I was in Da Nang, the 3rd (more or less) largest city.
There are 3 major private hospitals there:
Family;
Hoan My;
Vinmec.
They all have an International Department.
I used all 3.
My experience was that they are on a par with Bangkok Chiang Mai and Ram.
As far as not speaking English, in general it was not a problem but even if they told me "Yes, the Doctor speaks English" I would ask for a Translator/Nurse Helper to be there.
But it was rare if the translator in Vietnam was actually needed, and several times they took off once it was clear that the Dr. and I could communicate in English.
As you mention, I recall one older Dr. in Vietnam where a translator was fully necessary, perhaps 2, perhaps one younger Dr.
But the translators took care of that issue.
In CM, the 2 people at the International desk take care of translating if needed, and at Bangkok CM I don't know.
Come to think of it, I don't think I've ever insisted on having an English speaking translator at the 2 CM Hospitals.
In Da Nang, Family had at least 4 Nurses/Nurse Helpers with very good English and I would always make sure I could get one to come with me just in case.
(They had an American GP working there for awhile).
At Hoan My I found one when I first went there and would always have her come with me.
Vinmec had 2, both had excellent English. I had 1 accompany me most of the time, but I don't think it was ever necessary.
Vinmec was a bit more expensive than the other 2 and newer, more like Bangkok CM here vs. Ram.
I don't think I ever asked for a translator in CM so English is more of an issue at the Vietnam hospitals but it was always overcome without it creating much of a problem.
As far as Vietnam not being set up for medical tourism, I don't know exactly what you mean so can't agree or disagree.