Medical bribery commonplace in Vietnam: survey

TN News

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 An operation at Viet Duc Hospital, one of several in Hanoi having committed to not receiving unofficial bonuses from patients. But the practice is still happening.

In October last year, a campaign was launched against unofficial payment at five of Hanoi's largest hospitals general hospitals Bach Mai, Viet Duc and E; cancer care facility K; and the Central Obstetrics Hospital.

But reports by VnExpress found bribery is still popular at the hospitals.

Lam, whose son was a patient at Viet Duc, paid a surgeon VND2 million ($100) after a recent brain operation. "Once in a hospital, you know that you have to pay extra to doctors, especially when your son's life is threatened."

Though not a surveyed subject, the father has reflected the finding of a recent behind the scenes survey of Vietnam's healthcare system, that medical practitioners start taking bribes once they have their official title.

The survey, published in Hanoi Wednesday, was conducted between August 2010 and February 2010 in Hanoi, Son La Province in northern Vietnam, Dak Lak in the Central Highlands and Can Tho in the Mekong Delta.

"Unofficial payment" for health services in Vietnam became popular in 2000 and those in the health care industry have continued to receive cash, gifts and other "opportunities," such as the chance to purchase real estate at reduced prices or send their children to elite schools, the news website VnExpress reported.

Findings came from interviews with 17 policy makers and management officials, 119 doctors, nurses and patients.

Experts from the Transparency International Vietnam and Vietnam Research and Training Center for Community Development which conducted the survey, said the study subjects were given in-depth interviews which allowed investigators to uncover the root causes of many issues related to medical bribery.

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"My friend had managed to meet a high-ranking doctor one time she went to a hospital. After several words, she offered different opportunities to the doctor, provoking the doctor to ask for her phone number. After just two phone calls, they were close like family," said Tran Thi Thu Ha, a member of the survey.

"After that, every time she or her family or friends became ill, the doctor would come with a phone call, even if it was in the middle of the night," Ha said.

She said there exists a big difference between the bonuses at small and large hospitals, in rural and urban areas, like VND50,000 (US$2.5) compared to VND5 million, or even several dozen million dong, but it is a common practice.

Half of the surveyed patients said they "saw others do that" and one third said the nurses and doctors demanded the money "in a very clever way."

Nurses and doctors said the bonuses did not create much difference in the treatment quality, but patients who paid extra received longer, more gentle consultations and better post-surgery care.

Doctor Tran Tuan from the community development research center said the treatment quality in general was "surely" affected "as the treatment priority was not based on the patients' conditions but manipulated by money."

Both doctors and policymakers questioned said that the bribery destroyed people's trust and respect for the healthcare system, and could create internal conflicts within hospitals.

Tuan said the healthcare sector has institutionalized the practice, as patients now feel guilty when they do not give bonuses to their doctors.

Nguyen Duc Vy, former director of the Central Obstetrics Hospital in Hanoi, told VnExpress that bribery at hospitals can only be stopped when the medical fees are raised and doctors do not feel the need to earn extra.

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