Higher penalty if doctors flee mandatory public service

By THE NATION

 

File photo

 

Medical council says other changes needed to keep state hospitals staffed.

 

THE PUBLIC HEALTH Ministry plans to significantly increase the penalty from Bt400,000 to Bt2.5 million for doctors defaulting on their required state service after they graduate from state-run medical schools. 

 

The plan will be submitted to the Cabinet for approval soon. 

 

Although the proposed penalty is much higher than the current fine, it is still half the amount initially proposed. In July, it was proposed that the penalty be increased to Bt5 million given the actual cost of educating doctors. 

 

The Office of the Attorney-General (OAG) had recently nudged the Public Health Ministry to review the Bt400,000 penalty, which was first introduced in 1973. The low penalty came to the OAG’s notice when it was studying the draft of a contract that the Public Health Ministry planned to have medical students sign. 

 

In response, the ministry set up a committee to determine the new rate. 

 

Led by the ministry’s then-permanent secretary Dr Jedsada Chokdamrongsu, the committee revised the penalty to Bt2.5 million, taking into account inflation and the actual cost of training medical students. 

 

The government requires graduates from state-run medical schools to work in government hospitals for at least three years. 

 

It is believed that if the penalties rise, the shortage of doctors in the public sector will ease.

 

Choose to leave

 

However, the Medical Council argued that a high penalty would not necessarily keep new doctors in the public service. They may choose to leave due to other factors, such as their families’ needs, financial circumstances, work conditions and their team members. 

 

According to a recent survey, just 3 per cent of fresh graduates from state-run medical schools say they prefer to pay the penalty in order to dodge the mandatory public service. 

 

Of the 1,726 new graduates last year, only 57 said they did not want to work in the public sector, while 1,467 or 85 per cent said they had every intention to put in their three years of public service. 

 

The remaining 202 said they were still undecided about their career path. 

 

Hence, the Medical Council said that offering the new doctors reasonable pay, a good working environment, a great team and legal protection will motivate them to stay in the public sector. 

 

Source: http://www.nationmultimedia.com/detail/national/30358201

 

-- © Copyright The Nation 2018-11-09

Ah the wonders of the socialized medical system. It works, until it doesn't.

Next law, jailing any Doctor who doesn't work for slave wages in the public hospitals.

Thailand 4.0 right there... perhaps 3.0 was little bit better..

19 minutes ago, Time Traveller said:

Ah the wonders of the socialized medical system. It works, until it doesn't.

Next law, jailing any Doctor who doesn't work for slave wages in the public hospitals.

Yes at least this country a poor person has more chances then in the country of unlimited opportunities to get treatment.

32 minutes ago, Time Traveller said:

Next law, jailing any Doctor who doesn't work for slave wages in the public hospitals.

From your post I can understand that you DON'T agree that a doctor who's studies were sponsored for millions of Baht by the Thai tax payer, should give something back to the community.

5 hours ago, webfact said:

 

It is believed that if the penalties rise, the shortage of doctors in the public sector will ease.

Bet it doesn’t. 

our daughter is at uni now studying to be a doctor, the local public hospital is covering most of her costs and in return she is expected to give 3 years service there as an intern.  We and our daughter were grateful the hospital agreed to it, her aunty did the same thing and is now doing extremely well for herself, anyone trying to take anything away from hospitals doing this is a moron as it helps both the doctor to be/parents to be  able to afford the uni costs as well as give them somewhere near home to do their internship which is required before returning to  uni for any specialist training.  Problem appears to be there are those that do not want to have to repay what they have taken, they should be hit hard as those people that dont pay it back could never have become doctors without the financial help, time for thais to start accepting responsibility for themselves, something that is severely missing in some.

10 minutes ago, Bluespunk said:

Bet it doesn’t. 

Why not.. if its a purely economic choice it would sway doctors to stay longer. 

 

Say if you get a salary of 1.2 million in public.. and you can get 1.6 in private.. the fine is paid for in a year.. so switch early.. if the fine is higher the calculation might show them that staying in the public hospital is the best choice financially.

 

There could of course be other issues too like how much work.

Doctors are sucked into the private plastic surgery sector, the demand is insatiable. There's virtually a clinic in every little soi in Bangkok, only out numbered by 7/11s.

 

By the way, why not require 3 years work at a government hospital in order to be eligible to a license to practice?

 

Edited November 9, 20187 yr by RotBenz8888

18 minutes ago, robblok said:

Why not.. if its a purely economic choice it would sway doctors to stay longer. 

 

Say if you get a salary of 1.2 million in public.. and you can get 1.6 in private.. the fine is paid for in a year.. so switch early.. if the fine is higher the calculation might show them that staying in the public hospital is the best choice financially.

 

There could of course be other issues too like how much work.

Why not?

 

Because 57 doctors are considering not doing mandatory service. 

 

That’s hardly going to solve a crisis. 

 

If they want doctors to stay, pay them more and improve working conditions. 

1 minute ago, Bluespunk said:

Why not?

 

Because 57 doctors are considering not doing mandatory service. 

 

That’s hardly going to solve a crisis. 

 

If they want doctors to stay, pay them more and improve working conditions. 

My mistake, i did not read correctly.. if it is just 57 doctors then its not solving anything. Its trying to solve a problem that does not really exists. 

 

The shortage exists but is not caused by doctors leaving.

1 minute ago, Bluespunk said:

Why not?

 

Because 57 doctors are considering not doing mandatory service. 

 

That’s hardly going to solve a crisis. 

 

If they want doctors to stay, pay them more and improve working conditions. 

 

The 57 doctors is the result of a survey among graduates that are not active doctors yet.

 

I have such a feeling that the numbers in real life are a bit different, otherwise would this increase not even have been considered

4 minutes ago, Bluespunk said:

Why not?

 

Because 57 doctors are considering not doing mandatory service. 

 

That’s hardly going to solve a crisis. 

 

If they want doctors to stay, pay them more and improve working conditions. 

To be honest if any doctor doesn't want to do what's compulsory then don't give them a single baht in tuition fees. Make them pay their way through medical school and then they should be free to work wherever they want. Trouble is they want to have their fees paid and then not provide what they promised.

29 minutes ago, robblok said:

Why not.. if its a purely economic choice it would sway doctors to stay longer. 

 

Say if you get a salary of 1.2 million in public.. and you can get 1.6 in private.. the fine is paid for in a year.. so switch early.. if the fine is higher the calculation might show them that staying in the public hospital is the best choice financially.

 

There could of course be other issues too like how much work.

 

I read the ฿ fine situation a bit differently than you I think.

 

 

"THE PUBLIC HEALTH Ministry plans to significantly increase the penalty from Bt400,000 to Bt2.5 million for doctors defaulting on their required state service after they graduate from state-run medical schools."

 

 

 

 

10 minutes ago, janclaes47 said:

 

The 57 doctors is the result of a survey among graduates that are not active doctors yet.

 

I have such a feeling that the numbers in real life are a bit different, otherwise would this increase not even have been considered

I can only go on numbers in op and they are not enough to solve a crisis. 

1 minute ago, Bluespunk said:

I can only go on numbers in op and they are not enough to solve a crisis. 

Not sure if you are familiar with government hospitals, but if I want to see any doctor other than general doctor for my son who is Thai, it takes me between 6 and 18 months to get an appointment.

 

This not only accounts for the local hospital, but I make inquiries in a 60km range to where I live.

 

I doubt this is caused by 57 doctors

12 minutes ago, janclaes47 said:

Not sure if you are familiar with government hospitals, but if I want to see any doctor other than general doctor for my son who is Thai, it takes me between 6 and 18 months to get an appointment.

 

This not only accounts for the local hospital, but I make inquiries in a 60km range to where I live.

 

I doubt this is caused by 57 doctors

As I say, I can only go by the OP numbers. 

30 minutes ago, watcharacters said:

 

I read the ฿ fine situation a bit differently than you I think.

 

 

"THE PUBLIC HEALTH Ministry plans to significantly increase the penalty from Bt400,000 to Bt2.5 million for doctors defaulting on their required state service after they graduate from state-run medical schools."

 

 

 

 

I was talking about the old situation where the fine was only 400k.. new is 2.5M... in the old situation it could be economically smart to just pay the fine and get an higher salary in 3 years and make up for the difference. With 2.5M fine this is a lot harder to do.

 

But if this is only about 57 doctors then its just stupid as its not solving anything. So either the real numbers are higher or its just a stupid solution.

16 minutes ago, robblok said:

its just a stupid solution.

 

I misunderstood your original point then.    

 

Anyway, I'd not worry about any fine but rather just tell the offending doctors to pay back the whole amount loaned to them immediately or face a usurious kind of penalty for failure to pay back.     

5 minutes ago, watcharacters said:

 

I misunderstood your original point then.    

 

Anyway, I'd not worry about any fine but rather just tell the offending doctors to pay back the whole amount loaned to them immediately or face a usurious kind of penalty for failure to pay back.     

My original point was wrong because i though the numbers were higher.. if they were then the solution would work.. but for 57 its just not a problem. I did not read it correct at first.

 

 

27 minutes ago, robblok said:

My original point was wrong because i though the numbers were higher.. if they were then the solution would work.. but for 57 its just not a problem. I did not read it correct at first.

 

 

 

Thanks for that.

 

Would you be opposed to requiring the   offending doctors make an immediate pay back or face extreme interest penalties?

1 hour ago, watcharacters said:

 

Thanks for that.

 

Would you be opposed to requiring the   offending doctors make an immediate pay back or face extreme interest penalties?

I would not of course.. the whole point is they made an agreement to serve the public... and if they don't hold that promise there should be consequences.. what you say could be one of those consequences. 

4 hours ago, Araiwah said:

To be honest if any doctor doesn't want to do what's compulsory then don't give them a single baht in tuition fees. Make them pay their way through medical school and then they should be free to work wherever they want. Trouble is they want to have their fees paid and then not provide what they promised.

 

 

Is that not just the same as the UK for doctors and nurses?

 

They get qualified at taxpayer expense and go get a job on big money in the USA, then the NHS needs Filipino and other nationalities to make up the shortfall.

 

Then they were talking about noneU immigrants must earn a certain amount in the UK to say, the problem was they, the government, are/ were not paying the Filipino nurses enough to fulfil their own criteria, hence now.......rethink!

thailand the opposite exists, public schools are prestigious and private not. also gov schools tuition is relative quite low compared with private. a high % of students at public schools do indeed come from well to do families. lots of competition for public school entry and well off students can have an advantage in that they access prop courses, etc etc. public grads have a lot more opportunities in obtaining specialty training programs.