It's time to fix Thailand's dire healthcare system

In outpatient wards, nobody smiles, be they patients, their relatives, nurses or doctors. Patients and relatives are forced to play a waiting game, waiting for their files from the records room and praying they can see a doctor before service hours end. 

As they wait, they have no clue when they will sit in front of a doctor. Nurses and doctors, meanwhile, are apparently under stress trying to manage time so all the patients can see a doctor.

Such noisy and stressful environments raise a few questions? What has happened to Thailand’s healthcare systems? Should Thailand be pleased with the World Bank’s praise of its universal-coverage healthcare scheme? 

According to 2012 records, there were just four doctors per 10,000 people in Thailand. Add the unequal distribution of doctors at state compared to private hospitals and the problem is more acute. 

Long queues are normal at state hospitals. The more famous the hospital, the longer the queue. Only those with enough money can skip these long queues by seeking medical services from private hospitals. 

But what about the millions who don’t have the money? As they waste hours waiting, the doctors are getting overwhelmed. 

Academics say the risk of human error climbs when doctors have to handle long hours and rush to check patients each day. On average, each doctor at outpatient wards tends to 100 patients a day. Will the relevant authorities do anything to address this problem? 

Some medical experts believe Thais in general should share the flak as they go to hospital for non-serious complaints such as a cold. But other experts have argued that Thais on average see a doctor just a few times each year. This is far below the 6.5 visits a year for people living in Organisation for Economic Cooperation and Development nations, and the 13 visits a year by South Koreans and Japanese. 

As patients and doctors lament the state of the medical system, the relevant authorities need to rethink their approach. If both the service users and service providers are not happy, the system definitely needs an overhaul.

All stakeholders must come forward this time, air their concerns and explore solutions. If doctors feel they are overwhelmed with work, speak up. If patients feel the free medical services provided by the universal-coverage healthcare scheme make them feel helpless, speak up. 

If someone feels a few minutes with a doctor may not be enough for a proper diagnose, speak up. If doctors feel it’s nonsense for people to flock to famous hospitals out of concern that the doctors at less well-known hospitals may not be good enough, speak up. 

If hospitals feel patients just don’t understand the process of delivering healthcare services, or fail to accept the responsibility of taking basic care of their own health, they have to speak up. 

All sides need to raise their points, and discuss issues together. Only by doing that can all sides explore solutions together and opt for practical ones. 

There are so many problems with the country’s healthcare system. All sides concerned must tackle them, including the National Health Security System, the Social Security Fund, the Comptroller-General’s Department, the Public Health Ministry and private hospitals. 

It is the duty of all stakeholders to come forward, lay their cards on the table and discuss the possibility of overhauling the system. An overhaul is needed. The faster it is done the better.