effect on the signing date.

Article 3.The relevant Ministers, Heads of ministerial agencies, Heads of the Governmental agencies, Chairpersons of province-level People’s Committees, organizations and individuals shall implement this Resolution./.

For the Government

The Prime Minister

Nguyen Xuan Phuc

THE GOVERNMENT’S PROGRAM OF ACTION

IMPLEMENTATION OF THE RESOLUTION NO. 20-NQ/TW DATED OCTOBER 25, 2017 FROM THE 6TH MEETING OF THE 12TH CENTRAL COMMITTEE ON ENHANCEMENT OF PEOPLE’S HEALTH PROTECTION, CARE AND IMPROVEMENT IN NEW CIRCUMSTANCES
(Issued with the Government’s Resolution No. 139/NQ-CP dated December 31, 2017)

The Resolution No. 20-NQ/TW dated October 25, 2017 of the 6^thMeeting of the 12^thCentral Committee on enhancement of people’s health protection, care and improvement in new circumstances (hereinafter referred to as the Resolution No. 20-NQ/TW) has put forward the following general objectives: Improve both physical and mental health, stature, life expectancy and quality of Vietnamese people. Create a fair, high-quality, efficient and internationally integrated medical system. Develop a scientific, national and popular medicine. Ensure that all people have their health managed and cared for. Build the health staff that treat patients with motherly kindness and consideration, have high professional capacity and attain the international level. Improve the competitiveness of production in supply chains of pharmaceuticals and health services.

Pursuant to the primary directives, objectives, missions, tasks and solutions specified in the Resolution No. 20-NQ/TW, the Government promulgates the Program of Action for implementing the Resolution as follows:

I. PURPOSES AND REQUIREMENTS

1. Purposes

a) Determine the primary contents and tasks based on which the Government, ministries, agencies and local governments focus on direction and formulation of projects and tasks so that the tasks and solutions can be carried out comprehensively, hence fulfilling this Resolution’s goals.

b) Create a major change in awareness and actions of officials, agencies, local governments and the people with respect to protection, care and improvement of people s health.

c) Ensure consistency in the Vietnam Communist Party s leadership and the State’s management in protection, care and improvement of people s health.

d) Overcome the limitations and difficulties in the recent times in order to formulate reformative mechanisms and policies on protection, care and improvement of people s health, ensuring the goals of the Decree No. 20-NQ/TW are fulfilled, contributing to building and protecting our country.

2. Requirements

a) Determine the primary tasks and solutions for the ministries, agencies and local governments to formulate programs and plans of action; conduct and implement inspection, supervision and evaluation of implementation of the Government’s Resolution No. 20-NQ/TW and this Resolution.

b) Get the ministries, agencies, People’s Committees at all levels, unions and people actively involved in protection, care and improvement of people s health, with the medical sector as the main force. Integrate the health goals and indices specified in this Resolution into Socio-economic Development Plans of respective entities and local governments.

c) Require the relevant ministries, ministerial agencies, governmental agencies, People’s Committees of all levels to act in accordance with the Government’s Program of Action and their delegated functions, responsibilities and powers to formulate specific plans and projects relevant to protection, care and improvement of people s health.

d) Emphasize the responsibilities of ministers, heads of ministerial agencies, governmental agencies, province-level People’s Committees for carrying out tasks and solutions to fulfill the stated goals.

II. TASKS

1. Enhancement of leadership and direction of ministries, ministerial agencies, governmental agencies and local governments

a) Ministries, ministerial agencies, governmental agencies and province-level People’s Committees:

- Organize study sessions for the relevant agencies and local governments in order for them to achieve full and profound understanding of the contents of the Resolution No. 20-NQ/TW.

- Formulate and promulgate plans of actions of ministries, agencies and local governments to implement the Resolution. The plans of action have to follow the tasks and solutions stated in the Resolution closely and are appropriate for the circumstances of the ministries, agencies and local governments.

- Focus on leading and directing the protection, care and improvement of people s health, regard this as one of the most important political missions of all-level authorities, agencies and local governments.

- Integrate the health, medical goals and targets, alongside factors that affect health, such as the sport, cultural environment, etc., into the annual and 5-year socioeconomic development plans and the long-term development strategy of agencies, all-level authorities and local governments.

- Mobilize the Vietnamese Fatherland Front, the people’s unions and the entire community in protection, care and improvement of people s health. Delegate clear and specific responsibilities to each agency and union for fulfilling the goals of and carrying out solutions for protection, care and improvement of people s health.

- Frequently inspect, supervise the implementation process in agencies, and carry out preliminary and full performance review of the implementation process to give out awards.

b) Ministry of Health, other ministries and agencies

Advise the Government on formulating policies to carry out the tasks specified in the Program of Action for implementation of Resolution No. 20-NQ/TW.

2. Improvement of people’s health

a) The Ministry of Health

- Preside over and cooperate with relevant authorities in researching, proposing mechanisms and policies, alongside propagating and advocating increase of people’s awareness, sense of responsibility, and change of behaviors of people, Party committees and local governments in order to enhance protection, care and improvement of people s health; prioritize preventive healthcare activities associated with local healthcare such as: Developing nutritional regimens, school milk and nutrition programs; assuring food safety, increasing physical activities; advocating the people promoting the environmental sanitation , not smoking and not abusing alcohol; enhancing school healthcare; preventing and controlling occupational diseases, etc. in order to enhance the Vietnamese people’s physical fitness and stature; preventing non-infectious diseases such as cardiac diseases, cancer, diabetes, obesity, etc., reducing complications and deaths, increasing life expectancy and quality of life.

- Formulate the Vietnam Health Program based on connections between and synchronous implementation of projects and programs on protection and improvement of Vietnamese people’s health and stature, and local healthcare network building and development projects.

- Preside over and cooperate with relevant ministries and authorities in formulation and promulgation of policies, national technical code systems and national standards for ensuring food safety for health within the ministry s scope of management.

- Formulate and implement effectively programs and projects that can quickly decrease the health index gap between regions, enabling all people residing in rural, mountainous and island areas to access services that can help them improve their health, broaden their knowledge, change their behavior and lifestyle for disease prevention and health improvement.

- Cooperate with the Ministry of Industry and Trade and the Ministry of Agriculture and Rural Development in providing and implementing guidelines and regulations in which sufficient nutritional information and health warnings on packaged food products are required.

b) The Ministry of Education and Training

- Preside over and cooperate with relevant authorities in setting up projects on fundamental reform of physical and mental education, increase of elective physical education subjects in school, closely associated with physical activities outside of school. Enhance and reform school healthcare closely connected with local healthcare establishments.

- Preside over and cooperate with the Ministry of Health, other relevant ministries and authorities in providing sufficient guidance on building of complete school healthcare systems to provide primary healthcare services for children and students.

- Formulate plans for implementation of a medical insurance scheme for students.

c) The Ministry of Ministry of Labor, Invalids and Social Affairs

Preside over and cooperate with the Ministry of Health and other relevant authorities in protection of employees’ health; prevention of occupational diseases; ensuring occupational safety; prevention of drowning among children, etc.

d) The Ministry of Culture, Sports and Tourism

- Strongly develop fitness movements in agencies, schools and communities. Make good use of sport institutions. Advocate and provide the material facilities and space for physical training among the people, protecting and improving their health in the process. Step up cultural and sport activities in various forms.

- Step up the efforts in propagating and advocating civilized, healthy and sanitary lifestyle.

e) The Ministry of Industry and Trade

- Preside over and cooperate with other ministries and authorities in prevention of counterfeit goods production and trade, commercial fraud and consumer interest protection.

- Provide guidelines for and inspect food production and trade facilities within the scope of regulations on nutrition, increase supplementation of micronutrients in food products.

f) The Ministry of Agriculture and Rural Development

- Preside over and cooperate with other ministries and authorities in formulation of standards and codes for food safety, controlling residuals of antibiotics, veterinary medications and pesticides within the ministry’s scope of management.

- Formulate programs and projects alongside propagating and advocating for rural environmental sanitation, clean water access and use, sanitary lavatories.

- Develop the ecological system, ensure safe production, transport and distribution of food.

- Cooperate with the Committee for Ethnic Minority Affairs and other relevant authorities in propagating, advocating and directing the implementation of rural environmental sanitation in ethnic minority and mountainous regions.

g) The Ministry of Science and Technology

Implement the contents relevant to the scientific and technological mission, in order to increase the research capacity for medical, pharmaceutical, biological science and technology at both regional and global levels.

h) The Ministry of Public Security

Preside over and cooperate with relevant authorities in focus on directing drug prevention and rehabilitation.

i) The Ministry of Natural Resources and Environment

- Implement solutions for reducing the negative effects of environmental pollution and climate change to people’s health in sync.

- Review and step up implementation of waste treatment programs and projects; tackle pollutions in rivers, production facilities, industrial parks, trade villages.

j) The Ministry of Construction: Review the tasks of water supply, drainage, social infrastructure planning within the ministry’s scope of management, manage regular solid waste in urban areas, industrial parks, construction material production facilities.

k) The Ministry of Transport

- Implement solutions for ensuring environmental sanitation in transport vehicles.

- Develop the transport infrastructure, employing state-of-the-art technology in control and management of the road transport system.

m) The National Traffic Safety Committee and the National Emergency and Natural Disaster Response, Search and Rescue Commission carry out the solutions for national disaster management and ensuring traffic order and safety.

l) The Province-level People’s Committees

- Direct the implementation of programs, projects and tasks relevant to improvement of local health.

- Take interest in and facilitate protection, care and improvement of every person s health, especially those in the rural, mountainous and island areas.

3. Enhancement of the capacity for epidemic prevention alongside reform of local healthcare

a) The Ministry of Health

- Formulate and implement programs and projects for ensuring health security, timely response to emergency situations, especially recent outbreaks; implement solutions for enhancing and increasing efficiency of epidemic prevention, preventing occurrence of pandemics.

- Formulate a roadmap for increasing the number of vaccines employed in the Expanded Program on Immunization within the budget’s capacity and submit it to the Government.

- Focus on directing, stepping up implementation of non-infectious diseases; formulate mechanisms, policies alongside propagating and advocating screening among the people for early detection and control of disease; stepping up management, treatment of non-infectious and chronic diseases, long-term care in local health facilities.

- Implement the local healthcare enhancement policy with solutions for reform of apparatus, manpower, activities and finance. Formulate a payment mechanism, increase the medical insurance fund’s proportion for local healthcare, expand the scope of service and medicine payment for local healthcare within the basic health service package s capacity and the medical insurance fund s balance.

- Implement the commune-level medical station model which works in accordance with the principles of family medicine, working alongside family clinics in providing primary healthcare, disease prevention, medical examination and treatment for the local people. Make local healthcare become the frontline in disease prevention and providing healthcare, developing the people’s trust in local healthcare.

- Formulate, perfect and implement strictly the regulations on healthcare for mothers, children, the elderly, disabled people, those who suffer from the consequences of warfare and the priority entities, the people of mountainous, remote, disadvantaged, frontier and island areas. Formulate home and community care policies for the elderly, disabled people, patients with non-infectious or chronic diseases, palliative care for terminal cancer patients which are appropriate for the local habits, customs and socioeconomic conditions. Carry out preventive activities and give advice, examinations and tests to pregnant women for prevention of vertically transmitted diseases, early detection of reproductive cancers and disease control; stepping up management and treatment of non-infectious and chronic diseases, carry out long-term care in local health facilities effectively.

- Apply information technology in commune health stations; carry out programs and objectives of healthcare, management of people’s health profiles alongside medical insurance cards and medical insurance payment. Formulate mechanisms and roadmaps suitable for monitoring and management of all people s health.

- Cooperate with the Ministry of National Defense and local governments in formulating regulations for stepping up medical cooperation between the military and civilians, developing healthcare networks in frontier, island, ethnic minority and mountainous areas.

b) The Vietnam Social Security

- Cooperate with the Ministry of Health in formulating payment methods, increasing the medical insurance fund’s proportion for local healthcare within the basic health service package s capacity and the medical insurance fund s balance.

- Cooperate with the Ministry of Health in implementation of medical insurance policies for local healthcare, in order to encourage people to seek examinations and treatment in local health facilities, enabling those facilities to develop and improve medical insurance examination and treatment services.

c) The Ministry of Finance

Ensure the central government budget and instruct the local governments to increase spending on preventive, local and primary healthcare, and on the elderly, disabled people, those who suffer from the consequences of warfare and the priority entities. Ensure the domestic resources for expanding health improvement activities and prevention of HIV/AIDS, tuberculosis and malaria.

d) The Ministry of Planning and Investment

- Preside over and cooperate with the Ministry of Finance in advising the government to prioritize ODA projects for local healthcare and people’s health improvement activities.

- Advise the Government and National Assembly to allocate the development capital from the central government budget, instruct the local governments to prioritize capital for local and preventive healthcare, for regions with difficult socioeconomic conditions, frontier and island areas.

e) The Province-level People’s Committees

- Present the People’s Council at the same level the allocation of funds for implementing this Program of Action’s contents in accordance with the Law on State Budget.

- Prioritize the local government budget for investment, regular payments and other resources for local and preventive healthcare; prioritize the budgets for the National Target Program on Building New Rural Areas and the National Target Program on Sustainable Poverty Reduction for investment in commune health stations and district hospital in disadvantaged areas.

4. Improvement of medical examination and treatment; fundamentally tackling overcrowding in hospitals

a) The Ministry of Health

- Implement in sync the solutions for improvement of medical examination and treatment services in all levels, especially at local level in order to increase patient satisfaction; fundamentally deal with overcrowding in a number of top-level hospitals in general by 2020; continue developing the satellite hospital system, stepping up direction by levels and alternately, training for and technical transfer to lower levels; stepping up reformation of style and manners of service, improving medical ethics and building clean, green and environmentally friendly health facilities;

- Promulgate statutes, regulations, processes and instructions on treatment which are uniform countrywide in order to ensure medical examination and treatment quality. Formulate processes for safety of patients, adequate control of medical complications, curbing contaminations in hospital, controlling antibiotic resistance, restrictive nutrition and comprehensive treatment of patients. Promulgate technical lists appropriate for each level in order to ensure consistent service quality across health facilities in all levels. Formulate and implement regulations on transfer of test results, diagnostic imaging, information, diagnoses and treatment results between medical facilities and in local healthcare in order to continuously monitor and take care of patients. Carry out independent verification, evaluation of service quality and quality-based hospital ranking in accordance with international practice.

- Reduce nuisance and waiting time, increase convenience for patients by stepping up administrative procedure reform, application of information technology in managing medical examination and treatment (digital medical records, long-distance medical examination and treatment, showing medical images without printing). Formulate mechanisms and policies for implementing the roadmap for linking medical insurance examination and treatment between levels. Strongly develop the pre-hospital first aid system in the community.

- Reform mechanisms of operation and management in public hospitals alongside giving autonomy associated with accountability, ensure openness and transparency under control of the authorities. The public facilities provide sufficient basic health services; be able to provide premium on-demand service, ensure openness and transparency. Formulate mechanisms and policies for finance and resource and implement the roadmap for calculating the service fees accurately and sufficiently in order to provide comprehensive care for patients alongside improving income and providing adequate benefits for health staff (formulate a manpower roadmap for ensuring comprehensive care; the service fees take into account the employees’ wage, restrictive nutrition cost, consultation cost, etc. accurately and sufficiently)

- Formulate mechanisms, policies alongside encouraging private sector involvement in order to develop medical facilities with technical, service and care quality on the level of developed countries in the region so that well-off patients can go there instead of going overseas. Combine some medical and care facilities with tourism for both domestic and foreign clients.

- Formulate and perfect mechanisms and policies for encouraging private healthcare, especially the non-profit hospital model; step up cooperation between public and private sectors, create an equal environment for support, transfer of technical professional knowledge between public and private medical facilities.

- Cooperate with the Ministry of National Defense in stepping up medical examination and treatment of beneficiaries of incentive policies. Make good use of the armed forces’ medical advantage; implement flexible organization models appropriate for local conditions in order to ensure the services of medical examination and treatment for the people in remote, frontier and island areas.

- Step up training and improvement of professional capacity and work ethics for health staff. Strictly penalize violations of professional regulations and work ethics, damage to doctors’ dignity and health; ensure security, order and safety in health facilities.

b) The Vietnam Social Security

- Continue stepping up administrative reform, reducing nuisance in medical insurance assessment payment. Cooperate with the Ministry of Health in formulating a general project for application of information technology in the health sector, focus on implementation of digital health records, digital medical records and local health management software in order to enable easy examination, treatment, medical insurance payment alongside assessment and payment to health facilities for the people; connect medical insurance data to medical facilities accurately, punctually, safely and securely; combine medical insurance data with social security data and citizen identification number.

- Cooperate with the Ministry of Health in formulating mechanisms for price and co-payment, payment policies and methods in order to encourage the lower-level facilities to improve their service quality, hence encouraging the people to go to those facilities for medical examination and treatment; make payments to medical facilities punctually and sufficiently.

e) The Province-level People’s Committees

- Review, formulate and implement planning of local health facility networks in accordance with the principles of complete medical facility system in each province.

- Direct the health facilities within their jurisdictions to carry out technical development so that the people can place their trust in the lower-level service quality without relying on the upper level.

5. Development of traditional medicine and pharmacy

The Ministry of Health takes prime responsibilities on:

a) Formulation and implementation of the Traditional Medicine Development Program, combine traditional with modern medicine in facilities, examination, treatment, rehabilitation and care. Increasing the target number of examinations and treatments in traditional medicine in all levels, especially the local level.

b) Promoting the role of traditional medicine in health protection and improvement and primary healthcare. Propagating and advocating cultivation and use of traditional medicinal herbs and plants.

c) Formulation and implementation of projects for inheritance, conservation and development of precious herbal ingredients; sustainable use of natural herbal ingredients; creating specific criteria for Vietnamese herbal ingredient recognition;

d) Cooperation with Vietnam Social Security in research, expansion of the list of traditional herbal ingredients and drugs alongside herbal drugs in the medical insurance payment list.

e) Stepping up research, test and demonstration of the effects of traditional diagnosis methods, drug-free treatment methods, and traditional medicinal drugs. Stepping up training traditional medical practitioners. Formulation of mechanisms and policies for support, detection, application and recognition of intellectual property and commercialization of traditional medicinal drugs; honoring and ensuring the rights of renowned practitioners, mobilizing social organizations to participate in examination, treatment and disease prevention using traditional medicine.

f) Formulation of programs for stepping up publicity and dissemination at the worldwide level in order to promote traditional herbal ingredients and drugs alongside drug-free treatment methods to national products with Vietnamese brand names.

g) Formulation of specific mechanisms and policies for development of and prioritizing domestic herbal ingredients; strict control of herbal ingredients’ quality.

6. Stepping up development of the pharmaceutical and medical equipment sector

a) The Ministry of Health

- Continue implementing solutions for ensuring sufficient supply of high-quality, safe, effective, reasonably-priced drugs that satisfy disease prevention, treatment and rehabilitation.

- Preside over and cooperate with the Ministry of Planning and Investment, the Ministry of Finance, the Ministry of Industry and Trade and other relevant authorities in formulating and proposing mechanisms and policies for encouragement of production and use of domestic drugs, vaccines, biological, medical equipment and materials; enabling enterprises to participate further in the value chain of pharmaceutical products and medical equipment at both regional and global levels.

- Expand the list of drugs, medical materials, chemicals and equipment for centralized bidding at both local and national level and engage in price negotiation in order to decrease the price of those goods. Perfect the mechanism for investment and purchase alongside strict quality control, ensure openness and transparency; prevent loss and misspending.

- Strictly manage imports of drugs, medical materials, chemicals and equipment. Reinforce the distribution system of drugs, medical materials, chemicals and equipment, ensure efficiency, professionalism and compliance with the law. Finish off mechanisms, policies and regulations of law on the right to distribute drugs, prohibit enterprises from distributing drugs without permission.

- Formulate and implement projects for management of wholesale and retail trade systems, pharmacies both under and outside hospital management. Carry out in sync solutions for tracing drug origin; rectify the problems of selling prescription drugs without or not in accordance with medical prescriptions. Apply information technology, create network connections between medical facilities and pharmacies; ensure control of traded drugs’ origins and prices in all pharmacies nationwide.

- Increase the capacity for research, production of drugs and vaccines. Formulate mechanisms and invest sufficiently in order to harness new-generation and combined vaccine production technology, fulfilling the fundamental requirement of domestic expanded immunization and aiming for export.

- Formulate management systems, mechanisms and policies for developing networks for test and verification of medical equipment, contributing to improvement of quality and enable transfer of test results and images between health facilities.

b) The Ministry of Industry and Trade presides over and cooperate with relevant ministries and authorities in stepping up prevention of production and trade of counterfeit or low-quality drugs, dietary supplements, medical equipment and goods that can cause health hazards.

c) The Ministry of Agriculture and Rural Development presides over and cooperate with other ministries and local governments in reviewing, formulating plans, prioritizing investment and focusing on development of areas specialized in herbal ingredient farming; encourage homegrown herbal ingredients. Attract investment in building processing plants in large-scale herbal ingredient areas, forming links between production, preservation and procession of herbal ingredients.

d) The Ministry of Science and Technology formulate mechanisms, policies, programs and projects for supporting research and transfer of vaccine, drug and medical equipment production technology.

e) Vietnam Social Security cooperates with the Ministry of Health and other relevant authorities in formulating mechanisms for encouraging the use of domestic drugs and equipment.

7. Development of health staff, medical science and technology

a) The Ministry of Health

- Formulate regulations on fundamental and comprehensive reforms of health staff training in order to satisfy the health system s requirements and attain the international level, and submit those regulations to the competent authority for promulgation or promulgate those regulations itself within its competence. Draw a distinction between two disciplines: research and medical practice, and provide training in each of them accordingly. Formulate and promulgate standards for training facilities and health staff. Implement mechanisms and policies for close association between theoretical and practical training facilities, ensuring that the trainees attain the required fundamental competence for the health system.

- Formulate the project for establishment of National Medical Council, organize exams for fixed-term practice certificates and appoint independent agencies to issue of practice certificate on a trial basis in accordance with international practice. Research for inclusion of ethical criteria in practice certificate issuance. Submit the research to the authority with competence to modify legal mechanisms for official implementation.

- Increase research capacity for medical, pharmaceutical, biological science and technology to both regional and global levels. Prioritize applied research; focus on researching health and biomedical indicators suitable for Vietnamese people. Aim for promote a number of drugs and vaccines to national products. Step up application and transfer of state-of-the-art technologies; train and develop staff that specializes in medical equipment. Formulate and implement programs and projects for effective application and use of the 4th Industrial Revolution’s achievements in taking care of people’s health.

- Formulate and implement policies for linking and bringing into play roles and responsibilities of hospitals in training health staff in accordance with international practice. Have mechanisms for responsibility allocation, honor hospitals, research institutes, doctors and scientists who participate in health staff training.

- Formulate projects for arrangement and development of a number of health staff training facilities into Universities of Health Sciences in large centers and cities. Step up enabling training facilities to adopt autonomy mechanisms. Ensure that training fees are calculated accurately, sufficiently and closely associated with training quality; the State shall award scholarships to disadvantaged entities, good and outstanding students in order to encourage student in their studies.

b) The Ministry of Home Affairs presides over and cooperates with the Ministry of Health and other relevant authorities in proposing mechanisms and policies for ensuring manpower for protection and care of people’s health, giving adequate benefits to health staff, especially those with high professional capacity working in remote, disadvantaged, frontier and island areas, are those working in the fields of preventive healthcare, forensics, psychiatry, tuberculosis, leprosy, etc. Encourage local governments to formulate and implement policies for attracting health staff for local health facilities within their jurisdictions.

c) The Ministry of Science and Technology presides over and cooperates with the Ministry of Health and other ministries in implementation of the contents which are relevant to the scientific and technological mission and for medical, pharmaceutical, biological science and technology reaching both regional and global levels.

8. Reforming health service delivery and management system

a) The Ministry of Health presides over and cooperates with relevant authorities in

- Formulating a plan for the national health facility network; continuing reforming and perfecting the health organization towards more streamlined, effective and internationally-integrated model; ensuring the centralized direction in terms of profession from the central to local levels nationwide, and under the leadership of Party committees and local governments.

- Formulating projects for arranging units and health centers doing preventive works at provincial level into provincial epidemic control centers, units doing preventive works under central management into central epidemic control center, alongside creating regional centers for certain regions in order to streamline management and operation nationwide.

- Directing the implementation of the “one multipurpose health center per district” model, encompassing preventive healthcare, population, examination, treatment, rehabilitation and other health services; the center directly manages regional commune heath station and general practice clinic (if any). Reviewing and arranging regional general practice clinics reasonably. Organize the commune health station system so that it is closely associated with school healthcare and appropriate for local characteristics.

- Formulating the project for rearranging test and verification units to form a system of pharmaceuticals, food and medical equipment control authorities, consisting of central and some regional ones, for the purpose of decreasing the number of subsidiaries and increase efficiency. Organizing evaluation, classification of functions and responsibilities of test and verification units at both central and local levels in order to avoid sparse investment and misspending.

- Formulating a plan with a specific roadmap for transferring a number of hospitals under the management of the Ministry of Health, other ministries and central authorities (except the Ministry of Home Defense and the Ministry of Public Security) to the local governments’ management. The Ministry of Health shall only be in charge of a very few leading hospitals.

- Cooperation with other ministries, agencies and local governments in completing the comprehensive, continuous, incorporated health facility organizational structure, which has three levels: primary, secondary and tertiary healthcare.

b) The province-level People’s Committees

- Accelerate arrangement of units and health centers doing preventive works at provincial level into provincial epidemic control centers, which is due to complete before 2020.

- Implement the “one multipurpose health center per district” model, encompassing preventive healthcare, population, examination, treatment, rehabilitation and other health services; the center directly manages regional commune heath station and general practice clinic (if any). Review and arrange regional practice clinics urgently and reasonably. Organize the commune health station system so that it is closely associated with school healthcare and appropriate for local characteristics.

- Focus on perfecting general hospitals completely before establishing new specialized hospitals at provincial level. Adjust and arrange hospitals to make them geographically accessible for the people.

- Step up training, technical transfer, strict implementation of regulations on alternate practitioners in health facilities under local governments’ management; Alternate between provincial and district hospitals; between districts; between district health centers and commune health stations; between communes in order to increase the health staff’s professional capacity.

9. Reforming health finance

a) The Ministry of Health

- Cooperate with the Ministry of Finance and relevant authorities in formulating, and submitting to the competent authority for promulgation, the guidelines for allocation of budget healthcare, with minimum 30% of it for preventive healthcare, prioritize budget for local healthcare, hospitals in disadvantaged, frontier and island areas, specialized in the fields of leprosy, tuberculosis, psychiatry, etc.

- Formulate and implement the roadmap for changing regular budget payment from being given directly to medical facilities to supporting medical insurance participants, in association with the roadmap for accurate and sufficient calculation of health service fees (and fulfilling the goal of curbing inflation and macroeconomic stability). Enhance the task assignment and order placement methods of the state, implement the price mechanism associated with service quality, encourage the use of health services at lower levels.

- Submit the Decree on regulating the right to autonomy and self-responsibility of public health service units to the Government for promulgation. Step up giving autonomy on professional responsibilities, organization of apparatus, personnel and finance associated with accountability, openness and transparency. Implement a management model similar to enterprise management for public health service units in ensuring regular and investment payment.

- Cooperate with the Ministry of Finance in formulating, perfecting mechanisms and policies for restructuring health finance as follows: Public health tasks and activities are primarily funded by the state budget, and public sector involvement is encouraged. Medical examination and treatment are paid for by medical insurance and the people. Primary healthcare is jointly paid for by the state budget and the people, aiming for medical insurance covering a number of essential services. Medical insurance for employees has to be jointly paid for by employees and employers; the state budget covers a number of beneficiaries of incentive policies.

- Perfect mechanisms and policies for enhancing private sector involvement, mobilize every resource for health system development. Diversify forms of public-private cooperation, ensure openness, transparency, equal competition and no discrimination between public and private in health service provision. Encourage organizations and individuals to invest in building health facilities (including commune health stations and family practice clinics), focusing on provision of premium services on demand.

- Cooperate with relevant ministries and authorities in promulgating the “Basic health service package covered by medical insurance" within the Medical Insurance Fund s capacity and the "Basic health service package covered by state budget" within the state budget’s capacity. Formulate mechanisms and policies for mobilization of every resource for primary healthcare and people’s health management.

- Formulate mechanisms for service fees, medical insurance payment with the state budget taken into account; ensure the medical insurance being able to cover basic services, and the service users paying for any excess. The service fee and joint payment mechanisms are meant to encourage the people to seek medical examination and treatment at lower levels while the upper level focuses on providing services that the lower ones have not yet been able to provide reliably.

- Cooperate with the Ministry of Finance, Vietnam Social Security and other relevant authorities in researching, proposing diversification of medical insurance packages; plans for enhancing association and cooperation between social and commercial medical insurance in care and improvement of people’s health.

b) The Ministry of Finance

- Preside over and cooperate with the Ministry of Planning and Investment in informing the Government in order to present the National Assembly with prioritizing and increasing state budget allocation for health, ensuring the increase in spending on health outpaces the increase of state budget spending, with at least 30% of health budget being used for preventive healthcare;

- Preside over formulation of mechanisms and policies for credit and tax incentives in order to encourage health facilities to invest in expansion, upgrade and modernization, hence satisfying the diverse medical examination and treatment requirements of the people.

c) The Vietnam Social Security

- Implement solutions in sync, enhance communications, enable the people to easily participate in medical insurance so that the target of medical insurance for all citizens can be achieved as soon as possible.

- Propose, alongside the Ministry of Health and the Ministry of Finance that: The medical insurance payment level should be appropriate for economic conditions and incomes of the people and the costs and quality of medical services, ensuring the medical insurance fund’s balance, the rights of medical insurance participants and health facilities; diversification of medical insurance packages; plans for enhancing association and cooperation between social and commercial medical insurance in care and improvement of people’s health.

- Improve assessment quality; recruit personnel, provide advanced training for increasing professional capacity, refine organization of assessment, ensuring quality, accuracy, punctuality, objectivity and compliance with professional regulations on medical examination and treatment; accelerate implementation of digital medical insurance assessment; come to agreement with the Ministry of Health in the medical insurance assessment process.

- Implement solutions for frugal, effective management and use of medical insurance fund. Cooperate with the Ministry of Health in implementing in sync solutions for restricting overusing services, using services which do not suit professional requirements for medical examination and treatment.

d) The ministries and authorities assigned to preside over formulation of legal projects and ordinances whose contents are relevant to special excise duty have the responsibility to research and propose the roadmap for increase of special excise duty for goods that can cause health hazards such as alcoholic drinks, carbonated drinks, tobacco in order to reduce consumption of such goods.

e) The Province-level People’s Committees

- Allocate the local government budget for fulfilling all health tasks and activities in protection, care and improvement of people s health in accordance with Resolution No. 20-NQ/TW and this Resolution.

- Continue maintaining and improving the effectiveness of the Fund for medical examination and treatment for the poor; creating sources and formulate support mechanisms for the Fun to enable all people to seek medical examination and treatment.

f) The relevant ministries, authorities and People s Committee of all levels step up state management, formulate and implement in sync solutions for prevention and eradication of private sector involvement policy abuse for public resource exploitation.

10. Communications

a) The Ministry of Health

- Preside over and cooperate with the Central Propaganda Department of the Central Committee of the Communist Party of Vietnam and the Ministry of Information and Communications in formulating the plans and extensively propagate the Resolution No. 20-NQ/TW and this Resolution.

- Formulate and enhance communications, advocate the people adopting healthy lifestyle, physical training, exercise, sports, proper nutrition; the benefits of immunization; examination and screening for early detection of diseases; saying no to narcotics; curbing the negative effects of tobacco, alcohol, carbonated drinks; consuming thoroughly processed food and properly boiled water; keeping the living environment sanitary, using clean water, sanitary bathrooms and lavatories.

- Reinforce and develop the communications network from central to rural areas; forming appropriate messages and contents that are easy for the people to remember and understand, hence heightening awareness and causing change of behavior in protection, care and improvement of one’s own, families’ and the society’s health.

b) The Ministry of Information and Communications directs the press to extensively propagate the contents of the Resolution No. 20-NQ/TW and this Resolution.

c) Province-level People’s Committees step up propagating the contents of the Resolution No. 20-NQ/TW and this Resolution.

11. Actively and robustly integrating and enhancing the efficiency of international cooperation

a) The Ministry of Health

- Enhance cooperation, integrate actively, obtain technical, training and financial support from other nations and international organizations.

- Cooperate with the Ministry of Foreign Affairs, actively negotiate and effectively implement bilateral and multilateral cooperative medical agreements Actively participate in formulating policies, deal with regional and global health problems, elevate the role and international importance of Vietnamese medicine.

- Formulate and implement programs and projects for stepping up promotion of traditional Vietnamese medicine and pharmacy to the world.

- Harmonize medical procedures and processes with ASEAN and global ones. Step up formulating and implementing medical standards in accordance with regional and global ones. Strive to meet the sustainable health development targets of the United Nations; meeting a number of goals before their deadlines.

b) The Ministry of Public Security

Presides over and cooperate with relevant authorities in enhancing international cooperation in prevention of medical and pharmaceutical crimes.

III. IMPLEMENTATIONORGANIZATION

1. Ministers, heads of ministerial agencies, heads of the governmental agencies, Chairpersons of province-level People’s Committees

a) Incorporate the tasks, targets and goals of the Resolution No. 20-NQ/TW and this Resolution into the ministries’, agencies’ and local governments’ socioeconomic development plans within their functions, competence and assigned tasks. Urgently formulate and promulgate plans for implementation of the Central Committee’s Resolution No. 20-NQ/TW and this Resolution in the 1^stquarter of 2018. Focus on directing, stepping up inspecting and incentivizing implementation of solutions and execution of tasks in accordance with function and competence, appropriate for the actual conditions in each agency, field and local government.

b) Submit annual implementation reports to the Ministry of Health for consolidation and presentation to the Government.

2. The Ministry of Health presides over and cooperates with other ministries, authorities and local governments in monitoring, inspecting and incentivizing implementation of the Program of Action, forming preliminary and final reports, informing and making proposals to the Government and the Prime Minister about the required measures for ensuring synchronous and effective implementation of this Program of Action.

3. The Ministry of Information and Communications presides over and cooperate with the Ministry of Health, the Central Propaganda Department of the Central Committee of the Communist Party of Vietnam, the Central Vietnamese Fatherland Front and other ministries, authorities and local governments in information and communication works for creating societal consensus, making good use of agencies’, Party Committees , local governments’ and all the people’s efforts to strive for fulfillment of goals and tasks stated in the Resolution No. 20-NQ/TW.

4. The Ministry of Justice incorporates the laws, ordinances that need to be reissued and amended to fit the Resolution No. 20-NQ/TW into the proposal for the National Assembly’s Law and Ordinance Formulation Program.

5. The Central Vietnamese Fatherland Front and subsidiary organizations, widespread social organizations mobilize their members and the people of all classes to actively participate in physical training, health improvement and disease prevention movements. Monitor the implementation of the Resolution No. 20-NQ/TW and this Program of Action.

6. Province-level People’s Committees allocate sufficient resources from the local government budget for comprehensive and synchronous protection, care and improvement of people s health as assigned per regulations. Promulgate within their competence investment mechanisms, incentive policies, encourage authorities, units and private individuals carry out and provide health services in compliance with the law and the local situations.

7. During implementation of this Resolution, should a need for amendment of the Program of Action’s specific contents arises, the ministries, authorities and local governments actively send proposals to the Ministry of Health for consolidation and notifying the Prime Minister for consideration and decision./.

APPENDIX

SOME PROJECTS AND TASKS FOR IMPLEMENTATION OF THE RESOLUTION NO. 20-NQ/TW

(Attached with the Government s Program of Action in the Government’s Resolution No. 139/NQ-CP dated December 31, 2017)