General Assessment of the Capacity of Civil Servants of Public Service Units under the Department of Health of Dak Lak Province

2.3. General assessment of the capacity of civil servants of public service units under the Department of Health of Dak Lak province

2.3.1. Points achieved

It can be said that although Vietnam is a developing country, the healthcare system is not fully equipped, but the Vietnamese healthcare sector in general and the healthcare sector of Dak Lak province in particular have achieved the following points:

Firstly, the structure of civil servants is reasonable, moving towards rejuvenation of civil servants to have the nature of inheritance and development. The number of female civil servants is high, contributing to job creation and gender equality. The work of arranging and assigning civil servants is focused on to balance between units to avoid shortages or surpluses. The Dak Lak Health Sector has recruited and allocated 97% of doctors to work at commune and ward health stations.

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Second, the health sector has focused on training, fostering and standardizing the capacity of civil servants from the recruitment stage. The number of highly qualified civil servants has increased, meeting the demand for qualifications in the market economy. In particular, the number of university-level pharmacists, university-level nurses, and university-level technicians has increased over the years, partly meeting the health care needs of local people. In recent years, the health sector of Dak Lak has been sending civil servants for training in many forms such as recruitment, training from intermediate to university level and training of specialized doctors. With the support of the Central Highlands People's Health Care Project Phase 2; accordingly, many civil servants attending short-term professional training courses have received financial support from the project.

Third, the satisfaction rate of patients at hospitals and medical service centers is highly appreciated, mostly over 90%.

Fourth, issue preferential documents to attract human resources in Dak Lak province. Initially, it has been successfully implemented and contributed to the number of

The quantity and quality of medical human resources have increased over the years. The successful implementation of specialized technical categories and high-tech categories at grassroots levels has reduced the overload situation at upper levels, meeting the requirements of modernizing the health sector.

Fifth, the organizational structure of public health service units is increasingly streamlined and operates more effectively. In recent years, the health sector has focused on reorganization and has merged hospitals with centers at the district level.

2.3.2. Limitations and shortcomings

Although the Dak Lak Health sector has paid much attention and made positive changes in improving the capacity and quality of medical human resources, there are still some shortcomings such as:

Firstly, the number of officials with primary (6.58%) and intermediate (39.37%) qualifications is still high, not yet standardized in a timely and appropriate manner. The level of political theory for officials in the health sector has not been ensured and balanced appropriately, the rate of primary and untrained officials is high at 95.95%. The number of patients coming for examination are quite large ethnic minorities, but the number of officials with certificates (4.64%) and who can speak is 0%. This leads to the quality of officials in public service units being low and not fully meeting the medical examination and treatment needs of the people. The capacity of health officials is still weak, including many health stations, centers or hospitals that have invested in modern medical equipment but do not know how to use it. Doctors working at commune and ward health stations have a high rate (accounting for 97%), but most of them are trained in continuous education, in-service training, or specialized training, so their ability to diagnose and treat diseases is still low. Officials working at grassroots levels have low patient traffic and mostly simple diseases, so their skills are somewhat degraded.

Second, the relationship between doctors and patients is getting worse, partly due to public opinion and partly due to the behavioral skills of the medical staff. The grassroots medical network has not created trust for patients in medical examination and care, leading to overload at upper-level hospitals. The mechanism for using human resources is not reasonable in public medical service units, and the regulations on functions and tasks are not clear, so the responsibility of medical staff is not high.

Third, the annual evaluation and classification of civil servants is still a formality, without specific evaluation criteria, thus contributing to limiting the development of civil servants' capacity. Using evaluation tools to reward and promote civil servants' capacity is not effective, and does not create motivation for civil servants. Monitoring, management and planning work at public health service units still has many limitations.

Fourth, the salary, bonus and allowance regime in the health sector is not suitable to the living conditions of civil servants, leading to a large number of civil servants quitting their jobs and transferring jobs. These regimes have not been adjusted to match the dedication, qualifications and working conditions of the civil servants. This has also led to many shortcomings such as negative phenomena in medical examination and treatment.

Fifth, the working environment still has many units with internal fighting, localism, factions, group interests, repression, and labor oppression, causing a part of the staff to no longer believe in the development potential of the unit. This has a negative impact on each individual in the unit and affects the common goals of the entire health sector.

2.3.3. Causes of advantages, limitations and shortcomings

In this increasingly developing market economy, it requires thoroughness from ethics, professional skills to professional qualifications of each official. There are many things that are required of each official such as:

sense of responsibility in work, constantly learning to improve professional qualifications or attitude towards colleagues as well as in the work of taking care of people's health. Putting the interests and health of the people first, we see that the role of each civil servant is very important in this work. From many perspectives, we see that there are still a number of civil servants who have not met the above requirements. The reasons come from the following points:

Firstly, the training and development work is not comprehensive, civil servants are not fully aware of their responsibilities and duties in the work of taking care of people's health. When recruiting civil servants, it is always necessary to check the theoretical aspects as well as the professional skills of each individual. But in reality, after the recruitment is completed, if the responsibilities and duties of civil servants are mentioned, many people do not remember. Many civil servants do not clearly understand their responsibilities and duties in the work of examining and treating people, leading to ineffective work performance.

Second, the efforts and training of civil servants are not high. In addition to being trained at educational institutions, the training from each civil servant is an important factor. Each civil servant, when performing assigned duties, must fully comply with the assigned responsibilities and obligations. The attention of civil servants to efforts and training will contribute to improving their capacity to perform professional tasks. If civil servants do not pay attention to trying to learn and make efforts to improve their personal capacity, it will limit the work of medical examination and treatment for the people.

Third, the impact of the market economy. In addition to the positive aspects that develop social life, there are also negative aspects that affect the ethics and lifestyle of a part of civil servants. Specifically, with unsatisfactory salaries and benefits, not enough to cover living expenses, not meeting actual needs.

Materialism, selfishness, and disregard for ethical rules have led to self-serving behavior in the workplace.

Fourthly, some units have not been truly exemplary in their leadership and have not been able to manage their staff, which has negatively affected the image of the staff in the hearts of the people. This has negatively impacted the thinking, life and work performance of each staff member. The implementation of legal documents and policies of the Party and the State is still limited and has not achieved high results. Violations have not been strictly and satisfactorily handled. There is a lack of specific regulations and rules in the unit to have a mechanism to inspect and supervise staff members in the process of performing professional tasks.

Fifth, the working environment has not created effective motivation for the staff. A positive working environment will have a positive impact on each individual and conversely, a negative and dissatisfied working environment will have a negative impact on each staff.

Chapter 2 Summary

From the analysis of the current capacity of civil servants of public service units under the Department of Health of Dak Lak province, we see:

Officials of public health service units are recruited based on the needs of each unit, according to approved job positions and receive salaries based on the unit's revenue. In general, officials of public service units under the Dak Lak Provincial Department of Health have a fairly reasonable structure, professional qualifications are increasingly standardized, political theory qualifications have not been fully supplemented, foreign language proficiency is still low and the majority only stop at certificates. In terms of behavioral attitudes or communication skills, they are on the way to further development but are still limited and make some subjective mistakes.

The current capacity of civil servants in public service units under the Department of Health of Dak Lak province is still limited due to a number of reasons such as: training and fostering is not comprehensive, the efforts and training of civil servants are not high, the impact of the market economy, some units' heads are not really exemplary and cannot manage the staff under their authority, causing a negative impact on the image of the staff in the hearts of the people, the working environment does not create effective motivation for the staff.

Investment in healthcare is still limited, medical facilities at some district-level facilities are degraded, bed occupancy is still high, and sharing beds still occurs in some hospitals at certain times of the year.

Funding and human resources invested in hospital quality improvement activities are not high; the capacity of medical examination and treatment at some lower-level hospitals is still limited (especially surgical capacity and small specialties), not meeting the medical examination and treatment needs of the people is one of the reasons leading to the overload at the upper level, especially the local overload at the Central Highlands General Hospital. Human resources still do not meet the demand, especially the shortage of highly qualified and specialized doctors at district-level hospitals.

From these analytical contents, we have the basis to propose solutions to improve the capacity of civil servants of public service units under the Department of Health of Dak Lak province towards 2025.

Chapter 3:

SOME SOLUTIONS TO IMPROVE THE CAPACITY OF STAFF IN PUBLIC SERVICE UNITS UNDER THE DEPARTMENT OF HEALTH OF DAK PROVINCE

SHAKE

3.1. Perspectives on improving the capacity of health workers

3.1.1. Party's viewpoint

Of all the professions, medicine is the profession that is most closely related to people's lives and health. It is also considered the most important in the public service sector, medical staff examine and treat people on behalf of the state. For that reason, the medical profession is also given more attention and importance. The Party and the State have always paid attention to the work of training and developing human resources in the health sector for many years.

Sixty years ago, on February 27, 1955, President Ho Chi Minh wrote a letter to the Conference of Health Workers to give heartfelt advice and serve as a guideline for the entire health sector. His heartfelt words still resonate today. President Ho Chi Minh always aimed to take people as the root, the health of each citizen is a precious asset, thereby promoting humanity, promoting the development of capacity and responsibility of each health worker. Uncle Ho's thoughts on medical ethics are an example and a direction for building and developing the country's health sector for over 60 years. Inheriting the thoughts that Uncle Ho put forth, in the context of a socialist-oriented market economy, there are many advantages and pitfalls for the ethics of health workers. The Politburo issued Resolution No. 46-NQ/TW dated May 23, 2005 on the work of protecting and caring for people's health in the new situation with the following directions:

Medicine is a special profession that requires special selection, training, use and treatment. Every medical staff must constantly

Improve professional ethics and professional capacity, worthy of the trust and honor of society, and follow the teachings of President Ho Chi Minh: "A good doctor must also be a kind mother [5] .

Over the past time, the health sector has always complied with and implemented the Party's instructions and achieved quite good results in capacity building and development for the entire sector.

Replacing Resolution 46-NQ/TW, on October 25, 2017, the 12th Party Central Committee issued Resolution No. 20-NQ/TW on Strengthening the protection, care and improvement of people's health in the new situation. In this Resolution, our Party stated:

Medicine is a special profession. Medical personnel must meet professional and ethical requirements; need to be selected, trained, used and treated specially. The medical network system must be widespread, close to the people; be directed uniformly and consistently in terms of expertise and profession from the central to local levels throughout the country, while ensuring the leadership and direction of local Party committees and authorities [6].

Focus on issues of developing human resources for health, improving the capacity of the health system, modernizing machinery and equipment, and moving towards health care that satisfies the entire population. This is the goal of action as well as the direction for the entire health sector to strive for in the coming time.

3.1.2. State regulations

Grasping the current market economic situation, Dak Lak province leaders have also made basic decisions towards the development of Dak Lak province's health sector.

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