The secretary-general of Thailand\'s National Health Security Office has met with Vietnamese officials to recommend ways the country can deal with a funding crisis facing its national healthcare programme.

Thanh Nha vice-president Chu Thi Du visits patients in the hospital’s kidney dialysis unit which is operated by the private sector as a part of efforts to cut state funds for medical services. ONNUCHA HUTASINGH

Winai Swasdivorn shared his experience running Thailand\'s national healthcare scheme during a visit to Hanoi. Dr Winai handed over his chairmanship of the Asian Social Security Association to his Vietnamese successor last month.

Vietnam is extending its healthcare scheme to cover more than 85 million people in the next four years. Sixty-two percent of the population are now covered, according to a survey released in June.

The NHSO\'s universal healthcare scheme covers some 47 million people. The programme costs the country up to 100 billion baht a year, or 22% of the government\'s annual budget.

The Vietnam Social System (VSS) has been established as an independent organisation to manage the fund, which is derived from state subsidies and monthly contributions from employers, employees, state officials and anyone else who chooses to join the scheme.

Patients under the scheme are required to pay from 5% to 20% of their medical bills.

The VSS faces funding difficulties because of limited contributions. Many workers and students say they cannot afford the contributions, while employers often lie to the government about staffing levels to avoid having to pay into the fund, said Nghiem Tran Dung, vice-director of Vietnam\'s Health Insurance Department. Dr Winai said it was "natural" for people to avoid having to make payments if they are not forced.

He suggested that the VSS upgrade its information systems to keep a thorough database of fund members.

Vietnam is taking measures to stop employers from cheating on fund contributions. Last year, 150 employers were charged with avoiding payments worth 71.1 billion Vietnamese dong (107, 215 baht).

The lack of support for the fund has brought many hospitals in the country to a crisis point.

Thanh Nha, the fourth largest hospital in Hanoi, is an example of the strain placed on facilities by the lack of funding.

"The more people the national health security covers, the more patients at the hospital," said Thanh Nha vice-president Chu Thi Du.

Patients crowd the hospital\'s halls waiting for doctors and directors are forced to seek revenue from a variety of sources, such as collecting parking and toilet fees to soliciting donations and working with private companies, to provide services to employees, the doctor said.

Patients are left to wait for hours.

"I left home at 4am. It\'s 2pm now and the doctor hasn\'t called me yet," said Hoang Thi Nheau, 65, who was awaiting treatment at the hospital for her diabetes.