Cash Shortfall At State Hospitals Sparks Budget Probe: Thailand

[webfact]

Cash shortfall at state hospitals sparks budget probe

Kawintra Jaisue

The Nation

BANGKOK: -- Many state-run hospitals upcountry suffered a cash flow problem in the past 2-3 years to the point of near bankruptcy.

Now the Public Health Ministry has revealed the expense budget for medicine in these hospitals was nearly Bt100 billion per year, and included many items of suspiciously large amounts.

This prompted the Comptroller General's Department (CGD) and the Department of Special Investigation (DSI) to last year probe in retrospect the hospitals' medical expenses in search of alleged corruption.

One irregularity they uncovered was the prescribing of medicine to patients in larger-than-necessary amounts. Another was to lower the amount in stock so they could order fresh supplies from the drug company in exchange for commissions or other benefits.

This "drug-shopping" saw welfare-entitled officials visiting 2-3 hospitals to get expensive drugs for diabetes, heart disease and high blood pressure - which could reach Bt20,000 per visit - to sell to pharmacies cheaply. The CGD gathered evidence for lawsuits against eight such drug-shoppers. It was reported the drug-shopping caused losses of Bt16 million per year to the state.

As the DSI team, led by investigator Angsuket Wisutwattanasak dug deeper, they found more stock problems, pre-meditated or inadvertent - as well as 10 million tablets of cold medicine with pseudoephedrine, an ingredient for narcotics making, that had gone missing.

Udon Thani Hospital showed the largest loss - seven million tablets worth Bt11 million. When police discovered empty packs of cold medicine with pseudoephedrine in Chiang Mai's San Kham Phaeng district, the misdeeds became clearer.

Narcotics Control Board Office Region 4 director Songkram Khamtonwong said the unusual demand for cold medicine went on for a year. Some was being sent across the northern border to a neighbouring country, while home-made ya ba makers in the Central province were receiving pseudoephedrine supplies too.

-- The Nation 2012-04-03

[BookMan]

Hard to believe these hospitals have a cash flow problem. They must have been getting good coin for all those 'missing' cold/flu tablets.

[chiang mai]

It seems that corruption has no boundaries here and that the link between the hospitals and the yaba factories is a strong one.

[slapout]

This probe will follow the same road as most before it. Long, dusty/hazey and ends on a dead end.

We have heard " It takes a thief to catch a thief", there does not seem to be a scarity of those in this profession in government positions nor the private sector.Would we dare hope for improvement or can we expect as the share of funds start flowing upward again, a new souce/pipeline will be installed?

[scorecard]

It seems that corruption has no boundaries here and that the link between the hospitals and the yaba factories is a strong one.

There's also the point that the directors / senior officials of these hospitals have a duty to be continuously monitoring / managing every aspect of the poofessional operation of the hospital(s) they are responsible for, and promptly taking action when any form of discrepancy is discovered whether its medical care of medicine stocks or whatever. Clearly they are not.

[OzMick]

Gives a whole new meaning to stock-taking.

Do the Thais have the words for book-keeping, stock-taking, audits?

[ginjag]

Ozmick, Thais think bookkeeping is a library=stock taking is stealing= and audits are a type of tourist. Supervisor is a large add on to a crash helmet. Our local hospital administrator/manager is a well known corrupt person, especially on pharmacy stocks, working together with doctors for big handouts. Our health and environment officer is aware and unable to intervene as the person in charge has friends in high places. If this happens here it must happen in most town hospitals-my guess

[Unkomoncents]

"Narcotics Control Board Office Region 4 director Songkram Khamtonwong said the unusual demand for cold medicine went on for a year. Some was being sent across the northern border to a neighbouring country, while home-made ya ba makers in the Central province were receiving pseudoephedrine supplies too."

Burma. Just say it: B-U-R-M-A. It's good to encourage people in Thailand to attempt, just try, to be clear, direct, and honest. Because lying is so central to the strategy of preserving face, the mere concept of truth vs. untruth is rendered empty in the Kingdom. Hence the government's credibility amongst the public and the credibility of basically anyone in Thailand.

[LuckyLew]

Just give them more money and more cold medicine - problem solved

[Thai at Heart]

"Narcotics Control Board Office Region 4 director Songkram Khamtonwong said the unusual demand for cold medicine went on for a year. Some was being sent across the northern border to a neighbouring country, while home-made ya ba makers in the Central province were receiving pseudoephedrine supplies too."

Burma. Just say it: B-U-R-M-A. It's good to encourage people in Thailand to attempt, just try, to be clear, direct, and honest. Because lying is so central to the strategy of preserving face, the mere concept of truth vs. untruth is rendered empty in the Kingdom. Hence the government's credibility amongst the public and the credibility of basically anyone in Thailand.

The thing is that doctors in this country are given an almost god like respect and all the one's I have dealt with have been hard working honest people. But when the medical profession ends up being the source of one of the scourges of the country; methamphetamine, it really does show a very large loss of understanding of good and bad.

We all know there is corruption, but when a hospital is actively filching drugs out the door to make meth, it is impossible that an awful lot of people in that organisation didn't know about it, and that really shows a very worrying lack of morals for medical practitioners.

[Unkomoncents]

"Narcotics Control Board Office Region 4 director Songkram Khamtonwong said the unusual demand for cold medicine went on for a year. Some was being sent across the northern border to a neighbouring country, while home-made ya ba makers in the Central province were receiving pseudoephedrine supplies too."

Burma. Just say it: B-U-R-M-A. It's good to encourage people in Thailand to attempt, just try, to be clear, direct, and honest. Because lying is so central to the strategy of preserving face, the mere concept of truth vs. untruth is rendered empty in the Kingdom. Hence the government's credibility amongst the public and the credibility of basically anyone in Thailand.

The thing is that doctors in this country are given an almost god like respect and all the one's I have dealt with have been hard working honest people. But when the medical profession ends up being the source of one of the scourges of the country; methamphetamine, it really does show a very large loss of understanding of good and bad.

We all know there is corruption, but when a hospital is actively filching drugs out the door to make meth, it is impossible that an awful lot of people in that organisation didn't know about it, and that really shows a very worrying lack of morals for medical practitioners.

I agree. This is an extremely disconcerting trend. As Thai society is exposed to more and more consumerism, and consumerism becomes the defining status paradigm, it appears that people seriously lose sight of exactly what it is they're doing. I've talked to a number of middle-aged Thai people who truly lament the changes Thailand has experienced over the last two decades. I know it's cliche to pine on about how the latest generations are morally decrepit, etc, etc and the end is near (which is obviously irrational), there does seem to be some merit to the idea that personal boundaries (regarding what's acceptable and what's more or less corrupt) have expanded significantly in the last 20-30 years. If you walk through Lumpini Park around dusk, you can openly observe underage Thai high school students selling themselves so that they can buy what I suppose to be the latest Apple gadget. It's intense.

[Thai at Heart]

"Narcotics Control Board Office Region 4 director Songkram Khamtonwong said the unusual demand for cold medicine went on for a year. Some was being sent across the northern border to a neighbouring country, while home-made ya ba makers in the Central province were receiving pseudoephedrine supplies too."

Burma. Just say it: B-U-R-M-A. It's good to encourage people in Thailand to attempt, just try, to be clear, direct, and honest. Because lying is so central to the strategy of preserving face, the mere concept of truth vs. untruth is rendered empty in the Kingdom. Hence the government's credibility amongst the public and the credibility of basically anyone in Thailand.

The thing is that doctors in this country are given an almost god like respect and all the one's I have dealt with have been hard working honest people. But when the medical profession ends up being the source of one of the scourges of the country; methamphetamine, it really does show a very large loss of understanding of good and bad.

We all know there is corruption, but when a hospital is actively filching drugs out the door to make meth, it is impossible that an awful lot of people in that organisation didn't know about it, and that really shows a very worrying lack of morals for medical practitioners.

I agree. This is an extremely disconcerting trend. As Thai society is exposed to more and more consumerism, and consumerism becomes the defining status paradigm, it appears that people seriously lose sight of exactly what it is they're doing. I've talked to a number of middle-aged Thai people who truly lament the changes Thailand has experienced over the last two decades. I know it's cliche to pine on about how the latest generations are morally decrepit, etc, etc and the end is near (which is obviously irrational), there does seem to be some merit to the idea that personal boundaries (regarding what's acceptable and what's more or less corrupt) have expanded significantly in the last 20-30 years. If you walk through Lumpini Park around dusk, you can openly observe underage Thai high school students selling themselves so that they can buy what I suppose to be the latest Apple gadget. It's intense.

I think it comes down to the spread of wealth across society, the middle class educated people have educated their kids and they are getting 25 to 50k a month in Bangkok, which isn't enough. The only way forward is to work for yourself and not pay taxes or be bent and make millions. Just look at the companies moaning about 100 baht a day increase and looking more and more to imported labour they can exploit instead of sucking it up and doing better business. There is a really fundamental schism in Thai society about where this is going.

[smedly]

It seems that nobody can be trusted to manage a budget in this country, perhaps time to look at every state run organisation and start jailing firing people who are lining their pockets, the greed and frank dishonesty in Thailand is quite shocking

[hoaker]

state hospital officials are diversifying their portfolio into narcotics.

[robblok]

It seems that nobody can be trusted to manage a budget in this country, perhaps time to look at every state run organisation and start jailing firing people who are lining their pockets, the greed and frank dishonesty in Thailand is quite shocking

It is but those in power do the same thing. The higher up the food chain the less likely you are to get prosecuted. They will only jail some small fish and make sure that corruption goes on forever.

[billd766]

It seems that nobody can be trusted to manage a budget in this country, perhaps time to look at every state run organisation and start jailing firing people who are lining their pockets, the greed and frank dishonesty in Thailand is quite shocking

The main problem with that is that there is no respect for the law at all.

To fix that problem you need an honest police force to uphold the law, honest prosecutors to bring cases to trial, honest judiciary to judge on the cases, honest prison officials to run the jails, a willingness on the part of all the forgoing and having NO fear or favour of anybody, big or small who is breaking the law and an honest government to keep OUT OF any of the foregoing.

If any part doesn't work then nothing will change and only the politician have the power to do anything about it.

It will never happen in my lifetime, I am 67, a remote chance in my wife's lifetime, she is 46 with a good possibility in my son's lifetime as he is only 7.

The best place to start is with Education and teach children right from wrong, good from bad, honesty from thievery.

[blackthorn2005]

Patong Hospital can subsidise the other hospitals with the excessive amounts it charges foreigners for sub-standard healthcare.

[scorecard]

"Narcotics Control Board Office Region 4 director Songkram Khamtonwong said the unusual demand for cold medicine went on for a year. Some was being sent across the northern border to a neighbouring country, while home-made ya ba makers in the Central province were receiving pseudoephedrine supplies too."

Burma. Just say it: B-U-R-M-A. It's good to encourage people in Thailand to attempt, just try, to be clear, direct, and honest. Because lying is so central to the strategy of preserving face, the mere concept of truth vs. untruth is rendered empty in the Kingdom. Hence the government's credibility amongst the public and the credibility of basically anyone in Thailand.

The thing is that doctors in this country are given an almost god like respect and all the one's I have dealt with have been hard working honest people. But when the medical profession ends up being the source of one of the scourges of the country; methamphetamine, it really does show a very large loss of understanding of good and bad.

We all know there is corruption, but when a hospital is actively filching drugs out the door to make meth, it is impossible that an awful lot of people in that organisation didn't know about it, and that really shows a very worrying lack of morals for medical practitioners.

I agree. This is an extremely disconcerting trend. As Thai society is exposed to more and more consumerism, and consumerism becomes the defining status paradigm, it appears that people seriously lose sight of exactly what it is they're doing. I've talked to a number of middle-aged Thai people who truly lament the changes Thailand has experienced over the last two decades. I know it's cliche to pine on about how the latest generations are morally decrepit, etc, etc and the end is near (which is obviously irrational), there does seem to be some merit to the idea that personal boundaries (regarding what's acceptable and what's more or less corrupt) have expanded significantly in the last 20-30 years. If you walk through Lumpini Park around dusk, you can openly observe underage Thai high school students selling themselves so that they can buy what I suppose to be the latest Apple gadget. It's intense.

Regardling your consumerism point, my Thai adult son and his wife tell me that many of their school friends, most of them with advanced education, are up to their ears in debt and just keep spending and they don't hesitate to apply for more credit cards, etc.

My son has told me many times that friends have asked him to ask me (the automatic rich farang father) for loan monies.

In fact he has never asked me to loan money to a specific friend and he's strong enough to give an immediate but polite 'no, and don't ask me again'.

He also gets the occasional requests for loans from his friends, expected to come from his own funds (the automatic rich son of the automatic rich farang father).

He learned his lesson when at uni, he loaned 5,000Baht to a long-term student friend, it's never been repaid and his several requests for repayment ended the friendship (your not a good friend if you keep asking me to pay the money back).

An added point, lack of responsibiliy.

Edited April 3, 2012 by scorecard

[TallGuyJohninBKK]

Just a point here... There's no clear indication from the news report here that doctors are the ones responsible for the vanishing drugs... They might be involved, or might not.... But the other news reports I've seen on the subject seem to point more to pharmacy and other hospital staff.

Now over-prescribing of drugs to actual patients, that's a different matter from millions of pseudoephedrine and such pills going missing. It does seem to be the normal custom here for Thai doctors to load up their real patients will all kinds of medicines at the drop of a hat, even when they're not needed or necessarily even wanted. The Thais seem to think walking away with bags full of medicine is a necessary part of any successful doctor visit.

Either way, as others noted above, it's clearly the hospitals' management's responsibility to oversee such things and prevent rampant drug theft, which they're clearly failing to do... Unless of course, it's the managers of those same hospitals who might be getting a cut of the action.

[chiang mai]

Just a point here... There's no clear indication from the news report here that doctors are the ones responsible for the vanishing drugs... They might be involved, or might not.... But the other news reports I've seen on the subject seem to point more to pharmacy and other hospital staff.

Now over-prescribing of drugs to actual patients, that's a different matter from millions of pseudoephedrine and such pills going missing. It does seem to be the normal custom here for Thai doctors to load up their real patients will all kinds of medicines at the drop of a hat, even when they're not needed or necessarily even wanted. The Thais seem to think walking away with bags full of medicine is a necessary part of any successful doctor visit.

Either way, as others noted above, it's clearly the hospitals' management's responsibility to oversee such things and prevent rampant drug theft, which they're clearly failing to do... Unless of course, it's the managers of those same hospitals who might be getting a cut of the action.

Either way, as others noted above, it's clearly the hospitals' management's responsibility to oversee such things and prevent rampant drug theft, which they're clearly failing to do... Unless of course, it's the managers of those same hospitals who might be getting a cut of the action.

Almost certainly the latter I would have thought!

[atyclb]

state hospital officials are diversifying their portfolio into narcotics.

A win win situation. Make money from supplying meth ingredients, then make money treating consequential the meth addicts.

Even G 7 countries have "candy men/women" (doctors set up to just supply narcotics to drug seeking patients), but cannot recall anything on the scale of the thai pseudofed scandal.