Medical heavyweights battle over healthcare funds
Play
KEY PLAYERS in the country's healthcare sector are clashing over how to spend the state healthcare budget.
The conflict has worsened to the point where the Thailand Regional and General Hospital Society has made it clear it will no longer submit reports on additional treatment required by patients under the universal healthcare scheme to the National Health Security Office (NHSO).
NHSO, meanwhile, has reacted by publicly expressing concern that the failure to submit the reports might affect the medical welfare of many.
The society hit back by pointing out that its move is intended to heap pressure on the NHSO, which is seen as failing to spend the available budget efficiently.
“We believe the budget-management method used by NHSO does not deliver maximum benefits to people,” the society’s president Suthat Sriwilai said yesterday.
This is in addition to the fact that the Public Health Ministry has itself complained several times about the NHSO’s budget management.
NHSO runs the universal healthcare scheme, which covers about 49 million Thais.
The NHSO has defended itself from criticism by the Public Health Ministry over budgetary mismanagement and insufficient funding. It has issued a white paper to dismiss the ministry’s claims that many government hospitals faced severe deficits because the NHSO was servicing non-contributing patients.
Initially launched as the Bt30-per-medical-visit scheme 12 years ago, the universal healthcare scheme is now deemed problematic by the ministry, which supervises government hospitals. The ministry believes many state hospitals are financially staggering because of non- or delayed payment of NHSO-allotted money to government hospitals.
At a press conference in early December, permanent secretary Dr Narong Sahametapat accused the NHSO of non- or delayed payment, and also channelling budget funds for what should have gone to hospitals or to non-hospital agencies.
Shortly after the press conference, which was attended by a large number of government doctors siding with the ministry, chiefs of provincial public health offices and directors of general and normal state hospitals, NHSO secretary-general Dr Winai Sawasdiworn publicly accused Narong of having little knowledge about NHSO’ operations.
Winai also countered Narong's allegation that doctors working under the NHSO scheme spent more time on making reports than on giving treatment. Winai said that making such reports was part of the job and should not be deemed as an extra burden on their regular duties.
NHSO said its operation was a new way to run the country's public health service. It served patients on budgetary principles based in their age ranges and age structure, instead of giving money on the basis of areas where patients lived, a system to which the ministry and government hospitals had long prescribed.
NHSO has collaborated with local administrative bodies and jointly provided a mechanism to protect patients’ rights, providing them with greater access to public health services, said the white paper.
The universal healthcare scheme has long been a subject of debate. Critics wonder why medical services to the scheme’s non-contributing patients are better than those for members of the 5-year-old social-security scheme that collected financial contributions from its members.
Several medical workers also complained of heavy workload, and many hospitals lamented about how difficult it was to deliver medical services under very tight budgets.
The medical personnel who are against the universal healthcare scheme, together with many contributing social-security beneficiaries, have asked for intervention by the National Council for Peace and Order (NCPO), after it seized power last May, to solve the country’s public-healthcare problems once and for all.
On “hospitals facing deficits” claims, the NHSO white paper said many factors were involved, including the government’s failure to provide an adequate budget for public healthcare and services provided for other healthcare programmes, such as the medical benefit scheme for civil servants.
The Public Health Ministry has been pushing for a plan to allocate a budget based on “healthcare zones”, suggesting that NHSO hand over money to the ministry’s healthcare zones so that budget distribution becomes more efficient at the hospital level and resources can be shared.
Narong said this approach should help improve quality in the medical service and decrease deficits faced by the 105 government hospitals.
He said the deficit was serious at the hospitals and his ministry had found that the disbursement of Bt4.1billion for hospitals participating in the universal healthcare scheme remained pending between 2006 and 2014.
Major players had been trying to back their claims with information from their perspectives.
The bottom line, however, is not about which side can present the most convincing argument. What really matters is which approach will serve the best interests of the public.
Major players in the field must recognise that their moves affect millions of Thais.
Don’t take the fight or quarrel here personally. Their priority should be how the public benefits.
