QUY BINH DIEU KllN HANH N G H I C O A NGl/dl HANH N G H I KHAM C H O A BENH TRONG CAC CO Sd Y TE Tl/ NHAN HIEN NAY
Dinh Thi Thanh Thuy' Tim tStliing Viet: Trong quanh^ khdm chUa b$nh cua cdc ca sdy ti tu nhdn, chu thi cung ung true tiip cdc dich vu khdm chUa binh (ngudi hdnh nghe) tdi nguai binh phdi ddp ting cdc diiu ki^n chgt che vi hdnh nghi khdm chua hinh trudc khi dugc cdp^ chung chi hdnh nghi. Bm viit phdn tich cdc quy dinh cUa phdp ludt khdm binh, chOa bfnh ve cdc dieu ki$n hdnh jigAl cua ngudi khdm chira binh trong cdc ca sdy ti tu nhdn; ddnh gid thuc trgng thuc hiin cdc quy dinh vi diiu kiin hdnh nghi eita nguai hdnh nghi khdm benh chUa binh vd kiin nghi m&t si gidi phdp hodn thifn.
Tit khod: Chimg chi hdnh nghi; diiu kiin hdnh nghi; eg sg y ti tu nhdn; ngudi hdnh nghi; ddng ky hdnh nghe; khdm binh, chUa binh.
Nhan bai: 05/01/2017; Hodn thdnh bien tap: 05/02/2017; Duyet dang: 30/02/2017 Tdm tit tiing Anh:
Abstract: In clinical relationship of private medical establishments, subject directly providing medical services (workers) to the patient must meet strict conditions of medical practice before:
getting Certificate of practicing health care. The article analyzes provisions of the law on giving health examination and treatment regarding to conditions of the person practicing health care in private health facilities; assesses status of implementation of the regulations on conditionsfor professional practice of medical practitioners, and give some recommendations forfinalization.
Keywords: Certificate of practicing health care; conditions ofpracticing health care; private medical establishments; medical practitioners; register for practicing health care; health examination and treatment.
I. Quy flinh vi Oilu kien hanh nghe floi Lujt kham bfinh, chira bfinh ndm 2009 (co vdi ngirM hanh nghe kham b$nh, chira b^nh hieu Ivrc ttt ngdy 01/01/2011) quy dinh ngucri trong cic cff sfr y t i tir nhan hanh nghi khdm benh, chiia bfinh la "ngudi da 1.1. Bieu kien vi chu thi dugc cdp chimg chi hdnh nghi vd thuc hien Didiroc tham gia vao quan hfi dich vu khdm fdidm bfnh, chUa binh (sau ddy ggi chung H chtia benhi, vdi tu each la bfin cung elp dich vu "•?"?' *^"'' "Shiy. Khai nifim nguoi hanh kham chiia benh, ca nhiin hanh nghi cung ling "Shfi kham benh, chiia bfinh duprc dp dvmg dich vu kham chiia bfinh trudc hit phdi cc nang '^™8 '^^c co sd y tfi cong lap va y ti tu nhan.
luc chii thi phu hpp. Theo dd, ndng Ivrc phap Trong ^dd, khdm benh Id "vific hdi bfinh, klai luat cua cd nhdn cd tir khi ngudi dd sinh ra vd *?? ''^° ^^ H^, tham kham thvrc thi, khi can chim diit khi ngudi dd chit (khodn 3, Diiu 16 ''"^' * i chi dinh lam xet nghifim cjn ldm sanfe;
Bfi lujt ddn sir 2015); vd nang Ivrc hdnh vi dly '''am dd chiic nang di chdn doan va chi dinl dii cua ca nhdn dupc xac dinh la ngudi tir dii phtrong phap difiu tri phii hpp dd dupc cfing mudi tdm tuii tid len (ngudi thdnh nifin) khong nhSn" va chUa binh la "viec su dvmg phuanf thuoc ttudng hpp quy dinh tai Diiu 22, Diiu 23, P^ap chuyfin mfin ky thuat dd duprc cdng nhfil Diiu 24 Bp Iuat djn svr 2015 (ngudi mit nang ™, thuoc da duoc phep luu hanh di d p clili Ivrc hanh vi dan svr, ngudi cd khd khan trong * ™ hi, cham sdc, phuc hfii chitc nang clio nhan thiic, ldm chu hanh vi va ngudi han chfi ng"™ benh'". Nhu vdy, ngudi hdnh nghi kham ndng Ivtc hanh vi dan svt). benh, chira bfinh phai la ngudi dupc (i) dp
' Giang vien, Tnr6ng Dai hpc Thuong m^i
^ Khoan 6, Digu 2 Luat i c h ^ b^nh, chtta benh nam 2009.
' Khoan 1, khoan 2 Luat khSm b^nh, chtta benh nam 2009.
chftng cM hanh nghi; (ii) thyc Mfn vide khdm bfnh, chua bdnh cho ngudi bdnh.
1.2. Bieu kiSn hanh nghi cua ngirdi hanh nghi khdm b$nhf chtta b§nh
Ngudi hanh ngbl khdm bfnh, chua bfnh kM
r/tH* sdUf ngudi bdnh nghd da ddng ky ldm ngudi chiu trdch nhiem chuydn mdn k^
thugt cfta mpt ca sd khdm bdnh, chfta bfnh dupc ddng ky ldm vifc ngoai gid tgi co sd kham bfnh, chua bdnh khdc trdn cftng dia bdn tinh nhung tdng thdi gian ldm ngoai gid khdng qua 200 gid theo quy dinh cfta Bd ludt lao dpng.
Thu bdy, ngirdi hanh nghe da dang ky hanh nghe tai mpt co sd kham bfnh, chfta bfnh tiii khdng dupc ddng ky ldm ngudi chiu ttdch nMdm ehuyen mdn ky thudt cfta co sd khdm bdnh, chfta bdnh tten dia. bdn tinh khac vdi noi minh dang hdnh nghd dd bdo ddm tinh Kdn tuc, dn dinh ttong cung cap dicb vu khdm bfnh, chfia bfnh.
Thir tam, ngudi bdnh nghd da ddng k^
hdnh nghd d mpt ca sd kham bfnh, chiia bdnh kM thyc Mfn vide khdm bfnh, chfia bfnh theo chd df Man pMen cdn bd tfi tuydn trdn xudng tuydn dudi, kham bfnh, chfia bfnh nhdn dao hoac thyc hifn k5? thudt chuydn mdn (vf du: hdi chdn, md pMdn) theo bpp dong gifia cdc ea sd kham bdnh, chiia bfnh thi kbdng phdi ddng 1^
hdnh nghe.
1.2.2. Nguai kdnh ngke edn tudn thii cdc quy dink ye npi dung vd hinh thuc ddng ky hdnh nghe bao gom dia diim, thdi gian hank nghi, vi tri ckuyen mdn nai ngudi kdnkngki ddm nhiem; hinh thuc ddng ky kdnh nghi phdi du(rc thuc kiin bdng vdn bdn^.
Quy djnh tdt cd nhdn vidn y tl, du Id y tl cdng lap hay y td tu nhan ddu phdi ed chftng cM hdnh nghd kM hdnh nghd bat ddu dupe dd cap ttong Ludt kham bfnh, chfia benh ndm 2009. Quy dinh vd ngudi hanfa nghi xin cdp ehftng chi hdnh nghd ttong khu vyc y tl tu nhdn bao gdm: (i) Bde sT, y sT; (ii) Dieu duong vidn (iii) Hd sinh vien (iv) Ky thudt vidn (y) Luong y; (vi) Ngudi cd bai thude gia fruyin hodc cd phuong phdp chfta benh gia truyln*.
Quy dinh vl chftng chi hdnh nghi khdm chfta bfnh Id ydu edu bdt bude ddi vdi ngudi
* Khoin 13, Difiu 6 Lu^t kham bfinh, chfla bfinh nim 2009
' Difiu 11 Thdng ttr §6 41/^01 _1/TT-BYT ngiy 14/1 l/2011caa Bg Y te vl huong din cdp chm^
v(n ngum hanh nghe vi cap giay ph^p hoat d^ng doi vdi ca scr khim bfnh, chOa bfnh
* Dilu 17 Luit khim bfnh, chtta bfnh nim 2009 cac ffidu kifn vd chft thi tM cdn tudn tbft nhfing nguydn tdc, ffilu kifn vl bdnh nghi, bao gom:
1.2.1. Cdc nguyen tdc ddng ky kdnk nghi Thir nhdt, mft ngudi hanh nghd cM dupc
^ n g ky chiu trdch itiiif m chuydn mdn ky? thudt cua mdt co sd kham bfnh, chua bfnh, khdng dupc ddng thdi lam ngudi chiu ttdch nMfm chuydn mdn ky thugt tft bai co sd khdm bdnh, chiia bfnh trd ldn.
Thir hai, mpt ngudi hdnfa nghi chi dupc ddng l^ lam ngudi pbu trdch mpt khoa cfta mdt CO sd khdm bfnh, chiia bfnh (khdng dupc ddng thdi ldm ngudi phu trdch tft hai kboa frd ldn ttong eung mpt ca sd khdm bfnh, chua bfnh hodc ddng th£ri lam ngudi phu trdch khoa cua eo sd khdm bdnh, chfia bf Mi khdc).
rft«* ba, ngudi fadnh nghi cMu trdch nMfm chuyen mdn ky thugt cfta co sd kham benh, chiia bfnh cd ttid kidm nMfm phy frdeh khoa trong eftng mpt ca sd kham bfnh, efaua bdnh nhung cM dupc phu frdeh mdt khoa vd phdi phft fapp vdi vdn bang chuyen mdn dupe dao tgo cfta ngudi dd.
Thu tu, ngudi bdnh nghd tgi ca sd khdm bfnh, chua bfnh dupc ddng ky ldm ngudi chiu ttdch nMfm chuydn mdn ky thii|it cfta mdt co sd khdm bdnh, chfia bfnh ngoai gid.
Thu ndm^ ngudi hdnh nghd tgi ca sd khdm bfnh, chfia bfnh cfta Nhd nudc khdng dupc ddng ky ldm ngudi dftng dau cfta bfnh vifn tu nhdn hogc co sd khdm bfnh, chfia bdnh dupe thdnh lap vd hogt ddng theo Lugt Doanh ngMdp vd Ludt Hpp tde xa, tru trudng hpp dupc ca quan nhd nudc cd thdm quyin eft tham gia qudn ly, didu faanh tgi ca sd klidm bfnh, chfia benh cd phdn vdn cfta Nhd nudc*.
hdnh nghi dupc hdu hdt cdc qudc gia quy djnh khd chdt che va Vift Nam cung khdng ngogi If. Khoan 4 Lugt khdm bfnh, chiia bfnh ndm 2009 da neu rd: Chiing chi hanh nghd khdm bfnh, chiia benh la 'Van ban do ca quan nha nudc cd thdm quyin cdp cbo ngirdi cd dft ffieu kifn hanh nghd tiieo quy dinh cfta Lugt ndy".
Ngudi dft didu kifn hanh ngbd dupc cMa thdnh hai nhdm ngudi: (i) ngudi Vi^t Nam, (ii) ngicdi nu&c ngodi, ngudi Viet Nam dfnh cu a nu&c ngodi. Theo do, Ludt kham bdnh, chua bdnh ciing quy dinh nhiing dieu kifn de dupc cap chftng cM hdnh nghe vdi nhiing ddi tupng nay.
Ngudi hdnh nghi si bi thu hdi hogc dinh ehi chiing ehi hdnh nghi trong cdc tru&ng hgp (i) Chftng cM hdnh nghd dupc cdp khdng dung tiiam quydn; (ii) Chftng cM hdnh nghd cd npi dung trdi phdp lugt (iii) Ngudi hanh nghd khdng hanh nghd ttong tiidi hgn 02 nam lidn tyc (iv) Ngudi bdnh nghd dupc xac dinh cd sai sdt chuydn mdn ky thudt gdy hdu qud ngMdm ttpng den siic khde, tinh mgng ngudi bdnh (v) Ngudi hdnh nghd khdng cap nhat kidn tbftc y khoa hdn tyc ttong tfadi gian 02 ndm lidn tid^
(vi) Ngudi hdnh nghe khdng dft sftc khde dd hdnh nghe [vii) Ngudi hdnh nghe thudc mpt frong cde ddi Mpng qiQ' djnh tgi khodn 4 Dilu 18 ciia Lugt khdm bdnh, chiia bf nh^.
2. Thvc trao^ th^v hidn cac quy dinh ve dieu kifn hanh nghe doi vol ngvM hdnh nghe kham benh, chua bfnh trong cac co sd y t l to- nhan - Kien nghi mot so giai pbap hoan thifn
2.2. Thuc trgng thue hien cdc quy dinh ve dieu kifn hdnh nghe doi v&i ngudi hdnh nghi khdm benh, chUa benh trong cde cff sd ytetir nhdn
Thdng qua vide quy dinh cdc dieu kifn hdnfa nghd ddi vdi ngudi hdnh nghi kham bdnh, chiia bdnh ttong cdc co sd y tl tu nbdn dd ed nhiing tde ddng tich cyc vd Mdu qua trong vide quan ly, hdi nhgp vd ndng cao chdt Iupng dicfa vy khdm benh, chira bdnh efta nuac ta frong giai doan Men nay. Ddng thdi, cde
ffidu kidn chat che d6i vdi i^;udi hanh nghi d9 gdp phdn Mfu qua trong vifc ddm bao quyin duoc cham sdc, kham va chua bfnh an toan, chat Iuong cua ngudi benh Hon nua, tnjng bdi canh ^^ft Nam da ky mot sd cam kit thda thi^n cftng thiia nhgn lan nhau giiia cac nudc ASEAN ve ffilu kidn ngudi hanh nghi Id bdc sT, nha sT vd ffilu duong, vifc thyc Mfn edp chftng cM hdnh nghi cho ngudi hdnh nghe vd cdp gjdy phdp boat dpng cho ca sd kbam bdnh, chiia benh theo qi^ ffinh cfta Ludt kham bfnh, chiia bfnh Id mot ydu td quan ti^ng giup Vift Nam hdi nhdp vdi cdc nudc trong khu vyc vd trdn the gidi.
Bdn canh nhiing kdt qud dat dupc ndi ttdn, ttong giai dogn Mdn my, nhidu qay dinh cua phap luat lidn quan ddn ffieu kifn hogt ddng cua ngudi hdnh nghi khdm bfnh, chfia bfnh, ttong do cd quy dinh vd dilu kien hdnh r ^ l da bdc Id nMdu bdt c ^ , cu thd;
2.1.1. Quy dinh vi thdi kgn vd dieu ki$n ciia chiing cki kdnh nghi:
Theo quy dinh cfta Ludt khdm bdnh, chfia bfnh nam 2009, vifc cap chftng cM hdnh nghi cM cdp mpt ldn vd cd gia tti vmh vidn ^ e u 25 Ludt khdm bdnh, chiia bdnh). Quy dinh ndy dupc xem la tgo ffidu kidn thudn lpi cho vifc cap vd thu hdi chftng cM hdnh ngbl vdi tii cdch Id thft tuc hdnh chfnh nhung lgi khdng phft hop vdi ydu cdu hdi nhgp qudc td, dd Id ydu cdu phdi thfta nhdn ldn nhau vl chiing cM hanfa nghi kM hpi nhdp vdo khu vyc kinh tl chung.
Vi sy khdc bidt trdn, bdc sT d Vift Nam Mdn nay van chua dupt; cdng nhdn hanh nghd Idii ra nuac ngoai. Nhilu du dn ODA vl y ^ trong khu vyc ASEAN cung bi cdt giam. Quy djnh ndy dan ddn vide nMdu bdc sT, y td thudng khdm vd ffieu tri theo thdi quen, kinh ngMfm va nhfing kien thfte cii, trong kM cac md Mnh bfnh, didn bien bdnh Men nay da frd ndn rat phftc tgp, Iam nguoi bfnh phdi keo dai thdi gian didu tri, gdy ton kem vd tiln bgc va thdi gian, hodc nguy Mem vd tinh mgng cbo ngudi bdnh. Ddng thdi, chiing cM banh nghi "vd thoi bgn" kMdn cho vide kidm tra, gidm sat cdc tieu
' Difiu 29 Luat khim bfinh, chfta b^nh n i m 2009.
o
chuan, didu kidn boat ddng cfta cdc c a sd khdm bfnh, chfia bdnh tu nhan cung nhu ttinh dp chuydn mdn cua ngudi hanh nghd frong thuc tien cua c a quan quan ly Nha nudc gap nMeu khd khan. Hidn nay, da sd cac nude phat trien ddu quy dinh ve gia ban hoac dinh ky cap lai chftng chi hanh nghe khdm benh, chfia benh eua ngudi hanh nghe nhdm de dam bao ngudi hanh nghd bdn canh nhftng kinh ngMdm, kien thfte da cd van phai lien tuc hgc hdi nhiing phucmg thuc dieu tti mdi cua y khoa trong nudc cung nhu fren thd gicii trong kham benh, chfia benh. Tai Vidt Nam, vide xet cap chftng cM hdnh n^he chi cdn cft vao hd so ma khdng td chftc kidm tra ly thuyet va thuc hanh sat hach tay nghd, khdng gan vdi dao tao lien tuc anh hudng den chat lugng nhan luc chuyen mdn ve y te va gay kho khan cho viec danh gia nang luc eua Bd y te kM tien hanh cac thu tuc cap moi hoac cap Iai, thu hdi chftng cM hanh nghe..., do do, thuc chat viec cap chung chi hanh nghe van chi mang tinh hinh thtic. Ben canh dd, quy dinh nay cM dap ftng yeu cau dcrn gian hda thit tuc, thuan lpi cho viec xet cap chftng cM hanh nghe cho nhan vien y te trong thdi gian ngan nhung kbdng phii hgp vdi nhirng ddi hdi khat khe ve chuyen mdn ciia nganh y va xu hudng chung cua the gioi. Viet Nam khdng cd quy dinh ve thi qudc gia de xem xet cap ehiing chi hanh nghe trong khi da so cac nudc da thuc hien nhu mgt phuang thuc bat bugc de kiem soat chat lugng hanh nghe cua nhan vien y te.
2.1.2. Quy dinh ve vdn bdn xdc nhgn qud trinh thuc hdnh cua ngudi hanh nghe:
He thong van ban phap quy ve kham benh, chfta benh da bgc lp nhieu van de bat cap, chua phiJ hgp voi thyc te nhu quy dinh ve bat huge ngudi dang ky hanh nghe j)hai trai qua thdi gian thuc hanh Iam sang nhat dinh tai cac ca sd y te nhimg khong quy dinh cu the ve ngi dung, yeu cau nang lire dau ra va co che theo doi, danh gia nang lire chuyen mon va ky nang thuc hanh. Yeu cau ddi vdi van ban xac nhan
qua trinh thyc hdnh cua ngudi hanb nghd gdm 03 ndi dung cMnh: (i) xac nhan vd thdi gian thyc hanh; (ii) xac nhan n m g Iuc chuyen mdn;
(iii) xdc nhan dao due nghe ngMep. Tuy nMdn, trdn thuc te, viec xac nhan nay cdn dinh tinh, chua cd tieu chi cu the nhu nang luc chuydn mdn dupc ddnh gia qua nhftng ydu td nao;
chua gidi han so ngudi hudng dan thyc hanh cho ngudi hanh nghe nham dam bao chat lucmg va chuydn mdn thuc hanh; nhieu c a sd thyc hanh coi viec xac nhan qua trinh thyc hanh chi Id Mnh thuc, chua rang bupc trach nhiem ciia ngudi dung dau co sd y te ddi vdi qua trinh kham bdnh, chfta bdnh ciia ngudi dang ky thirc hanh ttong qua trinh thuc hanh.
Ben canh do, trudc day, theo Thdng tu 41/2011 /TT-B YT tM tiidi gian hgc dinh hudng chuyen khoa va sau dai hpc deu tinh vao thdi gian thuc hanh. Thdng tu 41/2015/TT-BYT sua ddi bd sung Thong tu 41/2011/TT-BYT van quy dinh thdi gian hgc dinh hudng chuyen khoa va sau dai hgc dugc tinh la thdi gian thuc hanh nhimg quy dinh rd la ap dung vdi trudng hgp hgc bac sT ngi tru, chuyen khoa cap 1, 2.
Thdi gian hgc thae sT va tien si y khoa se khdng dugc tinh la thdi gian thue hanh du do cung la hinh thuc dao tao sau dai hgc. Muc dich cua cac nha lap phap nham tach bach he thdng dao tao ve y hgc lam sang va dao tao phuc vu nghien ciiu khoa hgc. Tuy nhien, tren thuc te, chua cd van ban hudng dan cu the ve ca che dao tao ddi vtji cae ddi tugng ngudi hanh nghe va doi tuang nghien cftu khoa hgc trong y hgc.
2.1.3. Vekhdiniem "chimg chi hanh nghe":
Viet Nam la mgt trong it nudc (Singapore, Malaysia..) sft dung cum tft "chimg chi hanh nghe", cdn cac nudc phan ldn su dung cum tft
"giay phep hanh nghe". Thuat ngft "chftng chi" de gay Meu lam la loai giay td nay dugc cap mgt lan va khdng bi thu hdi. Hoac quan diem cho rang chimg chi hanh nghe la van ban chftng nhan ve trinh do chuyen mdn du kha nang hanh nghe cua ngudi hanh nghe^ (d day
' Luat gia Vu Xuan Tien, Chiing chi hanh nghe lu gi? http://[aodong,eom,vn/kinh-te/chung-chi-hanh-nghe-la-s?
21896!.bld
[i(rmv.muMmiA
la hdnh nghd kham bfnh, chfia bdnh). Rd rang, vdi dac tbu cfta dich vu khdm bfnh, chfta bfnh lidn quan tryc tidp ddn sftc khde, tfnh mgng cfta con ngudi, triiih dp chuydn mdn cua ngudi hanb nghd ndu khdng dupc lidn tyc dao tgo, thyc hdnh vd hpc hdi tM quan diem cho rang cfi cd chftng chi hanh nghd Id cd dft kbd ndng chuydn mdn khdm bfnh, chua bfnh that sy ddng lo nggi. Bdn canh dd, Yiet Nam Mdn cM cdp 1 loai cfaung chi hdnh nghd cho ngudi hdnh nghe kham bdnh, chfta bfnh ttong khi sd ddng cdc nudc deu cap nMdu Iogi giay phep Tidnh nghd nham dam bdo vi thd phidp ly cbo - nMdu hinh tfaftc hanfa nghd, nMdu nhdm tham gia faanfa nghi trong thyc td, vi du giay phep hdnh nghd hgn chd (tidn hdnh nghe) cap ttong thdi gian thuc tap cho ddi tupng bde sT y khoa (sau khi tot ngMfp cu nhdn y khoa vd dupc ddo tgo tidp dd banh nghd kham bfnh, chfta bdnh); gidy phep hdnh nghd cho bdc sT da kboa sau kM thJ do ky tM qudc gia vd chiing ehi hdnh nghd...
De khdc phuc nhftng han chd eiia vifc edp cfaftng chi mpt lan^ Ludt khdm bdnh, chfia bdnh vd Thdng tii sd 41/2011/TT-BYT da quy dinh ndu ngudi hanh nghd khdng cdp nhdt kiln thfte y khoa lidn tyc ttong thai ban 02 ndm lidn tiep hodc khdng hdnh ngfae ttong 02 ndm lidn tyc tM se thudc cdc trudng fapp phdi thu hoi cfafing chi banh nghd. Tuy nMdn, ttdn thuc td quy dinh nay hau nhu khdng cd ti'nh khd thi \d ca^ quan qudn ly Nha nudc khdng de dang kidm soat dupc hoat ddng cfta nhiing ngudi hdnh ngfae kham bdnfa, cfafia bdnh vdi du cdc chfic danh nfau bdc sT, dilu dudng, ky thudt vidn... ttong khu vyc y tl tu nhdn. Hon nfia nhftng CO sd dft ffidu kifn tien hanb ddo tao lidn tyc cho can bd y tl theo Thdng tu 22/2013/TT-BYT khdng nMlu, Mfn chi gidi ban ttong kbu vuc y te cdng, cbinh dilu ndy da khdng tao ra ddng luc cho ngudi fadnfa nghd kham bdnh, efaua bdnfa phin dau hpc tap ndng cao trinh dp chuyen mdn.
2.2. Kien nghi mot so giai phdp nham hoan thien quy dinh cua phap lugt ve dieu kien hanh nghe cua ngudi hanh nghe kham benh, chira benh hien nay
r/tif nhdt, lidn quan din quy dinh vl edp chftng chi hdnh nghd cfta ngudi hanh nghe frong Ludt khdm bfnh, chfta bfnh nam 2009 va Thdng tu 41/20UnT-BYT ngay 14/11/2011 cfta Bd Y td vd hudng dan cap chiing cfai hdnh nghi ddi vdi ngudi hdnh nghd, cdn sua ddi theo budng chung cM hanh nghd sau khi dupc cdp cM ed thdi ban frong vdng 05 (ndm) nam, cft djnh ky 05 ndm sd tM hogc sat hgch lgi. Myc dich nh&n nang cao trinh dp chuydn mdn^ dgo dftc ngbl ngMfp d6i vdi ngudi hanh nghd, va CO sd khdm bfnh, chua bfnh tidp tyc hoan tMfn bdo ddm an todn cho ngudi bfnh vd tgo co sd phdp Iy cho cdc ca quan quan ly Nha nudc frong thanh kilm tra chftng cM hdnh nghd ya gidy phep hogt dfng. Thdi hgn 05 ndm cdp phep lgi Id phft hpp vdi cac ly do:
(i) Thdi hgn 05 ndm la dft dd cdc co sd y tl thyc Mdn cdc gidi phdp nhdm ndng cdp, cdi tgo CO sd vdt chdt, trang tiiiet bj, ngudn nhdn lyc va cdi tMf n CO chd qudn ly phft hpp vdi cdc tidu cM vd didu kifn cdp phep boat dpng.
(ii) Khodng tbdi gian 5 nam cting Id kfaoang thdi gian md can ed nhiing thay ddi vd cac ffidu kifn cdp phdp cho pbft hop vdi su tiln bf vl khoa hpe ky thugt.
(iii) Khoang thdi gian ndy ciing phft hpp v6i cdc ehu ky vd tai chfnh, q i : ^ Iy, dau tu ciia Nhd nudc.
Thdr hai, quy djnb cfta Ludt kharn bfnh, chfia bfnh ndm 2009 chua dl cdp din viec ngudi bdnh nghi khdm bfnh, chfia bfnh dupc bd sung hodc tbay ddi phgm vi chuyen mon cfta hp, vi vgy frong thdi gian tdi, kM sua lugt, can dua quy dinh cd thi bd sung hogc thay ddi pbgm vi hogt dpng chuydn mdn trong chftng chi hdnh nghd, vi^ trong thyc tl kM yeu cdu ngudi hdnfa nghd khdm bfnh chfia bdnh phdi thudng xuydn hpc tap de ndng cao trinh dp, nhu cdu tdt ydu Id hp co thi md rpng hay thay ddi chuydn mdn kham bdnh, chua bdnh.
Thir ba, lien quan din qua tiinh thyc hanh cua ngudi fadnh nghd khdm bfnh, chiia bfnh hidn nay. Qud trinh tbuc hdnh la mpt frong nhirng didu kidn phai cd dl dupe edp ehfing chi hanb ngfai. Trong dd, tiidi gian tiiuc hanh eua
ngudi hanh nghd theo quy dinh Mfn hanh Id (i) 18 thdng thyc hdnh tgi bfnh vifn, vifc nghidn cum cd giudng bdnh (sau ddy gpi chung Id bfnh vifn) doi vdi bdc sy; (ii) 12 thdng thuc hdnh tgi bfnh vifn ddi vdi y sy; (iii) 09 thang thuc hdnh tgi bdnh vifn cd khoa phy san hogc tai nbd hp smh ddi vdi hf sinh vidn hoac tgi co sd khdm bdnh, chiia bfnh ddi vdi ffilu duong vidn, ky thugt vien. Tuy nMdn, s6 lupng cdc thdy thudc ed tudi ddi rdt tre (tit ngMfp dai hpe y vd cd thdi gian tbyc hdnh theo quy dinh vd cdc didu kifn de dupe cap chftng chi hdnh nghi) nhung lai khdng di ddi vdi chdt lupng chuydn mdn
• frong kham bfnh, chfia bfnh, dnh hudng true tidp ddn sfic khde, tfnh mgng ngudi benh dang Id vdn dl "cdp tiiiet" can dupc ngMdn cftu, sfta ddi quy dinh cua phdp ludt.
Thir tu, cdn bd sung quy dinh ddi v<5i cdc trudng hop ngudi nudc ngodi ddn Vift Nam dl gidng day, chuydn giao ky thugt mdi, pfaucmg p h ^ mdi frong kham chfta bfnh nhan dgo hogc hdnh nghd khdm chua bfnh nban dgo... frong mpt khodng thdi gian ngdn se dupc tfafta nhdn chiing cM hanh ngbe md ngudi hdnh nghd da dupc nudc xuat xu cdp yd rftt ngdn cde hd so, tfau tuc ddi vdi nhfing ddi tupng.
Thdr ndm, edn quy dinh ey thd trong npi dung xdc nhdn vl ndng luc chuydn mdn, dgo dftc nghe nghidp cfta ngudi hdnh ngbl, la dieu kifn dd cap chftng ehi hdnh ngbl bao gdm: (i) kbd ndng thyc hidn cdc ky thudt chuydn mdn eua ngudi bdnh nghd (ngudi huomg dan fadnh nghe phdi chiu frdeh nhidm vd kdt qua kfaam bfnh, chfia bdnh cfta ngudi 1 ddng ky thyc hanh frong qud frinh thue hdnh), (ii) cd dao dftc nghe nghifp bao gdm vifc r thyc Men ngMa vy theo Dilu 36,37,38,39 cua i Luat khdm benh, cbua bfnh vd vifc thyc hifn
Quy tdc ftng xft cua Bd y te. Bdn cgnh dd, cdn ] quy dinh ey thd, mdi ngudi huang dan thuc
\ hanh chi dupe hudng ddn thyc fadnh cho ldi da 05 ngudi thuc faanh tgi co sd kham benh, chua bdnh ttong cung mdt thdi gian nhdm
; dam bao chat lupmg vd chuyen mdn cho ngudi thuc hdnh.
,, ThA sdu, thuc bidn kiem fra sat hach '[ chuyen radn la co sd de qudn ly frinh dp
chuydn mdn vd cd ly thuyet va thyc hdnh tiirdc kM hanb nghd cftng ydi vide chftng chi hdnh ngbl cho tat cd cdc ddi tupng hdnh nghd. Dieu ndy se dam bao dupc mat bdng chat lupng chuydn mdn vd an todn frong khdm chfta bfnh gifia cdc vung, miln, khu vuc frdn ca nudc, thfte day nang cao trinh dp chuyen mdn vd la mpt frong nhimg ylu td dam bao cfao ngudi ddn fren toan qudc dupc hudng djch vy y td chdt lupng nhu nhau. Mdt khdc, ddi vdi qudn ly nhd nudc, ddy ciing Id co sd dd cho qudn ly chdt lupng chuydn mdn vd an todn dieu tri tdt hon. Nhu vdy, vdi quy dinh ndy tM tdt cd cdc cd nhdn mudn hdnh nghd khdm bfnh, chua bdnh cd trong ca sd y td nhd nudc vd tu nhan ddu sd dupc bmh ddng trudc phdp ludt ttong van dQ dam bdo vd ttinh dp chuydn mdn va thyc bdnh khi hdnh nghi frdn todn qudc vd dupc qudn ly hanh nghd rapt cdch chdt chd.
Vifc tM sat hgch chuydn mdn vd cap chftng cM hanh nghd da dupe hdu fadt cdc nudc ttdn thd gidi dp dung vd Id mdt xu thd tdt ydu frong vifc quan Iy banh nghd chuyen mdn cfta cdc cd nhdn. Trong sd ede nudc thudc khu vuc ASEAN Mfn cM cdn 2 nudc Id Viet Nam vd Lao la chua trien khai thyc Mdn cdc quy dinh ndy. Vifc ddo tao dd Idy vdn bdng chi thd hifn trinh dQ dao tgo, khdng the coi la ffidu kien dd dupc edp chiing chi hdnh nghd md cM Id mpt trong cdc dieu kifn dd ngudi hanb nghd tM ehftng chi hdnh nghd. Ddc bidt, Cfng ddng kinh te ASEAN da cMnh tbftc thanb lap vdo ngdy 31/12/2015, theo dd ttong ITnh vuc y tl cd 03 nganh nghd dupc ty do ffi chuyen ttong khdi theo Thda thudn khung cdng nhdn ldn nhau, do Id nha sT, bdc sT vd dieu dudng. KM do, cdc chuydn gia y td cd ttinh dp cao cfta cac nudc ttong khu vuc se den Vift Nam khdm chfia bfnh, ngudi bdnh se dupc cac bac sT cd trinh dp cao tgi Viet Nam dieu tri thay vi phdi ra nudc ngodi didu tii vdi cM phi rdt tdn kem va mat thdi gian, ddt nudc cung khdng bi
"chay mdu ngogi tf". Nguoc lgi, cac bdc sT Viet Nara kM ra nudc ngoai khdm chfta bfnh cftng phdi tuan thu cdc guy dinh hanh nghi efta nude sd tai. Do do, dd phft fapp vox thdng Id qudc te, cdn cMnh sfta, bd sung quy dinfa vd tM chiing cfai bdnh nghd trong Lugt khdm
o
LMtlHiiHli'lil!M.»
bdnh, chfia bfnh theo hudng can phdi cd ky tM qudc gia dd cdp chftng cbi hdnh nghi./.
TAI Ll£U THAM KHAO
Bf chinh tri (2005/ Nghi quyit sd 46- NQ/TW ngdy 23/2/2005 vi cdng tdc bdo vi, chdm soc vd ndng cao sue khoe nhdn ddn trong Hnh kinh m&i, Hd Ndi.
Lugt Khdm bfnh, chfia bdnh nam 2009.
Bp Y tl (2011), Thong tu s6 41/2011/TT- BYT ngqy_ 14/11/2011 cua Bp tru&ng^ Bd Y ti hu&ng ddn cdp chung chi hanh nghe ddi vai n^r&i hdnh nghi vd edp gidypkep kogt ddng ddi v&i ca sd khdm b$nk, ckua bink, Hd Npi.
Bp Y tl (2015), Tkdng tu sd 41/20IS/TT- BYTngdy 16/11/2015 vi Sica ddi, bd sung mpt
s6 diiu cua Thdng tu sd 4}/20iI/TT-BYTngdy 14/11/2011 cua Bp tru&ng Bp Yti hu&ng ddn cdp ckirng chi hdnh nghi doi v&i ngudi kdnh nghi va cdp gidypkep hogt dpng doi vai ea sd khdm b4nk, ckita b$nh, Hd Nfi.
Bd Y tl (2015), Bdo cdo sd 63/BC-BYT ngdy 15/3/2015 vi qudn ly nkd nu&c ddi vdi vi$c cdp ckicng chi hdnh nghe vd gidy phep kogt dpng tkeo quy dinh cua Lu^t khdm benh, chira bink, Hd Npi.
Mai Danh, Bdt cap ckirng chi kdnh nghi ddi v&i edn bp y ti, ngudn:
htn3://cadn.com.vn/news/102 130332 bat^
cap-chung-cbi-hanh-nghe-doi-voi-can-bo-v- te.aspx
BAO DAM QUYEN CON NGUdt, QUYEN CONG DAN CUA DUONG SU TRONG THU TUC YEU CAU VA THU LY VIEC DAN SU
(Tiip theo trang 31)
4. Hinh thirc don ydu cau
Dan ydu cau pbai ed cdc npi dung chinh tiieo Dilu 362 BLTTDS ndm 2015. Theo quy dinh tai Dilu 165 BLTTDS nam 2004 (sfia ddi, bd sung nam 2011) tM kM khdi kifn vy dn dan sy, ngudi khdi kidn phai gfti kem tiieo don khdi kidn tdi lifu, ebftng cft dd ehiing minh cho nfaftng ydu cdu cfta minb Id cd cdn cft vd hpp phap. Xudt phdt tii thyc tien gidi quylt vu an ddn sy efao tiiay, vdi co cfal qudn ly hdnh cMnb va trinh dd hiiu bilt phdp ludt cfta duong sy Men nay thi quy dinh ndy la rao cdn ddi vdi quydn khdi kien efta duong sy. Do dd, khodn 5 Dilu 189 BLTTDS ndm 2015 da sfta quy dinfa ndy theo hudng, kem theo dom khdi kien ngudi cd thd chi pfadi nop tdi lifu, chftng cft hifn cd dd chftng minh quyin, lpi ich hpp phap cfta ngudi khdi kifn bi xdm pham*. Tuy nMdn, khodn 5 Dilu 362 BLTTDS nam 2015
quy dinh : "Kem theo dan yiu cdu, n^&iyeu cdu phdi gui tdi li^u, chung cu di chimg mink eko yiu cdu cua minh Id co cdn cu vh hap phdp". Nbu vdy, quy dinb nay chua tfaye sy bdo dam quydn binh ddng cfta duong sy trong vide ddn su vd duang sy trong vy an dan sy ndn Nghi quydt hudng (ian thi faanh BLTTDS nam 2015 ndn hudng dan khodn 5 Dilu 362 BLTTDS nam 2015 nhu sau: ''Kem tkeo dan yeu cdu, ngu&i yeu cdu gui cko Toa dn tdi lieu, ckung cu Men eo di chung minh cho yeu cdu cUa minh Id cd cdn cie vd kgp phdp".
Trdn day Id nghien cftu cfta tac gid vd thu tyc yeu edu, thy ly vifc ddn su vd mot sd kiln nghi hodn tMdn phdp Iuat vl vdn dl nay nhdm bdo dam quydn con ngudi, quyin cdng ddn cfta duong sy, rdt mong nhdn dupc y kiln ttao ddi cfta quy bgn doe./.
' Ktm theo dem khai kifn phai co tii lifu, chiing cii chirng minh quyen, lgi ich hgp phdp cua nguiri khoi kien bj xim phpi. Tnrimg hgp vi ly do khich quan mi nguiri khoi kifn khong the ngp ddy du tii lifu, chiing cii kfem theo dcrn khdi ki^n thi hg phii ngp tii lieu, chtmg c(r hifn c6 dl chiing minh quyin, lgi ich hgp phip ciia ngiriri khdi ki^D bi xam phgm. Nguoi khdi ki^n bl sung hoic giao ngp bl sung tii lifu, chung cu khic theo yfiu ciu cua T6a in frong qua trinh giai quylt vy in.
