Two decades ago, I joined doctors and a civil society group with an ambitious dream – making affordable healthcare accessible to every Thai.
Led by visionary Dr Sanguan Nitayarumpong, the group managed to convince Thailand’s political leaders and gained public support to launch the Universal Coverage Scheme (UCS) in 2002.
The government at the time founded NHSO to manage the scheme and Dr Sanguan became NHSO’s first secretary-general. Since then, I have been working for the NHSO and have watched it grow from a small governmental unit to the most crucial player in the Thai health system.
Today the NHSO employs more than 1,000 people and looks after some 49 million UCS beneficiaries. I am honoured to be part of this organisation and to be elected as the current secretary-general.
NHSO has made a big mark as it manages the most significant social welfare scheme ever established in Thailand. However, it needs to move beyond its previous successes and become a “future-oriented organization” – a direction I aim to take it to in the four years of my term.
Becoming future-oriented means NHSO must be ready to adapt, be flexible and resilient to overcome the different challenges lying ahead.
It needs to address challenges in four areas, namely the people, health services, finances and organisational development.
The people, who are diverse in terms of age, background, health conditions, and social strata, have different things influencing the state of their health, hence they all have different healthcare needs. For instance, the elderly need community-based long-term care. Ethnic minorities living in remote villages may need telehealth, while the homeless in cities may need mobile health services.
So, how can NHSO cover everybody’s health needs as well as protect them from catastrophic bills?
Currently, the quality of health services provided is of great concern. People often crowd hospitals seeking quality care. How do we improve access to primary care so people do not get sick and fill up hospital wards?
Finding a sustainable health financing model is another challenge. As the cost of public healthcare is rising every year, we need to implement a cost-effect financial model, find new funding sources and ensure good governance through real-time audits, responsive reimbursement and effective monitoring and evaluation.
A study conducted by Chulalongkorn University's Faculty of Medicines found that the efficiency of the healthcare system rises by 10 per cent if the efficiency of the management system increases. No matter how big the health budget is, public health care will only be effective if services are of good quality and provided efficiently.
In the next four years, we shall focus on boosting UCS management's efficiency in controlling rising costs and improving the quality of healthcare. That can be done using several strategies, including implementing health promotion and disease-prevention programmes, reducing the length of stay at hospitals while focusing on community-based care, and cutting the cost of medical supply procurement by effective negotiation with suppliers.
Moreover, NHSO and staff need to adapt to changes as well as adopt the concept of lifelong learning and developing new skills and abilities. NHSO will also require digital transformation to speed up our work and improve UCS funding management.
A merit system will be promoted and prioritised to encourage staff to do their best in serving UCS beneficiaries and the NHSO mission.
The NHSO will also find more partners to achieve that mission. Under the last secretary-general, Dr Sakchai Kanjanawatana, collaborations were built with several partners including the Public Health Ministry, health professionals and private health providers, to deliver health services to UCS beneficiaries.
Other important partners are UCS beneficiaries. We will boost participation channels, including social media and face-to-face public consultation, to get an idea on how to improve UCS. Each idea is vital to our future as we are still far from perfect.
The media and the international community often portray the NHSO as a 100-per-cent successful organisation, which may be misleading as all organisations experience failure first before becoming successful.
A future-oriented organisation does not just focus on its past successes but also considers its failures and challenges as lessons learned for the future. This is the path NHSO will take, so it can always find room for improvement and never stop looking for ways to achieve its missions.
#NHSO #UHC #NHSOThailand #UCSThailand #UHCThailand #HealthForAll
Published : April 23, 2021
By : Dr Jadej Thammatacharee Secretary-General of National Health Security Office