Hospitals fear major impact of legal advice

MEDICAL service providers and patients stand to experience a huge impact from the State Council’s ruling on universal health coverage, which could prevent its budget being used for hospital utility expenses and preliminary financial assistance in medical malpractice cases.
But, to prevent massive adverse impacts, the National Health Security Office (NHSO) board resolved yesterday that it would continue with its current budgetary practices.
“I will take responsibility for this and so will other board members,” Public Health Minister Piyasakol Sakolsatayadorn said in his capacity as chairman of the NHSO board. “This is because we have to act in the public interest”.
He added that the NHSO board also planned to appeal the ruling.
Using a budget of about Bt165 billion, the universal healthcare scheme covers about 48 million people.
Though it has managed the scheme for a long time, questions have recently emerged on whether the NHSO has used the funding properly. Hence the case was taken to the State Council.
Late last year, it was concluded that some funding was being wrongly spent on hospitals’ utilities, providing initial financial assistance for medical malpractice victims and for procuring equipment via the Government Pharmaceutical Organisation (GPO).
If the ruling is enforced, many |hospitals will also not be able to hire temporary workers or pay overtime.
Nimit Tien-udom, former NHSO board member, said such a ruling could destroy the very principle of the scheme and cause huge problems.
“It will significantly increase the financial burden on hospitals, as they use this budget to cover operational costs and staff salaries. This ban will see the hospitals face financial crisis and affect the morale of medical staff.”
He also said that procuring equipment in bulk through a central system made it cheaper than purchasing it separately.
The Thai Kidney Club said the scheme’s budget management was very beneficial to chronic kidney disease sufferers.
Piyasakol said he has already asked State Council representatives to explore solutions with the Public Health Ministry and the NHSO.
“For the short term, we may need to amend regulations. For the long term, we may have to amend the Act to facilitate smooth operations,” he explained.
Betong Hospital’s director Banyong Laocharensuk revealed that the scheme’s budget restrictions would not really affect his hospital, because it already had funding to cover operational costs. However, some hospitals may face problems if they do not have enough funding.
Dr Wasan Udayachalerm of the Cardiovascular Interventional Association of Thailand, however, said he was not that worried about the ruling when it came to the procurement of medical equipment, such as the purchase of stents.
Wasan said he believes it would be more appropriate to let hospitals purchase stents for heart-disease patients directly instead of having the NHSO purchase them for the sake of transparency.
“Though the NHSO can purchase them at a cheaper price, the stents are not always of the best quality and many models are not even being used in many countries.
“Therefore, it would be better to have the hospitals purchase their own stents using NHSO funding,” he said.