Cash-Strapped Thai Hospitals Say They Are On The Critical List

[webfact]

Cash-strapped hospitals say they're on the critical list

By Pongphon Sarnsamak

The Nation

Phang Nga province's Koh Yao Chaipat Hospital is facing a shortage of medicine and life-saving medical equipment such as insulin, medical gloves, surgical needles and liquid oxygen because of serious financial problems.

Hospital director Dr Monthit Poonsa-nguan said that in recent months the hospital had been unable pay its debts with pharmaceutical and medical-equipment companies, which had stopped supplying the vital supplies and equipment.

"The hospital is now on a blacklist with many companies," he said.

Some medical workers had asked for a week's leave from the hospital to make money by catching fish from the sea, as the hospital had no money to pay their salaries. It also had no money to pay water and electricity bills.

The financial crisis has been with the hospital for several years since the National Health Security Office, the hospital's main financial resource, slashed its budget for the facility.

In 2008, the office allocated Bt 140 million to hospitals in Phang Nga province, but this budget was reduced to Bt126 million in 2009 and Bt118 million in 2010. Koh Yao Chaipat is Bt3 million in deficit.

"I think the hospital will be [forced to] close, leaving only the outpatient department," Monthit said.

Prachin Buri province's Choaphaya Abhaibhubejhr Hospital is also facing a similar financial crisis with debts of Bt200 million. It has not settled bills with pharmaceutical and medical-equipment companies for 10 months, hospital director Dr Vicharn Kerdchai said.

The hospital has been in a Bt10-million deficit each year since 2002, as most of its budget has gone in salaries for its medical staff.

In 2009, the hospital asked the Public Health Ministry to allocate Bt80 million to it, but the ministry provided only Bt7 million, he said.

National Health Security Office secretary-general Dr Winai Sawasdivorn said the financial crisis facing several hospitals was caused by an imbalance between the number of healthcare providers and receivers.

Some had to employ temporary medical workers at expensive monthly wages. Others had spent their budgets on new buildings and medical devices, leaving them short on funds to run their facilities.

Public Health Ministry deputy permanent secretary Dr Narong Sahamethapat said the ministry had found that about 250 hospitals across the country were facing financial-liquidity problems, totalling Bt3 billion to Bt 4 billion this year. The ministry is searching for new financial resources to cope with the budget shortage.

-- The Nation 2010-12-21

[asiawatcher]

Sounds like there is a lot of mismanagement going on within the hospitals such as .. building new sections when they could not pay current liabilities. Who is responsible for that decision?

Irrespective, a Government cannot leave an essential medical facility to fail. The amount of money squandered on even Feng Shui at Govt House rearranging the garden, these funds could have gone to help. It would appear by the total amount of funds being scammed from Public Works sector overall, there needs to be a huge shake up, pull the corruption money back and if necessary, sell off the assets associated with corrupt people, and put it back where it is most needed. And if billions were taken from the crook Thaksin, why not send a bit of that to these hospitals and even replace the management with people who are responsible.

Considering there are two new hospitals being built in my area at present, I cannot see why these outlying areas cannot be subsidised as there IS money in hospitals.

This scenario of workers needing to go fishing for a day to earn money is criminal. Wake up Thailand!

[Colabamumbai]

Thai hospitals should be allowed to hold lotteries to earn income as in Canada, each hospital could have its own lottery and the needed funds will appear. Support the hospital of your choice buy purchasing their lotto tickets. The solution is simple.

[newtronbom]

Thai hospitals should be allowed to hold lotteries to earn income as in Canada, each hospital could have its own lottery and the needed funds will appear. Support the hospital of your choice buy purchasing their lotto tickets. The solution is simple.

That's an excellent idea. The amount people spend on lotteries would solve a lot of their problems and go to a good cause too. Have to be well run mind.

Edited December 21, 2010 by newtronbom

[geriatrickid]

Oh my, it seems that now the media is reporting what I have been saying for the past year. Remember the thread on the crackdown on street people and my comment that there would be nowhere to treat the mentally ill? Some people couldn't believe it. Well, now they can see a bit of the problem.

Sounds like there is a lot of mismanagement going on within the hospitals such as .. building new sections when they could not pay current liabilities. Who is responsible for that decision?

Irrespective, a Government cannot leave an essential medical facility to fail. The amount of money squandered on even Feng Shui at Govt House rearranging the garden, these funds could have gone to help. It would appear by the total amount of funds being scammed from Public Works sector overall, there needs to be a huge shake up, pull the corruption money back and if necessary, sell off the assets associated with corrupt people, and put it back where it is most needed. And if billions were taken from the crook Thaksin, why not send a bit of that to these hospitals and even replace the management with people who are responsible.

Considering there are two new hospitals being built in my area at present, I cannot see why these outlying areas cannot be subsidised as there IS money in hospitals.

This scenario of workers needing to go fishing for a day to earn money is criminal. Wake up Thailand!

Not mismanagment per se but,

1. Strategic underfunding and,

2. Conflict of interests.

There are three parallel health systems in Thailand;

1. Public healthcare

2. Private healthcare, i.e. the hospitals that will feature in the Medical Hub proposal and

3. Super private healthcare, reserved for people in high positions such as private military facilities.

The majority of people in Thailand make do with the public system. Underfunded and understaffed. The private health care system caters to the 40% or so of the population that can afford it. And then there are the 10% super elites who have the special wards and facilities. The money goes to facilitating the private a super private sector. The people that are in the positions to do something about it won't. If you had an "association" with a private hospital would you be inclined to undertake public policy that might have a mnegative impact on that "association"?

Thai hospitals should be allowed to hold lotteries to earn income as in Canada, each hospital could have its own lottery and the needed funds will appear. Support the hospital of your choice buy purchasing their lotto tickets. The solution is simple.

The lotteries available in Canada raise money for services outside of medicare such as research facilities, for palliative care and for general assistance. Lotteries are a p*ss poor way of raising funds due to their high overhead, ethical issues related to promoting an activity that is considered addictive, and the risk associated with the lotteries. Hospital lotteries are not considered a charitable actiivty and that's why tax receipts are not given. The most successful fund raising in Canada are community based. Examples are the Cedars Cancer foundation and the Sir Mortimer Davis Cancer facility of the Jewish General. These hospitals raise funds by involving all parts of the community and do not rely on lotteries. Don't believe me? read this. http://list.moneysen...1=a&sp2=1&eh=ch

Therein lies the key to success for a public hospital: It must become part of the community. In Thailand, When is the last time anyone saw a public hospital engaging in public outreach? They just don't have the funds and the establishment discourages the activity. It is incredible that the national government relies of foreign countries to fund major health initiatives in HIV, malaria and child nutrition. There's no need for it as Thailand has the means to do all these things itself. Unfortunately, the money is sucked out of the public health sector because of competing vested interests such as the super wealthy's investment goals, the insatiable military appetite and the ubiquitious corruption that permeates the public sector. One need only look at the way medical school enrolment is managed to understand that point. On and on it goes.

[Colabamumbai]

Oh my, it seems that now the media is reporting what I have been saying for the past year. Remember the thread on the crackdown on street people and my comment that there would be nowhere to treat the mentally ill? Some people couldn't believe it. Well, now they can see a bit of the problem.

Sounds like there is a lot of mismanagement going on within the hospitals such as .. building new sections when they could not pay current liabilities. Who is responsible for that decision?

Irrespective, a Government cannot leave an essential medical facility to fail. The amount of money squandered on even Feng Shui at Govt House rearranging the garden, these funds could have gone to help. It would appear by the total amount of funds being scammed from Public Works sector overall, there needs to be a huge shake up, pull the corruption money back and if necessary, sell off the assets associated with corrupt people, and put it back where it is most needed. And if billions were taken from the crook Thaksin, why not send a bit of that to these hospitals and even replace the management with people who are responsible.

Considering there are two new hospitals being built in my area at present, I cannot see why these outlying areas cannot be subsidised as there IS money in hospitals.

This scenario of workers needing to go fishing for a day to earn money is criminal. Wake up Thailand!

Not mismanagment per se but,

1. Strategic underfunding and,

2. Conflict of interests.

There are three parallel health systems in Thailand;

1. Public healthcare

2. Private healthcare, i.e. the hospitals that will feature in the Medical Hub proposal and

3. Super private healthcare, reserved for people in high positions such as private military facilities.

The majority of people in Thailand make do with the public system. Underfunded and understaffed. The private health care system caters to the 40% or so of the population that can afford it. And then there are the 10% super elites who have the special wards and facilities. The money goes to facilitating the private a super private sector. The people that are in the positions to do something about it won't. If you had an "association" with a private hospital would you be inclined to undertake public policy that might have a mnegative impact on that "association"?

Thai hospitals should be allowed to hold lotteries to earn income as in Canada, each hospital could have its own lottery and the needed funds will appear. Support the hospital of your choice buy purchasing their lotto tickets. The solution is simple.

The lotteries available in Canada raise money for services outside of medicare such as research facilities, for palliative care and for general assistance. Lotteries are a p*ss poor way of raising funds due to their high overhead, ethical issues related to promoting an activity that is considered addictive, and the risk associated with the lotteries. Hospital lotteries are not considered a charitable actiivty and that's why tax receipts are not given. The most successful fund raising in Canada are community based. Examples are the Cedars Cancer foundation and the Sir Mortimer Davis Cancer facility of the Jewish General. These hospitals raise funds by involving all parts of the community and do not rely on lotteries. Don't believe me? read this. http://list.moneysen...1=a&sp2=1&eh=ch

Therein lies the key to success for a public hospital: It must become part of the community. In Thailand, When is the last time anyone saw a public hospital engaging in public outreach? They just don't have the funds and the establishment discourages the activity. It is incredible that the national government relies of foreign countries to fund major health initiatives in HIV, malaria and child nutrition. There's no need for it as Thailand has the means to do all these things itself. Unfortunately, the money is sucked out of the public health sector because of competing vested interests such as the super wealthy's investment goals, the insatiable military appetite and the ubiquitious corruption that permeates the public sector. One need only look at the way medical school enrolment is managed to understand that point. On and on it goes.

But it is ok for the Provincial Governments in Canada to have lotteries 649 etc. everyday and no tax receipts are given.

[SweeneyAgonistes]

Thai hospitals should be allowed to hold lotteries to earn income as in Canada, each hospital could have its own lottery and the needed funds will appear. Support the hospital of your choice buy purchasing their lotto tickets. The solution is simple.

That's an excellent idea. The amount people spend on lotteries would solve a lot of their problems and go to a good cause too. Have to be well run mind.

That's a terrible idea. Lotteries are played overwhelmingly by the poor. A decent progressive tax, inheritance tax, and/or land tax is what's needed. At the very minimum.

[harrry]

What is the bet that the doctors and administrators got paid first

[Bagwan]

The underfunding of the 30 baht scheme became obvious soon after it was implemented. That it cost more than 30 baht to collect a similar amount didn't seem to faze anybody. Another nail in the coffin of the myth that Thaksin was a world class manager. Since he has been removed from the scene nothing has improved the situation. Nobody in succeeding Governments escapes their share of the blame for such a 'Harry Tate' situation.

My heart goes out to those heroic staff working in Government hospitals battling against impossible odds.

[TackyToo]

Phang Nga? Are we talking about the same Phang Nga that received millions and millions of Euros and Dollars after the Tsunami?

Get rid of the bankers and officials who filled their pockets first and you won't have problems like this!

[jayjay0]

The underfunding of the 30 baht scheme became obvious soon after it was implemented. That it cost more than 30 baht to collect a similar amount didn't seem to faze anybody. Another nail in the coffin of the myth that Thaksin was a world class manager. Since he has been removed from the scene nothing has improved the situation. Nobody in succeeding Governments escapes their share of the blame for such a 'Harry Tate' situation.

My heart goes out to those heroic staff working in Government hospitals battling against impossible odds.

I was thinking along those lines also. 30 baht for a hospital visit is woefully inadequacy. And as you said the paper work to collect it can cost more than the fees Please resist referring to Canada. Particularly B. C. I lived and worked there in the road building trade. There is a lot of hospitals in the smaller communities that do not have the problems as the hospitals here are having with cash flow..

The reason is they don't have the services that cost that kid of money. I am familiar with one that has a Registered Nurse on duty at night that's it. Pretty hard to run a $10,000,000 deficit with that kind of staff.

[mkawish]

Sounds like there is a lot of mismanagement going on within the hospitals such as .. building new sections when they could not pay current liabilities. Who is responsible for that decision?

Irrespective, a Government cannot leave an essential medical facility to fail. The amount of money squandered on even Feng Shui at Govt House rearranging the garden, these funds could have gone to help. It would appear by the total amount of funds being scammed from Public Works sector overall, there needs to be a huge shake up, pull the corruption money back and if necessary, sell off the assets associated with corrupt people, and put it back where it is most needed. And if billions were taken from the crook Thaksin, why not send a bit of that to these hospitals and even replace the management with people who are responsible.

Considering there are two new hospitals being built in my area at present, I cannot see why these outlying areas cannot be subsidised as there IS money in hospitals.

This scenario of workers needing to go fishing for a day to earn money is criminal. Wake up Thailand!

asiawatcher

Agree with most of what you said.

Are you willing and ready to take some concrete actions in behalf of some of these poor Thai hospitals?

Just let me know when, K?

Will be more than happy to lend you a hand, alright?

Be waiting for your signal anxiously but patiently.

Last week, I was an outpatient at a local hospital. The medicines cost 1,200 baht.

I could have bought the same kind of med for under 400 baht from reputable pharmacies.

A hospital will charge about 800 baht for a capsule of Viagra too, where it costs only 200 from some pharmacies.

I suspect dishonesty runs rampant also in medical fields.

Edited December 21, 2010 by mkawish

[mkawish]

The underfunding of the 30 baht scheme became obvious soon after it was implemented. That it cost more than 30 baht to collect a similar amount didn't seem to faze anybody. Another nail in the coffin of the myth that Thaksin was a world class manager. Since he has been removed from the scene nothing has improved the situation. Nobody in succeeding Governments escapes their share of the blame for such a 'Harry Tate' situation.

My heart goes out to those heroic staff working in Government hospitals battling against impossible odds.

I was thinking along those lines also. 30 baht for a hospital visit is woefully inadequacy. And as you said the paper work to collect it can cost more than the fees Please resist referring to Canada. Particularly B. C. I lived and worked there in the road building trade. There is a lot of hospitals in the smaller communities that do not have the problems as the hospitals here are having with cash flow..

The reason is they don't have the services that cost that kid of money. I am familiar with one that has a Registered Nurse on duty at night that's it. Pretty hard to run a $10,000,000 deficit with that kind of staff.

I bet if ever we were allowed to lend them a hand in organizing and running some of these very pronounced hospitals, we would be able to turn the table and charge less but pay more with our know-how.

Boys, that will the day!