Stringent measures to clean house at profiteering public-run hospitals

Bach Mai Hospital

Last Monday, a visitor was making his daily rush to the canteen of Bach Mai Hospital, where a relative is being treated, to queue up to get her dinner. Already having to deal with the stress of caring for a loved one in hospital, the murmurings over price hikes in medical devices – and therefore higher hospital fees – has only depressed the visitor further.

“I am so disappointed. We do not know whether other similar violations will be uncovered. It is a pain for those of us who are struggling to cover hospital fees,” he said. “There must be strict punishments to deter any future cases.”

He is among many Vietnamese people displaying their disgust at the alleged wrongdoings at Bach Mai Hospital, which has seen patients potentially conned out of up to VND10 billion ($435,000). Some had to simply give up treatment because of unexpected sky-high fees.

After the VN Pharma scandal – in which 12 defendants were charged last year with manufacturing and trading counterfeit medicines, including fake cancer drugs – the healthcare sector has been shaken up yet again. The Investigation Agency under the Ministry of Public Security (MoPS) arrested the leaders of BMS Medical technology JSC and Hanoi Valuation and Financial Services JSC (VFS), who are said to have colluded with others to illegally raise the prices of medical devices in the Bach Mai-BMS cooperation contract.

The MoPS is currently expanding the investigation while the Ministry of Health (MoH) has set up a price appraisal team to work out adjustments at state-run hospitals, with many services set to reduce prices and a decree on cooperation contracts forthcoming.

Last week, the MoH launched a portal to publish the price of medical devices. Nguyen Thanh Long, acting MoH Minister said, “The publication of prices and configuration of medical devices, as well as the winning prize of tenders of medical equipment packages on the portal, will increase transparency and a healthier market, thus preventing similar wrongdoings in the future and ensuring patient benefits.”

Bach Mai Hospital signed a cooperation contract with BMS in 2017 to bring Rosa – a new robot device useful in many neurosurgical procedures – into use until 2024, making it the first hospital in the country to utilise the equipment.

However, investigations have found that the price of Rosa went inexplicably from the imported figure of VND7.6 billion ($330,400) to VND39 billion ($1.69 million). As a result, surgeries involving Rosa that should have cost around VND4 million ($175) instead climbed to an eye-watering VND23 million ($1,000). Thus far, around 550 patients at Bach Mai Hospital have been operated on with Rosa.

It remains to be answered why Bach Mai Hospital was willing to accept certificates provided by VFS without verifying the price of imported medical equipment via invoices and receipts of the imports provided by the customs agency.

Hospital director Nguyen Quang Tuan explained last week that Bach Mai has stopped using the robot since May when the investigation began, while the health facility is checking all medical equipment involved in cooperation contracts with partners.

Dr. Nguyen Trong An, former head of the Child Care and Protection Department under the Ministry of Labour, Invalids and Social Affairs, said that the events display a serious violation of the code of ethics in the healthcare sector. As the number of people affected may never be truly discovered, it will be difficult to pay back money to patients who were treated at Bach Mai, or to the families of those that have since passed away.

“Evidently, there is collusion between the suppliers and the hospital in this scandal. They dimmed with calling private investment at public-run hospitals to make a profit. The main responsibility should be given to the director of the hospital – without his permission, no business is allowed to bring medical equipment to the hospital,” Dr. An said.

Former National Assembly deputy Bui Thi An agreed that the wrongdoing has been unacceptable. To help prevent this kind of violation, she recommended that prices of medical equipment subject in cooperation contracts between suppliers and state-owned hospitals should be made public.

Bach Mai is one of four public-run hospitals given autonomy in purchasing medical equipment without appraisal from the MoH. Since 2017, Bach Mai has called on the private sector to invest in many medical devices and services.

“As this case could damage the confidence of the locals, wrongdoers should get the highest possible punishment,” Dr. An suggested. “The case is an alarm bell for the healthcare sector, which is urged to address this issue at public-run hospitals nationwide so as to prevent any new similar cases.”