Hospitals bleeding to death as govt stands dithering

It seems ironic that while the government has been quick to use give-aways to buy its way out of other problems, it has chosen to drag its feet over the critical issue of 17,000 state-employed nurses on temporary contracts.
The nurses are asking the Public Health Ministry to fulfil its pledge to improve their job security by giving them permanent status. Otherwise, say the nurses, they will have to quit in January and find work at private hospitals.
If the nurses do quit, it will take a huge toll on the quality of healthcare in the public hospitals where they currently work. And even if some of them decide to stay, the lack of job security afforded by their temporary status would affect their morale, which would likely affect the quality of their care.
Despite this, the ministry has so far been unable to provide clear answers to the nurses or to the public – who would obviously suffer too should the level of healthcare in state hospitals be allowed to deteriorate.
The main obstacle to resolution of the issue is an order by the Office of the Civil Service Commission to freeze permanent employment so as to curb public spending. The government is trying to cut its budget by rehiring state employees on a temporary basis. In fact, many of the nurses have been working on temporary contracts for a decade or more.
No, the issue is not a new one, but finding a solution has been put on the backburner by a government more concerned with eye-catching schemes. In addition, the solution would likely require the removal of the Civil Service Commission’s prohibition against hiring new permanent staff.
Such a change would require a decision from the top, since both the Health Ministry and the Finance Ministry would be involved.
Last week the nurses rallied outside Government House to draw public attention to their plight. The protest was only the latest manifestation of a chronic shortage of nursing staff that has affected healthcare in public hospitals for years.
Each year, nurses on the temporary contracts quit in search of better job security, as offered by private hospitals. The Thailand Nursing and Midwifery Council reports that demand for nursing staff from private hospitals has doubled, to 2,000 per year over the past five years, and that private hospitals pay as much as Bt40,000 a month for nurses with more than four years’ experience.
The result is a shortage of staff in public hospitals, with nurses who have chosen to remain forced to work longer hours to make up the shortfall.
The situation needs to be resolved soon if further damage is to be avoided.
First, the government has a duty to set a standard for other employers by taking good care of employees who do their job well.
Second, the issue threatens Thailand’s growing reputation abroad as an international hub for medical care.
Meanwhile, the 2015 launch of the Asean Economic Community will put yet more pressure on our state hospitals, with nurses given the freedom to work in other Asean countries where welfare benefits are better. Nurses are among the skilled workers who will be given freedom of movement within the Community.
The Yingluck government is mandated to provide a healthcare service that is adequate to the public’s needs. Given its massive misspending on populist policies, it cannot complain about the fiscal burden of providing such a service.
This issue is a wake-up call for the government. It must be more cautious in its spending, focusing on sustainable projects that are in the best interests of the public, rather than wasting taxpayers’ money on quick fixes.