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GIAO DUC Y DLCC CHO CAN BO Y T i VIET NAM HIEN NAY LAM VAN BONG' Tdm tit: Giao due dao ddc la mpt ngi dung quan trpng dugc Dang, Nhi nudc va xa hpi quan tam Hien tugng suy tholi dao due dang dien tram trpng nhilu Hnh vuc, dd cd nganh y tl Bai vilt danh gia thuc ttang y ddc; dua cac giai phap nham.g6p phin giao due dao ddc cho can bp nganh y te Viet Nam hien Tir khda: Dao due; y ddc; giao due y due Md dau Mdt ttong nhumg vln dl "ndng" hien nglnh y, dd II y ddc eua ngudi thiy thudc Dd ring khdng thi phu nhan dugc nhumg ddng gdp cda ein bd nganh y tl sy nghiep bao ve sdc khde eho nhin dan, song sy xudng cip vl dao ddc cda mdt bd phan nhin vien nglnh dang gly nen nhung hue xuc cho ngudi dan Hon bao gid het gilo due dao dde cua nglnh y ein duge die biet quan tim, can phii sdm khic phuc nhdng yeu kem ve d?o dde cua can bd nglnh y te Thuc trang y dire d Viet Nam Tai ky hgp thd Qudc hgi khda XIII nghj trudng ndng Ien nhieu dai bieu tap trung ehit van Bg trudng Bd Y te Nguyen Thi Kim Tien ve sy xudng cap y dde v i tieu eye nglnh dang dien phuc tap nhu Men Toan nglnh y te Men cd khoing 400 ngin cin bg Da sd het Idng tan tim ehim sdc ngudi b?nh, khdng quan ngai khd khan gian khd de hoan thinh nhiem vu dugc giao Chi tinh rieng nim 2012 cac eo sd kham 42 chda benh da khIm eho 120 ttieu lugt ngudi benh va dilu trj eho 12 trieu lugt ngudi, eim sdng nhieu ea benh Mem ngheo, hang trieu ea dd de HIng ngan cin bd y tl dang lim viec tan tyy ngly dem dl gilnh gilt sy sdng eho benh nhan, tham ehi cd nhilu ngudi da hy sinh bin thin dl ehdng lai djch benh (Trong dot djch SARS nam 2003 da co ein bd y te da hy sinh) The nhimg cd khdng It ngudi bj tholi hda ve y dde Su xudng eip ve mat dao due d mdt bd phan khdng nhd ngudi hinh nghe y dang Ii mdt van nan gay bde xde cho ca x i hdi NhQng ngudi phii ginh chju va tin thuang nhieu nhit tinh trang nly la ddng dao nhin din, die biet Ii ngudi ngheo Dieu dang bao dgng la, d hau nhu tit ca eic khau, linh vuc va cle Io?ii ein bp eua nganh y deu xuat hien cac hien tugng tieu cue Tinh trang nhung nhieu ddi bdi dudng, tie trleh ve ehuyen mdn, vd cam vdi benh nhin khdng cdn la ea biet Th$m chi Men tugng tryc Igi '' Th^ si, Trucmg Dai hpc Dilu duSng Nam Dinh Gido duey diic cho cdn bdy li ttd nen thd a, vd elm Trong dd ngudi benh mong mudn duge ehOa trj benh tat v l su eim thdng chia se cda cda thiy thude Vi the, dao ddc y te ludn phai dugc de eao de diy Idi nhdng nhu clu nhd mpn, khdng ttong sang cua cl nhan Ding tiec Men mdt bd phan cin bd y te khdng chiu Wx dudng, de bj sa nga Hp eoi nhe y dde ciia nhirng ngudi dang Iam viec mgt nghe duge egi la cag quy ma d ddi hdi phii ed tim, cd ddc va "thiy thude phii nhu me Men" Mdt khio sit Cdng doan Y te Viet Nam phdi hgp vdi Vu Td chdc can bd (Bd Y tl) thye hi6n vao thing nim 2011 tai benh vien, gdm benh vien Viet Dde, Phy san Trung uomg, K, Bach Mai vl Benh vien E cho ket qui: khoang 45% benh nhin, ngudi nhi khdng hii long vdi nhin vien y te, thu tyc hinh chinh Theo Van phdng Bd Y tl ttong thing 11 vl 12 nam 2013 cd 2.626 cudc ggi vio dudng diy ndng, trung binh mdi thing ed 49 eude gpi, cd ngly ed tdi 198 eude Trong sd 34%i cupc gpi ddng pham vi tiep nhan ed tdi Thit nhdt, thii thieu ttich nhiem 39,8% phin Inh chuyen mdn, thai dp eua mdt sd ein bd y te eua thiy thude Tai phien ehit van cua Y tl la nganh nghi die biet ma d dd Uy ban thudng vu Qude hdi ngly 01 ngudi thay thudc thudng xuyen tiep xdc thing nim 2014, Bd trudng Bg Y tl vdi ngudi bSnh v i nhung ngudi thin cua Nguyen Thj Kim Tien da cho biet: ttong gia dinh hg nhttng hoin eanh khd sd 6.700 cugc ggi ed 2.000 y kien dung khan de gianh giat giQa su sdng v i eii vdi cac vln de thi da ed tdi 40%i phin ehet Vi the, dudng nhu nghe y va nhQng anh thai eua cin bd y te ngudi thiy thude cd "quyen lye" ddi vdi ngudi benh bat ke dja vj nio cua hg Cic sd tten day cho thay sy thd Dilu dl din den Iam dung quyen o, thii ddi xd khdng dung quy djnh Iyc va khdng dap dng dugc Ipi ich cua nginh y eua ein bg van ehua gilm ei nhan cua minh thi ngudi thay thudc vl dieu khien ngudi dan bit binh v i ve khim chQa benh, thudc chua suy gilm da lim tdn hai den hinh anh eao quy cua nganh y Din nay, ehua cd thdng ke nio cdng bd cic sd lieu ve tieu eye ttong nglnh y eflng nhu suy thoai dao dde cua ein bd y te Tuy nhien, theo thdng ke so bd fren ci nudc vdng 35 ngly (td 18/4 den 23/5/2012) da xiy tdi vu tai biin sin khoa cudp di sinh mang eua sin phu vl tre so sinh Trong thang diu nim 2014 di cd 88 vu tai biin thai sin nhi, dd cd 64 vy diin tai eie benh vidn, eo sd y te Nguyen nhin cua cic vu tai nan dd II, thieu trich nhiem eda can bd y te Dilu ding bio ddng 11 cic hi?n tugng tieu cyc vin cdn phd biin, sy xudng eip d^o ddc eua cin bg y te vln chua bj chJin ddng Mac du Bd Y te cflng nhu cic eo sd eua nglnh da cd nhilu giii phip quylt liet, song y ddc vin Ii van de ludn "ndng" gay nhieu bdc xdc eho nhin dan Cd the neu Ien mdt sd bilu Men sau day ve xudng clp dao dde eua ein bd y te hien 43 Tgp chi Khoa hgc xd hdi Viet Nam, so 10(83) - 2014 cung 11 dilu ding bio ddng vl sy lanh eim vi chit lupng phuc vu kem cua nhilu eo sd y tl vl thiy thude d eie clp Tinh trang thd o, vd cim din den nhtmg he luy rit tai hai: tie trich vl chuyen mdn, eham tri ttong cip cim dieu ttj v i khdng it trudng hgp da coi re tinh mang cua ngudi benh Thit hai, tieu cyc tai cic co sd khIm chua benh, nhit Ii hdi Id (phong bi), quan lieu vln cdn II van nan nhdc nhdi Viet Nam, "van hda phong bi" da trd nen binh thudng "tham ehi nd da dugc diy len thinh mdt thd "van hda" an sau, bam rl vio timg gdc eanh eua cuge sdng vao suy nghi cua ngydi din mi d benh vien, noi dirng gida ranh gidi mong manh sy sdng - chet cua ngudi thi vai ttd cua "van hda phong bi" eang duge bde Id mdt cich ro ring vi "phat huy" vaittdcua nd hon bao gid het" Ngay cdng doin Bd Y te phit ddng cam ket "Ndi khdng vdi phong bi" thi mdt khao sit ve vln nan phong bi vdi 6.000 dde gil cho thiy: 7% dua phong bi de cim on bic si da cdu chua; 73% dua phong bi vi sp khdng dugc bac si chim sdc tdt; 15% dua phong bi II nhin vien y te ggi y Trong eic cuge ggi den dudng day ndng cflng cd den 12,2%i y kien phin inh tinh trang hdi Id, nhflng nhilu eua cin bg y te Ro rang, ngudi benh dua tiln "bdi dudng" cho thiy thudc da phin khdng phii xuit phat tu sy ty nguyen ml II mgt sy bit huge khdng cdng khai Thye te da cd vd van chieu trd de moi tien ngudi benh: tu thu tue khim chQa benh, den ehua trj, cap 44 phit thude, sd dung eie dich vu y te Ngudi phii chju dyng dd chinh 11 cac benh nhin, nhttng ngudi dang phai ehay dua vdi thdi gian, tiln bac dl chdng choi vdi benh tit Nan tieu cyc d cle bSnh vien khdng ehi lim suy mdn dao due eua mpt bg phan can bd nglnh y ml tag nen sy phan biet ddi xd bit edng gida nhdng ngudi ngheo va nhdng ke lim tiln Dilu dd, da Ilm inh hudng din hinh inh eao quy eua ngudi thay thudc vl ei nhdng ddng gdp khdng met moi cua can bd nganh y te dang ngly dem tan vi sy nghiep bio ve sdc khde cho nhin dan Dd cd vien eg cic Iy nio di ntta, hien tugng "eho" va "nhin" phong bi da trd thinh ehuyen "thudng ngly cr huy$n" da gidng hdi chudng bio ddng Xi hgi can phii ed cic giii phip manh de chan chinh vl tang cudng giio due y ddc eho cin bg y te Men Thir ba, lgi dung chdc trich nhiem vu duge giao de true lgi cho cl nhin Sy xudng clp ve dao ddc y te khdng ehi d mdt bd phan thiy thudc d eac cd so khim chda benh ma d hlu het eie Ilnh vyc nhu bao Mem y te, cung cap thudc men, tiem chdng, eie trudng y Hien tugng phin biet ddi xd ttong kham benh theo Bao Mem v i khim tu nguyen da ttd nen phd bien Dieu ding budn la, viee ddng bao hiem y te II mot hinh thdc kha uu viet ddi vdi viec khim chua benh nhtmg thyc te benh nhan cd bio hiim y te \^\ bj gay khd khin vdi ehit lugng djch vu thip, thdi gian chd dgi nhilu va khdng dugc hudng diy du cac quyin Igi theo quy djnh Thim ehi, nhilu ea sd y tl Gido duey due cho cdn bg y ti cdn Igi dung bag Mem y te de tryc lgi, ddng Iyc Ilm gilu eua mdt bg phan tham d Hien tugng tieu eye xiy d thiy thude, dd Ii Iam dung edng nghe benh vien Holi Ddc (Hi Ndi), Phdng eao frong chin doln v i dieu trj de ehay khim da khoa Nguyin Binh Khiem huyen theo muc dich Igi nhuin" An Ducmg, phdng khim da khoa Quang Cd rit nhieu nguyen nhin din tdi sy Thanh huyen An Lao (Hii Phdng) da xudng cap ve dao ddc d mdt bg phan kMen cho ngudi din phin no ve hinh vi ngudi thay thude Dd Ii tie dgng td mat true Igi eua nhiing cin bd ao tting d eie frai eua kinh te thj trudng, du khdng quy Cd sd niy CU tinh rieng nam 2011, Bio het vio kinh te thi trudng, nhimg phai hiem xa hdi Viet Nam da thue hien kiem thda nhin rang, kinh te thj trudng vdi tta gilm djnh tai tuih va da xuat toin tic ddng tu phat eua nd, die biet 11 50 ty ddng cic ea sd khim chda benh dieu kien quan Ii nhi nude edn nhieu bit lim sai quy djnh cap, din den sy xudng eip dao dde Viec nang khdng gii thudc, sd dung chung cua xa hdi ttong dd cd ngudi Iam thudc khdng ddng quy djnh khdng cdn ttong nglnh y te Tren thye te, nhumg Ii Men tugng ei biet Cic nha thudc, quan he mua bin lanh Idng cua thj nhieu thiy thudc vi Igi ieh ei nhin da ke trudng da thim nhip vio Hnh vyc y te dan eho benh nhin sd dung thudc qui vl Ilm bien ehit mgt sd lugng khdng mdc cin tMet Xu hudng su dung thude nhd ngudi lam nghi y Dd eung la ngoai ttin lan dl thu ldi cao da khien tinh trang nhu clu khim chua benh vl nhieu cin bd y te bj ddng tien lim md eham sde sue khde eiia nhin din ting mat vl da ty minh thap danh dy eao Ien rat nhieu ma kha ning hien ed eua nginh y ehua thi dap dng Dd eung Ii cl cda nganh y Mdt frong nhumg bieu hien xudng tam Ii xem thudng elc benh vien tuyen cip dao dde cua cin bg y te II Iam dung CO sd din den tinh ttang qui tii d cle cdng nghe eao Ilm eho ngydi benh tdn benh vien tuyen tten Dieu dd tao mdi rat nhilu tien sd dung cic djch vu y trudng thuin Igi chg viee Igi dung kiem te Ding Ie ra, viee ap dung tien bg Idi Dd eung 11 han ehe td eic chinh khoa hpe edng nghe la dieu kien tdt de sich ddi vdi nglnh y, nhirng bat cap, nang eao ehit lugng kham chua benh, han ehe ttong cdng tic quin li Trong song mdt sd thiy thude d i Igi dung de sd rat nhieu Iy tten, cd nguyen nhan true Igi ea nhan Ong Nguyen Manh Ii cdng tie giio due dao ddc cho ngudi Hung, Chu tjch Tong hdi Y hpc Viet thay thudc cdn nhttng bat cap, han ehe Nam da binh luan: "Neu nhu thdi bao Do do, viec diy lui sy xudng cap dao eap ngudi thay thudc chi cd hai dgng due d mgt bd phan khdng nhd can bg, Iyc chinh Ii edu chtta ngudi benh v i ding vien, nhan dan, ttong dd cd ngudi dgng Iyc tim hieu khoa hgc thi ttong thay thude dang ttd nhiem vu cip bdi clnh thj trudng Men cdn ndi len bich ttong giai doan Men 45 Tap chi Khoa hgc xd hdi ViitNam, sd 10(83)-2014 Giai phap nang cao y dire D I khie phuc nhiing yeu kem vl y due Men ein phii ip dung ddng bd mdt he thing giii phip td kinh tl, quin Ii, phlp luat den tuyen truyen gilo due Trirdc het, gido due nhdn thirc ddy dii han ve dgo dire nghe nghiep cho cdn bo ngdnh y Trong boat ddng nghe y, quan he gida ngudi thay thudc vl benh nhin ed sy gin bd kha die biet Dilu nly dupc thi hien d chd, ngudi benh bao gid cflng d the bj ddng, the yen horn ngudi thay thudc Ngudi benh ludn phii d hoan canh budc phii lua chgn giua mgt ben Ii sdc khde, tham chi II ci tinh mang bin thin vi mdt ben II tien bae, chi phi, tinh elm Khi hg den vdi ngudi thiy thudc, hg mudn benh tinh dugc chtta trj, mong mdi dugc tu vln, cam thdng chia se vdi nhOng ldi khuyen chan tinh, ddi cdn quy gil nhu nhiing "lilu thude bo" "Ngudi thiy thude ching nhttng cd nhiem vu ciiu chua benh tat ml edn phai ning dd tinh thin cua nhttng ngudi dm ylu"*" Hom thi, ngudi benh ve co ban II khdng hiiu bilt vl y hgc bing ngudi thiy thudc Vi thi, ngudi thiy thude, nlu thilu nhin eich dao due thi de Igi dung tinh thi dl gay phiin nhilu vl true Igi Mgt khdng dat duge mue dich ei nhin, thiy thudc cd the chi ehtta eho benh nhan mgt eich qua loa, thieu trich nhiem Nhumg ein bd dang cdng tic nglnh y phii hdi du cl dao due vi nang Iyc ehuyen mdn Chi cd nhu vay, ngudi thiy thudc mdi thye Men dugc su menh cao cl duae 46 giao, dd la tri benh cdu ngudi Trong thu gdi Hdi nghj y tl ngly 27 thing nim 1955, Chd tjeh Ho Chi Minh nhin manh: "Ngudi benh phd thac tinh m^nh cua hp noi eie ed, cic chd Chinh phil phd thie eho eie cd, cie chd viec chtta benh tat va giu sure khde cho ddng bao Dd la mdt nhiem vu rat ve vang Vi vay, cin bp can phai thuang yeu, sin sdc ngudi benh nhu anh em rudt thjt ciia minh, coi hp dau ddm eung nhu minh dau ddn "Luong y phii nhu td miu", eau ndi iy rat ddng" Ro ring, da ed mot sy gin bd hflu co khdng the tieh rdi dugc giua dao due va tai ning d ngudi thiy thudc Viec phan chia ddc tii ehi cd y nghia tuang dli Bdi le, khdng thi hinh dung dugc mpt ngudi thiy thude ndi tieng ve y ddc ma lai khdng ed tai ning, khdng chua dugc nhieu ea benh hiim ngheo; ngupc lai, mgt ngudi thay thuoc tii danh tumg cim dugc nhieu ngudi benh dua ho ttd vi vdi eude sdng lai la ngudi kem cdi vl y dde Do vay, ehi ed toln tim, toln y, khdng ngung hge tap trau ddi nghi nghiep, ngudi thiy thudc mdi thi Men dugc dao due cua minh hinh nghi Vi thi, ngudi thiy thude t(r thiy minh ed bdn phan phue vu ngudi, phuc vu ly tudng cua nghi y, thi hg ludn phii sue hge tip, nang cao trinh dg vl thi hien dao due cflng nhu tai nang hoat ddng nghi nghiep '" Thu H6 Chu Tjch gui Hpi nghj quan y thang nam 1948 Gida ducy dire cho cdn bgyte Danh y Le Httu Trie da timg viet: "ludi, ddt 11 nhimg tdi m i ngudi thay thude chin chinh phii trinh xa" Ddi vdi dng, ludi, ddt khdng chi la chi bao ve sy non kem ehuyen mdn ml edn 11 chi bio ve mat dao ddc, li phin gil tri ve dao due Giio due dao dde cho ngudi thiy thudc khdng cd nghia la giio due dao ddc sudng, chung chung, phi thyc te Gilo due dao due cho ngudi thay thudc nghia la giao due dao Ii lim ngudi, gilo due nghia vu edng din; ddng thdi eflng ed nghia II giio due Idng yeu nghe, yeu thuong ngudi benh, 11 giio due tinh thin va y ehi, nghj Iyc hgc tap ren luyen de tmh thdng y thuat va the Men sy tinh thdng ly viec trj benh edu ngudi VI chinh ttong qua ttinh chd dgng tieh cyc tiep nhan gilo due nhu v^y m i nhin eich ngudi thiy thude duge hmh thanh, phat triin, duge kiem ehiing, duge khing djnh tren thyc te Theo nghia dd, giio due dao ddc cho ngudi thay thude II giao due nham hinh thinh nen ting nhan each ngudi thay thudc vl viee nang eao nhan thue ve nghe nghiep cho cin bd y te phai duge dat len hing diu Vi the, viee gilo due y ddc can phai Iam ro nhthig nhin thuc dd, nhit II dao ddc nghe nghiep eua nganh y Thir hai, ddu tu vd tdng cuang cdng tdc qudn ly nhd nu&c ngdnh y Tieu cyc nglnh y te v i sy xudng cap ve y ddc lien quan den dieu kien lam viec, co sd vat ehat va trinh dp ehuyen mdn, cie ehe dii ngd eua nganh y te Vi the, nha nudc can tiep tue diu tu eo sd vit ehat eho nginh y te; thyc Men da dang hda cie djch vu khim chua benh; huy ddng eae ngudn Iuc ttong vl ngoli nudc; xly dyng cic quy trinh, quy pham quin ly chuyen mdn, eae khiu lien quan den tinh mang ngudi benh nhu cap ciiu, hdi sue, sinh sin, tiem ehdng Cin tiep tuc ning clp CO sd vat chit eua cie benh vien vl eie phdng khim td myen trung uong va co sd Die biet chu trpng ning cao tay nghe chuyen mdn, bdi dudng dio tao, dio tao lai eho dpi ngfl cin bd nganh Cham lo tdt cho ddi sdng ein bd nhin vien cl ve vat chit vl tinh than dl hg yen tim edng tic Quan tim giii quyet tdt eie che dp bdi duang da duge quy djnh, ehu y den eie ein bd y te d viing slu "vdng xa, bien dio Dau tu cho cic trudng y v i tiep tuc hoan thien ehuong trinh dao tao, ttong dd ed viee tang sd tiet giing va thyc hanh ve y due eho sinh vien Lim tdt cdng tic thi dua khen thudng, ddng vien kjp thdi nhumg ci nhin guomg miu, tan tinh phuc vu ngudi benh, xd Iy ngMem khac nhirng bilu Men thieu ttaeh iiMem giy phien nhieu cho benh nhan va Iam tdn hai den uy tin cua nginh Thir ba, tdng cuang cdng tdc kiem tra tra hogt dongy te noi chung, gido due y dice ndi rieng cd khu vuc y te cdng vd khu vuc y te tu nhdn Hoat ddng y te d nude ta Men rit da dang bao gdm ea khu 'vyc y te edng v l y te tu nhan Chu truong xa hdi hda y te dan den gia tang cac co sd ngoli cdng 47 Tgp chi Khog hgc xd hgi Viet Nam, sd 10(83) -2014 lap viec chim sde sdc khde eho nhan dan Vdi khu vye y te tu nhan, tham gia boat ddng d Hnh vye hp khdng thi khdng tinh din doanh thu, Igi nhuan Ben eanh nhdng phdng kham, benh vien chit lupng, nhttng nhi thudc uy tin, thdi gian qua, eflng da xuat hien kha nhieu nhttng hien tugng tieu eye trgng khu vye y te tu nhin Dd II sy Ida dio, bat ehet, tang gii djch vu hole vd trich nhiem vdi ngudi benh Vi the, Bd Y tl cin phdi hgp vdi eic eg quan chuyen nglnh, elc sd y te cic dja phuang tang cudng kilm tta tra cic hoat dgng y te va y due ca khu vuc y te cdng vl nhat la d khu vyc y te tu nhin Tiep tuc thyc Men cic quyet djnh sd 256/QD-Bd Y tl ngly 21 thing nam 1999 vl tieu chuin eu the phan diu ve y ddc ap dung eho mdi ci nhan, tip the, khoa, phdng v i benh vien tit ci cic CO sd kham chda benh; Quylt djnh sd 2965 QD-Bg Y tl 30 thing nim 1999 cua Bd trudng Y tl ve kiem tra danh gia boat ddng edng tie ehuyen mdn; Dl in "Diy m?nh eii cich che dp cdng vy cdng chdc cda Bd Y tl giai doan 2013 - 2015"; Kl hoach sd 49 triin khai thye hien chi thj 03 CT/TW eua Bd Chinh trj vl "Tilp tuc diy manh hpc tap v i Ilm theo tim guong dao ddc Hd Chi Minh" ciia nganh Y t l giai doan 20II -2015 d eic Hnh -vye ehu khdng rieng gi nganh y te Trong dd viee ren luyen dao ddc lai II mdt qui frinh gian khd kien tri cua mdi mdt ei nhin Vi the, giio due dao ddc ndi ehung, y dde ndi rieng II rit cin thiet Diy cung II yeu cau dang djt hien ddi vdi ein bd y te nudc ta bdi clnh nhilu hien tugng tieu cue cua nginh chua bj day Idi, nhit la sir xudng eip ve y ddc cua mgt bd phan thiy thude Do do, nhan thde ddng tim quan trgng eua giio due y dde, nhan dien diy du thuc trang va ed elc giai phip phd hgp de nang cao y dde la mpt nhiing nhiem vu hing dau cua , nganh y te Viet Nam hien vl thdi gian tdi Tai liiu tham khdo Thanh Le (Suu tim va bien so&n) (2004), Tu ludng Hd Chi Minh vi dgo due mdi, Nxb Thanh nien Ha Npi Bp Y tl (2002), Ngdnh y li Vifl Nam vOng budc vdo the ky XXI, NxbYhpcHaNoi Thu Ho Chii Tjch giri Hpi nghi quan y thang nam 1948 Thu gOri Hpi nghj y tl 27/2/1955 ciia Chu tjch H6 Chi Minh Vu Khieu - Thanh Duy (2000), Bgo due vg phdp ludi qudn ly phdt triin d Viil Nam, Nxb Khoa hpc xa hpi Ha Npi Trin Van Binh (2011), Xdy dung vdn hoa, dgo diic, ldi sdng cita ngudi Viit Nom, Nxb Kit lu^n Dao due, la phuang dien ca ban ddi sdng eua edng ddng cung nhu tdng el nhin Mat trii eua kinh tl thj trudng da tie dgng din dao due cua mgi ngudi 48 Quan dpi nhan dan Ha Npi Bp Y te (2010), Bdo cdo chung Idng quan ngdnhyli ndm 2010, Ha Npi Bp Y tl (2011), Bdo cdo chung long quan ngdnhy te ndm 2011 Ha Npi ... diy du cac quyin Igi theo quy djnh Thim ehi, nhilu ea sd y tl Gido duey due cho cdn bg y ti cdn Igi dung bag Mem y te de tryc lgi, ddng Iyc Ilm gilu eua mdt bg phan tham d Hien tugng tieu eye... hoat dgng y te va y due ca khu vuc y te cdng vl nhat la d khu vyc y te tu nhin Tiep tuc thyc Men cic quyet djnh sd 256/QD-Bd Y tl ngly 21 thing nam 1999 vl tieu chuin eu the phan diu ve y ddc ap... nhu nghe y va nhQng anh thai eua cin bd y te ngudi thiy thude cd "quyen lye" ddi vdi ngudi benh bat ke dja vj nio cua hg Cic sd tten day cho thay sy thd Dilu dl din den Iam dung quyen o, thii

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