[Inside Chodong] What National University Hospitals Must Do to Safeguard Regional and Public Healthcare

The government is pursuing a national policy initiative to transfer oversight of national university hospitals from the Ministry of Education to the Ministry of Health and Welfare and foster them as regional hub hospitals. However, the process does not appear to be progressing smoothly. The Ministry of Health and Welfare maintains that national university hospitals should be transferred under its jurisdiction to enable expanded financial investment and systematic management. In contrast, the hospitals themselves have expressed strong reservations, arguing that their educational and research functions may be diminished and that university autonomy and identity could be undermined.

At the National Assembly’s Health and Welfare Committee audit on October 15 and the Education Committee audit on October 22, Jeong Shin, Director of Chonnam National University Hospital, stated, “As the head of a regional hub hospital, I agree with the government’s policy direction,” but also expressed concern, saying, “If transferred to the Ministry of Health and Welfare, there are worries that the hospitals’ functions will be strengthened more in terms of medical care and administration, rather than education and research.” Survey results were also disclosed, showing that 73% of the more than 1,400 national university hospital professors surveyed opposed the transfer.

Legally, national university hospitals are affiliated institutions under the Ministry of Education, but in practice, they have served as the leading public medical institutions in their respective regions. They provide care for severe and emergency patients that local medical centers or small- and medium-sized hospitals cannot handle, and they also take on areas that private hospitals tend to avoid, such as infectious diseases, trauma, and rare diseases, all while training future medical professionals.

However, most have suffered from chronic budget shortages and operating deficits for an extended period, making it difficult to invest properly in facilities and equipment. Their financial condition has further deteriorated due to the COVID-19 pandemic and mass resignations of medical residents. Unlike private hospitals, they operate as public institutions and have limited means to increase their own revenue. Restrictions on total personnel costs and staffing levels have also resulted in relatively low salaries for medical staff, worsening the physician recruitment shortage. This physician shortage has led to reduced patient volume and expanded deficits, creating a vicious cycle that ultimately threatens the collapse of regional healthcare. For this reason, the issue of transferring national university hospitals to the Ministry of Health and Welfare has been discussed multiple times since 2005, but each time, opposition from hospitals and universities has caused the issue to fade away without resolution.

Ultimately, the core issue is not which ministry has jurisdiction, but how national university hospitals should be defined. It is essential to clarify whether they will remain as “university-affiliated institutions” or move forward as “regional healthcare centers.” If they are transferred to the Ministry of Health and Welfare, there must be an institutional framework that maintains their educational and research functions while strengthening their role as hospitals responsible for regional healthcare. The principle of reinforcing public healthcare must remain central, and detailed institutional design is needed to ensure that hospitals’ educational and research functions are not undermined.

The Ministry of Health and Welfare plans to complete the transfer of national university hospital work within this year and foster them as regional hub hospitals to strengthen local, essential, and public healthcare. The ministry has also promised to improve regulations on personnel management, such as salaries, upon transfer, and to provide robust support to enhance the clinical capabilities of national university hospitals.

There is not enough time to be caught up in inter-ministerial power struggles or negotiations over vested interests. If the transfer debate, which has been repeated for 20 years, fizzles out once again, our society will miss yet another opportunity for public healthcare reform, and if national university hospitals fail to fulfill their roles, the collapse of regional healthcare and the concentration of patients in the capital area will inevitably continue. In every decision, the highest priority must be safeguarding the lives and health of the people.