Negligent Hospital.

[Moonrakers]

In another thread I stated that my daughter is epileptic. That situation has improved dramatically recently though, as thanks to the thorough care and attentiveness of the good doctors and nurses at the state run children's hospital near the victory monument, my daughter has not had a fit for nearly 2 months now.

However, she still needs to go for an MRI as a precaution, and the Children's hospital informed us that we qualify to have it done under the 30 baht scheme, and they signed all relevant documents for this to happen......... So far so good.

In order for the MRI to be booked under the 30 baht scheme we had to have some document signed at another hospital in our district, and this is when some very ugly events unfolded.

This other hospital is the kluaynamthai hospital on Rama 4, which is a private hospital.

I never went to the kluaynamthai hospital myself, but my wife tells me that the minute it was known that she there under the 30 baht scheme then she was treated like a second class citizen, being made to wait to the end of the queue with the other 30 baht'rs whilst the more 'important' paying customers where seen to first regardless of their place in the queue. At the end of the day, when my wife was finally seen to she was simply told to go to another hospital, which she couldn't actually do because the bueracracy assigns our location to that specific hospital.

A return trip to the childrens hospital told my wife that the kluaynamthai had no right to refuse, and so my wife heads back to kluaynamthai........ Same thing, being made to wait all day with the rest of the 30 baht 'cattle', and with no end result.

This continued 3/4 times, still with no end result and so my wife decided to call whatever relevant government department it is. The government were very helpful and and echoed what the children's hospital had said, that kluaynamthai had neither the right nor the authority to refuse. By now it was blatantly clear that these people were simply being belligerent, evil a*holes and were begrudging us (And others) the treatment because we were considered lower class.

During this time my daughter went 3 days without her medication, not good for an epileptic. This lead my wife to do some reserarch on kluaynamthai hospital and she found that just recently they have lost a lawsuit because of neglect when they refused to treat a very sick person because he was under the 30 baht scheme...... sadly that person died as a result.

After a while an individual within the government was actively helping us by calling kluaynamthai and telling them that they had no authority to decide otherwise and must give my wife what she wants. Unfortunately this had an adverse effect because it caused some individuals at kluaynamthai to lose face, and so whenever my wife returned she was met with even more resistance (by this time they recognised my wife and knew that she had complained to the government). They were now ignoring direct orders from the government, and all this whilst my daughter was STILL in need of an MRI, this had now been going on for about 6 weeks.

It all came to a head today when, again after being made to wait all day with the rest of 'cattle', kluaynamthai refused the necessary paperwork........ yet again. The reason they gave this time was that the paperwork would not be supplied because of my wife complaining to the government. Well my wife is more than just a pretty face and anticipating another problem she managed to record the conversation using her telephone. After quick call from her mobile to the person working for the government whom she is now familiar with (After many calls both way), kluaynamthai received a call themselves and within 10 minutes my wife finally had the documentation we need and was outta there.

At last, after 6 weeks of uneccessary and completely unwarranted delays our daughter now hs a confirmed appointment for the MRI scan that she needs.

We are lucky though as the MRI is just a precautionary yet necessary yet scan for my daughter, and her medication is controlling her condition well, others are not so fortunate however. Asides from the person that has already died, when my wife was at the hospital today she was with another 30 baht'r whose daughter had contracted pneumonia. As well as being made to wait for 4 hours before her daughter with a very high fever was seen, this lady was eventually sent packing with a bag of paracetomol and an appointment for next week whilst other kids with paying parents were being treated for more trivial things such as a bit of a cough. Again this kid had Pneumonia, a condition which is fatal if not treated. My wife put this lady in a taxi, told the taxi to take her to the childrens hospital and gave her 200 baht for the ride, at least now that kid will be receiving the treatment that she needs.

The lady with a daughter with pneumonia is no doubt one of many cases of blatant neglect and on each ocassion my wife went to kluaynamthai there was always somebody/people in a similarly desperate position. The person that my wife was speaking to that worked for the government commented that my wife was "Chalat" for contacting them, and they are sure they a multitude more cases such as this go un-reported because most 30 baht'rs dont understand that they do have a voice, and that they can complain to a higher power.

So now to my point:....... What to do?

OK we got what we wanted, and yes I am grateful to the government for that. But this hospital and individuals within it infuriate me. For starters at least one person has died and no doubt there are countless more cases gone un-reported, these people simply should not be allowed to continue with their inhumane practices unchecked. Not only does it infuriate me that such people can be so ignorant and uncaring, but the lives of further people/children may well lost.

So maybe we (My wife and I) can do something. Asides from the correspondance and witnesses that we have from both the children hospital and the person working for government that my wife has been speaking to, I now have on my PC the recording of an individual saying that they will refuse the documentation purely because my wife complained.

With this being Thailand it is likely to be innefectual, although my wife does now have a contact who works for government and so maybe sending her the recording would help?????? Or the press/media?? Would they be interested and if so would they be allowed to do anything about, bearing in mind the libel laws here?

Maybe it would be a waste of time but perhaps somebody here could steer us in the right direction, after all it is worth a shot surely?

P.S. If my naming the hospital breaks forum rules then mods please fell free to edit my post.

[endure]

Any more posts which don't refer specifically to the OP's original request and which are posted simply for argument's sake will be deleted and will earn their poster a holiday. If you can't be civil, be quiet.

[endure]

A number of off topic posts have been deleted. The Op's original request was how to complain about shoddy treatment at a particular hospital. If you have no information on this subject don't post.

[citizen33]

A number of off topic posts have been deleted. The Op's original request was how to complain about shoddy treatment at a particular hospital. If you have no information on this subject don't post.

The OP could complain to the National Health Security Office, which will be paying this private hospital for any work it is doing under the universal coverage health care scheme (the new name for the 30 baht project) and should take an interest in how contracted hospitals perform. Probably the response will depend upon whom one approaches.

http://www.nhso.go.th/NHSOFront/SelectView...000000000000044

This information was contained in one of the 'off topic' posts.

[Moonrakers]

Thank you endure. And maybe I should clarify that I am not concerned now about myself or my family as we have got what we needed. Rather I am concerned about others at that hospital who are in need of help.

My daughter is fine and so why else would I be posting this?

[JetsetBkk]

I would put it on Youtube - the story, the recorded conversation (with sub-titles), pictures of the hospital, map of the hospital's location, the phone number and name of the contact in the government (maybe ask their permission first) so others can benefit from your experience.

It's easy to do with "Windows Movie Maker" - part of XP. Have a play with it - you'll see how easy it is.

Embarrass the h3ll out of these b@stards.

[onethailand]

How disgusting that your wife was put through that ordeal - she must be an angel to have that kind of patience!

My suggestion would be to "leak" some information to Thai Rath or Daily News. That would likely stir up a hornet's nest as other affected people come forward to complain.

Then of course, there's a new incoming Public Health Minister who would probably be happy to show how he's ready to protect the interests of the people... some chap by the name of Chalerm Yubamrung...

I understand why hospitals don't like the 30-baht scheme - but if they don't want to follow the regulations then perhaps they should be decertified.

Edited September 23, 2008 by onethailand

[onethailand]

You might find it interesting to know that this thread comes up on the first page of a search for Kluaynamthai Hospital.

Anyhow, in case you want to complain to the owner, Sranyoo Chanote, his email address is [email protected] - or perhaps that's the son of the owner - in any case that's the family that owns the hospital.

[PattayaParent]

Enlist the help of the government contact and go down to the hopsital and hand out leaflets to the 30 Baht'ers informing them of their rights?

Contact the the hospitals that refer patients to that hospital and provide them with this information so that they can advise referred patients of their rights and who to contact?

Contact the newspapers in you own country and give them this information, it's the sort of thing The Sun would love in UK.

Edited September 24, 2008 by PattayaParent

[Moonrakers]

Some good thoughts here, I might test my creative skills on windows movie maker later today, and the damning recording has already been sent to the government for them to use as they see fit.

Here is a link to the guy who died due to neglect: http://www.blogth.com/blog/Talk/News/5427.html.

It is all in Thai but basically after an operation, the guy was left in a room with no care from nurses/doctors whatsoever.

Again it's a shame that the vast majority of these cases of neglect and discrimination go unreported as the majority of 30 baht'rs don't know what to do about it.

[mrtoad]

It may worth looking to see what accreditation the hospital has. Does it have ISO or JCCI? I've tried looking on the website, but having problems viewing, seems that it's as slow as the waiting times. If they are acreddited with either, it may be worth contacting them. In the end there is no excuse for this type of behaviour, and as a Health Care Professional, organisations such as these, and staff who also perpetuate this attitude are a disgrace to the profession (rant over) .

Thanks for giving the name of the hospital, as it will be one place that I will most certainly avoid. I wish you all the best with your daughter.

[Moonrakers]

Here's another, same hospital: http://www.siamrath.co.th/UIFont/NewsDetai...3&nid=19707

No mention of the 30 baht scheme, but basically some guy is shot and taken to emergency there. But he is not seen to for 2 hours because there were no doctors present.

No doubt I could dig out more, only I cannot read Thai.

Edited September 24, 2008 by globalj

[citizen33]

Here's another, same hospital: http://www.siamrath.co.th/UIFont/NewsDetai...3&nid=19707

No mention of the 30 baht scheme, but basically some guy is shot and taken to emergency there. But he is not seen to for 2 hours because there were no doctors present.

No doubt I could dig out more, only I cannot read Thai.

Private hospitals are not forced to take part in the universal coverage scheme (previously the 30 baht project). They elect to do so in return for the payments on offer. As I understand it, this is either as a contracted unit offering the full range of primary and secondary care services in return for an annual payment per member of the population covered, or DRG-based payments of referrals coming from such contracted units (i.e. a predetermined payment for surgery or specialist investigations after a referral). Hospitals have to meet certain requirements to be allowed to participate in the UC scheme and can be removed from the scheme if they perform poorly. If this is correct, this case is not so much an issue of a right to free charity care, but an hospital's obligation to do the contracted work for the payments from public funds it is receiving. This is not the 30 baht per visit co-payment, (which was discontinued in 2006) but a larger sum based either on an annual capitation payment per member (just under 2000 baht) or the DRG payment for the treated condition. So I would say that the 'payer' - the NHSO - is the right department to contact, though no doubt its research office (the Health Insurance System Research Office) would also be interested to hear about provider behaviour. In Thai the NHSO is known as saw-baw-saw-chaw for short (i.e. the initials SBSC), and perhaps the OP should check that the contact is indeed within this organisation. The Ministry of Public Health might also take an interest but it is not in the payment loop.

Edited September 24, 2008 by citizen33

[Dakhar]

I sure would like to have seen the tone of those posts that were deleted, & maybe even my post will be deleted.

But lets face it.... 30 baht is 30 baht. Which is almost the cost of a slurpy at 7/11. At 30 baht, in my opinion, I do not think it even comes down to making money, but a matter losing money. There is no way 30 baht is going to cover the cost of the use of a multi-million dollar machine (USD).

I do not condone what has happened, but I am just pointing out that the math does not work out and something has to be done. Honestly 30 baht is even too little for those earning 6K a month. If you look at the math and the percentage of income to health care costs, 30 baht is really nothing to even a 5-6K earning family. What the Thai govt has attempted to do with the 30 baht scheme is admirable, but I don't think it is mathematically possible to utilize the scheme and expect it to work.

[elkangorito]

I sure would like to have seen the tone of those posts that were deleted, & maybe even my post will be deleted.

But lets face it.... 30 baht is 30 baht. Which is almost the cost of a slurpy at 7/11. At 30 baht, in my opinion, I do not think it even comes down to making money, but a matter losing money. There is no way 30 baht is going to cover the cost of the use of a multi-million dollar machine (USD).

I do not condone what has happened, but I am just pointing out that the math does not work out and something has to be done. Honestly 30 baht is even too little for those earning 6K a month. If you look at the math and the percentage of income to health care costs, 30 baht is really nothing to even a 5-6K earning family. What the Thai govt has attempted to do with the 30 baht scheme is admirable, but I don't think it is mathematically possible to utilize the scheme and expect it to work.

Which planet are you from?

[Moonrakers]

I sure would like to have seen the tone of those posts that were deleted, & maybe even my post will be deleted.

But lets face it.... 30 baht is 30 baht. Which is almost the cost of a slurpy at 7/11. At 30 baht, in my opinion, I do not think it even comes down to making money, but a matter losing money. There is no way 30 baht is going to cover the cost of the use of a multi-million dollar machine (USD).

I do not condone what has happened, but I am just pointing out that the math does not work out and something has to be done. Honestly 30 baht is even too little for those earning 6K a month. If you look at the math and the percentage of income to health care costs, 30 baht is really nothing to even a 5-6K earning family. What the Thai govt has attempted to do with the 30 baht scheme is admirable, but I don't think it is mathematically possible to utilize the scheme and expect it to work.

I think that you are mis-understanding the 30 baht scheme, and completely missing the point mate.

[Dakhar]

I sure would like to have seen the tone of those posts that were deleted, & maybe even my post will be deleted.

But lets face it.... 30 baht is 30 baht. Which is almost the cost of a slurpy at 7/11. At 30 baht, in my opinion, I do not think it even comes down to making money, but a matter losing money. There is no way 30 baht is going to cover the cost of the use of a multi-million dollar machine (USD).

I do not condone what has happened, but I am just pointing out that the math does not work out and something has to be done. Honestly 30 baht is even too little for those earning 6K a month. If you look at the math and the percentage of income to health care costs, 30 baht is really nothing to even a 5-6K earning family. What the Thai govt has attempted to do with the 30 baht scheme is admirable, but I don't think it is mathematically possible to utilize the scheme and expect it to work.

Which planet are you from?

A planet that has rules such as math, physics etc. I don't live on a planet where every thing is free. Where is your planet? I would like to go there.

[onethailand]

A planet that has rules such as math, physics etc. I don't live on a planet where every thing is free. Where is your planet? I would like to go there.

The 30-baht scheme means that a patient pays 30 baht per visit. It does not mean that the hospital only gets 30 baht per treatment.

[Dakhar]

I sure would like to have seen the tone of those posts that were deleted, & maybe even my post will be deleted.

But lets face it.... 30 baht is 30 baht. Which is almost the cost of a slurpy at 7/11. At 30 baht, in my opinion, I do not think it even comes down to making money, but a matter losing money. There is no way 30 baht is going to cover the cost of the use of a multi-million dollar machine (USD).

I do not condone what has happened, but I am just pointing out that the math does not work out and something has to be done. Honestly 30 baht is even too little for those earning 6K a month. If you look at the math and the percentage of income to health care costs, 30 baht is really nothing to even a 5-6K earning family. What the Thai govt has attempted to do with the 30 baht scheme is admirable, but I don't think it is mathematically possible to utilize the scheme and expect it to work.

I think that you are mis-understanding the 30 baht scheme, and completely missing the point mate.

You may be correct about not understanding the 30 baht scheme. I have used it before in the past, and I have no complaints. But I work in the health care industry, so my views may be skewed, or maybe more "rounded" because I have some insight on expenses and such.

As I said, I do not condone what occured here, I am just saying mathematically, how does 30 baht cover anything? Or is the 30 baht a co-pay with govt subsizement? Which makes more since, but then one has to ask what is the sub. percentage. In America, it is really bad, around 20-30 cents per dollar, if not less pending procedure etc.

[way2muchcoffee]

I agree with Dakhar. The 30 baht scheme was never workable. It was a populist policy designed to secure votes from a historically disenfranchised population. Even 200 bt wouldn't be enough if the scheme were to include expensive surgeries/treatments/medicines. This government simply doesn't have the resources to subsidize such a scheme to the level it would require. Passing the costs along to hospitals and doctors isn't the solution. Taxes?

Regarding the OP. I feel great sympathy for you and your wife. The story is an outrage.

Edited September 24, 2008 by way2muchcoffee

[astral]

I am glad the OP and his wife had a successful outcome.

As for the other case, I feel there is little that can be done.

There are all too many cases like this. I have experienced a few with my Thai family.

Fortunately there were no fatalities, but only because I forked out of my own pocket

for private treatment.

[citizen33]

I sure would like to have seen the tone of those posts that were deleted, & maybe even my post will be deleted.

But lets face it.... 30 baht is 30 baht. Which is almost the cost of a slurpy at 7/11. At 30 baht, in my opinion, I do not think it even comes down to making money, but a matter losing money. There is no way 30 baht is going to cover the cost of the use of a multi-million dollar machine (USD).

I do not condone what has happened, but I am just pointing out that the math does not work out and something has to be done. Honestly 30 baht is even too little for those earning 6K a month. If you look at the math and the percentage of income to health care costs, 30 baht is really nothing to even a 5-6K earning family. What the Thai govt has attempted to do with the 30 baht scheme is admirable, but I don't think it is mathematically possible to utilize the scheme and expect it to work.

I think that you are mis-understanding the 30 baht scheme, and completely missing the point mate.

You may be correct about not understanding the 30 baht scheme. I have used it before in the past, and I have no complaints. But I work in the health care industry, so my views may be skewed, or maybe more "rounded" because I have some insight on expenses and such.

As I said, I do not condone what occured here, I am just saying mathematically, how does 30 baht cover anything? Or is the 30 baht a co-pay with govt subsizement? Which makes more since, but then one has to ask what is the sub. percentage. In America, it is really bad, around 20-30 cents per dollar, if not less pending procedure etc.

It seems that you can lead a horse to water but cannot make it drink. I explained the funding mechanism a few posts above. The 30 baht co-payment was ended in late 2006, and it was never the main way hospitals got their money for treatments under the scheme. Actually it has been calculated that the co-payment accounted for less than 2 per cent of the receipts and partly explains why it was phased out. As stated above, the 30 baht project is now known as the universal coverage scheme. Private hospitals would never have joined the scheme if they did not think they could make some money by using excess capacity, albeit at a lower rate of return.

Edited September 24, 2008 by citizen33

[Howsitgoin]

With this being Thailand it is likely to be innefectual, although my wife does now have a contact who works for government and so maybe sending her the recording would help?????? Or the press/media?? Would they be interested and if so would they be allowed to do anything about, bearing in mind the libel laws here?

Maybe it would be a waste of time but perhaps somebody here could steer us in the right direction, after all it is worth a shot surely?

P.S. If my naming the hospital breaks forum rules then mods please fell free to edit my post.

In case of you contacting the media, at the present moment i would suggest NBT station.

Your scandalous story is a perfect example how a well meaning initiative by the government is undermined by hospitals. The question is not if the 30 Baht system is workable or not, but that there are clear rules that have been broken, and needed repeated intervention from government officials.

I would definately contact NBT or other TV stations (Not ASTV - they will just use this story as a anti government rant). Most Thais do not have the necessary contacts, or are too afraid of the hospital authority, and might benefit from your experience.

[Moonrakers]

For anybody who may be interested (And can understand Thai), here is the recording:

I still need to add subtitles and jazz it up a bit, but it is my first time and I don't really know what I am doing yet .

EDIT. I don't actually know what this will prove as no names are mentioned apart from my daughters Christian name.

Edited September 24, 2008 by globalj

[JetsetBkk]

For anybody who may be interested (And can understand Thai), here is the recording:

I still need to add subtitles and jazz it up a bit, but it is my first time and I don't really know what I am doing yet .

EDIT. I don't actually know what this will prove as no names are mentioned apart from my daughters Christian name.

Well, I think that's a pretty good start! Well done - now you could add some more pictures that are the translations of the conversation and get them in sync with the sound. As you say, a bit more stuff either side of the sound/translation to introduce the story and to sum it up at the end, and it's done.

Good work!

[elkangorito]

I do believe that the OP's wife only recorded sound. Pictures are not, therefore, available. Are you suggesting that actors be employed to provide a possible "visual" effect?

[Dakhar]

I sure would like to have seen the tone of those posts that were deleted, & maybe even my post will be deleted.

But lets face it.... 30 baht is 30 baht. Which is almost the cost of a slurpy at 7/11. At 30 baht, in my opinion, I do not think it even comes down to making money, but a matter losing money. There is no way 30 baht is going to cover the cost of the use of a multi-million dollar machine (USD).

I do not condone what has happened, but I am just pointing out that the math does not work out and something has to be done. Honestly 30 baht is even too little for those earning 6K a month. If you look at the math and the percentage of income to health care costs, 30 baht is really nothing to even a 5-6K earning family. What the Thai govt has attempted to do with the 30 baht scheme is admirable, but I don't think it is mathematically possible to utilize the scheme and expect it to work.

I think that you are mis-understanding the 30 baht scheme, and completely missing the point mate.

You may be correct about not understanding the 30 baht scheme. I have used it before in the past, and I have no complaints. But I work in the health care industry, so my views may be skewed, or maybe more "rounded" because I have some insight on expenses and such.

As I said, I do not condone what occured here, I am just saying mathematically, how does 30 baht cover anything? Or is the 30 baht a co-pay with govt subsizement? Which makes more since, but then one has to ask what is the sub. percentage. In America, it is really bad, around 20-30 cents per dollar, if not less pending procedure etc.

It seems that you can lead a horse to water but cannot make it drink. I explained the funding mechanism a few posts above. The 30 baht co-payment was ended in late 2006, and it was never the main way hospitals got their money for treatments under the scheme. Actually it has been calculated that the co-payment accounted for less than 2 per cent of the receipts and partly explains why it was phased out. As stated above, the 30 baht project is now known as the universal coverage scheme. Private hospitals would never have joined the scheme if they did not think they could make some money by using excess capacity, albeit at a lower rate of return.

At a lower rate of return.... trust me, if there was a "return" to be made, a hospital, at least the hospitals I have worked at, would gladly perform a procedure. If the hospitals was going to operate at a loss.... forget about it. If you really contend that hospitals make money via the 30 baht plan, then why did the hospital in the OPs situation delay, stall and essentially deny service? Racial, lazy, or is that there just is not any money to be made?

Quick storry. I once got rolled in to a hospital with an open skull fracture... as soon as they got me out of the helocopter, I started telling every one that saw me.... "I have insurance." It seems silly now, but I was worried they were just going to stick me in a corner & triage me for a in-grown toe nail case that had private pay.

Latter, one of the hospital managers got wind of me telling people I had insurance... and she asked me in a very somber tone, "Who asked you if you had insurance?" I replied "no one, I just know how the system works." She said, "It does not work that way at my hospital." She was pretty serious too. Funny thing is, my employers, (physicians) performed surgeries at that same hospital, and they were the greediest SOBs I have ever met.

Edited September 24, 2008 by Dakhar

[elkangorito]

I thought the fact that a hospital had a written & legal agreement with the government (is this not the case here?) would be enough to guarantee the treatment of people? Some people would have us believe that this is not the case & do not cite sufficient resources to prove so.

[onethailand]

At a lower rate of return.... trust me, if there was a "return" to be made, a hospital, at least the hospitals I have worked at, would gladly perform a procedure. If the hospitals was going to operate at a loss.... forget about it. If you really contend that hospitals make money via the 30 baht plan, then why did the hospital in the OPs situation delay, stall and essentially deny service? Racial, lazy, or is that there just is not any money to be made?

Geez, Dakhar, you sure are making this harder than it looks.

Citizen clearly stated "lower rate of return". OP stated "end of 30 baht line".

Which basically means - if we have no paying customers, we then take the next customer from the 30 baht line. If you don't get service today, come back tomorrow.

Obviously the rate of return is not the same. Obviously the hospital would NOT be doing it if they were losing money, as they are private and can opt out of the scheme. But as long as they have customers willing to pay more money (than they would receive from government funding), they will serve them first.

[Dakhar]

At a lower rate of return.... trust me, if there was a "return" to be made, a hospital, at least the hospitals I have worked at, would gladly perform a procedure. If the hospitals was going to operate at a loss.... forget about it. If you really contend that hospitals make money via the 30 baht plan, then why did the hospital in the OPs situation delay, stall and essentially deny service? Racial, lazy, or is that there just is not any money to be made?

Geez, Dakhar, you sure are making this harder than it looks.

Citizen clearly stated "lower rate of return". OP stated "end of 30 baht line".

Which basically means - if we have no paying customers, we then take the next customer from the 30 baht line. If you don't get service today, come back tomorrow.

Obviously the rate of return is not the same. Obviously the hospital would NOT be doing it if they were losing money, as they are private and can opt out of the scheme. But as long as they have customers willing to pay more money (than they would receive from government funding), they will serve them first.

We are talking about the use of an MRI machine, not a microwave oven. It is not like an MRI is on 24/7 and you have a coveyor belt line up for the use of such a machine. So one would think the back of the line, would not be toooooo far back even if one was going use the 30 baht plan. But yes, I do see your point.