More
doctors needed in state hospital system
Ammar Siamwalla, a scholar at the Thailand
Development Research Institute (TDRI), believes the government's plan to
increase medical services fees will stem the ongoing brain drain from state
hospitals to private institutions
Mr Ammar said the fee hike will attract
medical staff, especially doctors, with state hospitals currently facing a
shortage of physicians. However, he warned the policy must be implemented with
care.
"I agree in principle with the hike on
medical services fees but the government must flesh out the policy more to make
it work effectively," Mr Ammar said.
The Foundation for Consumers (FFC) earlier
slammed the ministry's plan to increase medical treatment fees by 5-10% on
average at every state hospital, saying it could create chaos in the healthcare
system.
The FFC warned the hike may encourage private
hospitals to boost their fees in line with the increase at public hospitals,
which could result in higher health insurance premiums.
The higher fees will take effect soon for
patients who are not covered by the country's three health schemes _ the
30-baht universal healthcare scheme, the social security fund and the state
officials' scheme.
About 99% of Thais are members of one of
these three health schemes.
Mr Ammar is worried about the government's
plan to turn Thailand into an international medical services hub. He said this
would drive physicians away from state hospitals.
Private hospitals catering to medical
tourists have lured many skilled physicians and specialists away from public
and university hospitals. That will reduce the quality of service at state
hospitals for the majority of Thais, he said.
He said TDRI research in 2008 on the impact
of medical tourism found that it had the effect of raising medical services
fees in Thailand to cover physicians' incomes.
TDRI said the Public Health Ministry doubled
physicians' salaries in all community hospitals in 2008.
The research was published in the World
Health Organisation's online bulletin in 2011.
Mr Ammar said that the government's policy of
promoting medical tourism had caused physicians' incomes to rise.
"The government's continuing support for
medical tourism will result in physicians' incomes rising even further,"
he said.
He said it was not yet certain if the fee
hike would encourage operators of private hospitals to follow suit by raising
their own rates.
He also said the public health system does
not have a regulator ensuring that fees are maintained at a reasonable rate.
This lack of regulation has resulted in a large gap in the quality of
healthcare available between the rich and poor.
Dr Thaworn Sakunphanit, deputy director of
the Health Insurance System Research Office, said medical labour costs in state
hospitals have soared in the past four years.
Medical labour costs in state hospitals have
increased by about 6% each year, he said, although medical technology costs
have fallen as technology has become more accessible.
Salaries at state hospitals have been
increased at more frequent intervals than at private hospitals to catch up with
the higher pay on offer at the private institutions, Dr Thaworn said. Medical
staff are attracted to private hospitals because of the higher pay.
The government is under pressure to increase
pay further to retain medical staff at state hospitals, he said. This has
become a major cost for the healthcare system.
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