Future solutions to public investment in healthcare

How has the disbursement of public investment in healthcare been so far this year?

Deputy Minister of Health Do Xuan Tuyen

Through the 2024 state budget investment plan, the Ministry of Health (MoH) has allocated 56.7 per cent to projects which have investment procedures completed. The remaining funds have not been allocated because some projects have not met the capital allocation deadline.

The MoH has sent documents to the Ministry of Finance and Ministry of Planning and Investment on this matter. The latter is synthesising and reporting to competent authorities to allow extending the capital allocation time.

By May 20, the MoH had disbursed 8.4 per cent of the total capital assigned. It strives to disburse all assigned capital plans by the end of 2024 after projects are allowed to extend the capital allocation time, newly started projects have had their estimates approved, and projects have had their difficulties resolved.

Do you think that public investment in the health sector is ineffective?

Through review, the MoH found that a number of projects are still not effective, and the ministry is taking solutions to solve complexities.

There are some objective reasons for this. Specifically, global political and economic uncertainties have impacted the domestic economy, affecting the supply and stabilisation of raw material prices. Moreover, institutions and policies on public investment, and related documents are not really synchronised and are being reviewed and completed.

The need for investment capital is considerable, while balancing development investment capital from the state budget still faces difficulties and is yet to meet the investment needs of medical facilities.

There are also subjective reasons. The quality of preparation of some projects is low, and survey and project design are still limited. This leads to a number of approved projects still not being eligible for disbursement because of problems related to planning, location, land, site clearance, and more.

Site clearance currently faces many obstacles, thus slowing down the progress of many projects. Some projects had to adjust total investment due to increased site clearance costs, affecting capital balance and project completion on schedule.

What are the solutions to increasing disbursement of state funding in the healthcare sector?

To increase the efficiency of public investment disbursement, the MoH will continue to implement solutions to accelerate the implementation and disbursement of projects.

Specifically, key activities are organising regular meetings with investors to promote disbursement and remove difficulties; ensuring speedy project implementation; as well as deploying the acceptance of completed projects and making payments according to regulations.

Continuing to direct heads of units and investors to enhance their sense of responsibility in leadership, direction, urging, inspection, and determining that disbursement of public investment is also a key political task.

Urgently reviewing and immediately handling problems in implementation to increase disbursement of public investment, and committing to the amount of the capital to be disbursed, transferred to other potential projects is also critical

Coordinating with localities in resolving problems related to site clearance of projects, and organising inspection and supervision of investment in projects to fast-track implementation progress and remove issues during implementation, is also necessary.

What can Vietnam learn from other countries about legal reform to increase efficiency of state budget spending?

In recent times, many countries have implemented a number of policies on public investment management to create a foundation and motivation to increase public investment.

For instance, Japan implements cost-benefit analysis methods to evaluate the efficiency of public investment, and standardises and publicises appraisal processes and methods to ensure transparency.

China has laws on state budget, procurement, development planning, and planning and estimates to manage the government spending. It focuses on social welfare and public infrastructure projects to increase efficiency and promote the role of public investment in social investment, especially in difficult and underdeveloped areas.

Meanwhile, South Korea established a public and private investment management centre to conduct pre-feasibility study reports for large-scale public ventures and established an inter-ministerial task force to resolve public investment issues.

Through the international practices in public investment, the MoH learnt some lessons. These include prioritising state budget allocation to invest in grassroots healthcare, regional testing facilities, and more; promoting digital transformation an IT in managing public investment projects; deploying solutions to promote disbursement of public investment; recommending improvement of mechanisms on public investment and related laws; and improving quality from the survey and project planning stages to avoid future adjustments.

Other lessons include strengthening inspection, supervision, and strict handling of violations; controlling objectives and effectively using capital to ensure fairness, openness, and transparency; and preventing and combating corruption.