A gloomy reality was highlighted last month when a picture of a tooth unit using a frog-hunting head torch in Ratchaburi province’s rural community hospital went viral.
The clinic, which is close to the Thai-Myanmar borders, had been struggling for three years because its request for new equipment was unresponsive.
Only after the outcry over social multimedia did the Ministry of Public Health rescind the funds with immediate effect.
Tanao Sri’s history may have come to an end that was positive, but many other state-run clinics are still in crisis, according to experts.
The Ministry of Public Health reports a 9.5 % decrease in income from healthcare services fees across the public hospital program, dropping drastically from 60 billion ringgit to 40.6 billion ringgit this fiscal year.
At least four of the largest institutions global are reportedly experiencing a severe financial crisis that calls for urgent financial assistance to stay in activity.
Chutinart:” Quite poor working conditions”
A personnel exodus, to
According to Chutinart Chinudomporn, the Thai Frontline Physician Union’s representative, the issues go beyond the budget.
She claimed that 18 assistant physicians from Bueng Kan Hospital recently resigned from the northern state of Bueng Kan.
According to Dr. Chutinart, the working environment at state hospitals was “zombie-like,” with crammed workloads, bad work-life balance, organizational injustice, and weak salaries.
Some doctors work up to 100 hours per month, which is more than twice the labor law’s 45-hour workweek, mainly as a result of Thailand’s large person demand under Thailand’s 30-baht universal healthcare system.
More doctors and healthcare workers may retire without serious structural reform, according to Dr. Chutinart, noting that staff shortages have already caused longer wait times for treatment. In the end, patients will suffer.
On average, 455 specialists left the public sector between 2013 and 2022.
One dentist in the public health system serves roughly 2, 000 people, which is twice the recommended amount according to the World Health Organization, she said, with around 24 000 physicians under the government.
The government is attempting to increase the number of specialists to make up for this, but she contends that this tactic does not address the root cause.
She contends that a significant overhaul of the system is required to give medical practitioners greater equality and justice. No one will decide to stay, she continued, “without a sympathetic work environment.”
According to Suwimol Namkanisorn, co-founder of Nurses Connect, an organization of medical professionals, midwives also face similar problems.
She claimed that more than 7, 000 nurses leave state institutions annually, many of whom relocate to private clinics or change careers.
Some state institutions ‘ caregivers and support staff are paid untenable income, she said. Some, especially support staff like stretcher personnel, make far below the minimum salary that the law requires.
Because workers at state institutions, which are run by the government, are not subject to traditional labor laws but instead are.
True healthcare reform calls for collaboration across all facets, not really solutions for doctors, according to Ms. Suwimol. She said,” Leaving nurses and additional staff on does not repair the system.”
Suwimol: Midwives need better give.
administrative chaos
Ms. Suwimol also cited the state hospitals ‘ lack of funds mobility.
In order to increase management freedom, she suggested allowing the Ministry of Public Health to work independently from the Office of the Civil Service Commission.
According to a recent survey conducted by the Medical Council of Thailand, 84.8 % of the 2,431 state hospital volunteer doctors were unhappy with their problems. Alarmingly, 35 % of employees said they planned to quit before their jobs actually begin.
Poor working environments, which include unfair hierarchies ( 61.4 % ), heavy workloads ( 51.7 % ), and low pay ( 42.9 % ), were among the main causes cited.
The Health Systems Research Institute ( HSRI )’s deputy director, Jarauyporn Srisalux, also proposed changes, including flexible employment practices, outsourcing, and pay scales tied to headcount budget allocations.
She also supported a raise of the maximum fine for assistant physicians who violate their deals from 400, 000 to 2.5 million baht, which would encourage resignations.
The “autonomous clinic” model, in which hospitals manage their personal finances and operations freely while also receiving government support, is another long-term option being considered.
Since gaining freedom, Banphaeo General Hospital in Samut Sakhon has grown in revenue and improved working conditions for its employees.
The sole state hospital in Thailand that is a cross between the government and the private sectors and operates autonomously from the standard administrative system.
In order to meet the requirements for a loan from the Asian Development Bank ( ADB), it was established in 2000 as part of a reform of the healthcare system.
Jarauyporn: The program must be adaptable.