Thailand's Public Health Minister Pradit Warns Critics Of Libel Action

[webfact]

PUBLIC-HEALTH BATTLE
Pradit warns critics of libel action
Pongphon Sarnsamak
The Nation

Refuses to change policies, says he will stay in hot seat right to the end

BANGKOK: -- Public Health Minister Pradit Sinthawanarong yesterday warned that those accusing him of wrongdoing could face libel lawsuits. He also vowed that the government would not change or discontinue its policies to improve the country's public health system even if Pradit was removed from the ministerial position.

"I've been thinking about whether what I've done during the past few months is right or wrong for the people. I've decided that I have to follow the policies I announced to the public on the first day I landed in this post," he told a press conference yesterday. Pradit has been criticised for his pro-active policy and his probes of alleged irregularities at the ministry in the past seven months. "All I have done is to improve the national health security and the universal healthcare scheme. I will not shy away from this job until I feel I can no longer do good for the people," he added.

Since becoming minister on November 2, Pradit's policy has been accused of destroying the public health system, weakening the national health security and benefiting private hospitals. "There was no evidence for this accusation," he said.

During Pradit's first three months in this post, he tried to adjust the allowance for medical workers, especially doctors, by introducing pay-for-performance or P4P scheme as well as improve the work efficiency and healthcare services at state hospitals.

But this policy was strongly opposed by a large group of medical workers at rural hospitals and the Rural Doctors' Society, as they claimed the new system would push doctors to work at private hospitals. They said it reduced the amount of their current allowance, which is based on the location and the number of years the person has worked.

In late March, a group of rural doctors and medical workers held a massive protest, demanding that Prime Minister Yingluck Shinawatra drop this policy from a Cabinet resolution, but there was no response.

The Rural Doctors' Society recently vowed to organise another demonstration on June 6 in front of Yingluck's home, to submit their demands. The society also blamed Pradit, saying his P4P policy was part of a plan to weaken state hospitals and encourage doctors to work at private hospitals.

Pradit also faces opposition from health advocates who accuse him of trying to destroy the Government Pharmaceutical Organisation (GPO) by having the Department of Special Investigation (DSI) probe irregularities in the procurement of precursor drugs to produce paracetamol, as well as delays in building a flu-vaccine factory and an HIV/Aids drug plant. The DSI found that the former GPO director Witit Artavatkun had breached a number of laws and will send its findings to the National Anti-Corruption Commission (NACC) for further investigation.

The GPO's executive board agreed to fire Witit for negligence, due to his failure to prevent irregularities in buying paracetamol ingredients and the flu-vaccine factory construction delay. Pradit was accused of being behind the GPO's board decision and the DSI probe. Pradit, meanwhile, insisted that the GPO's executive board and the DSI had done the job themselves.


-- The Nation 2013-05-28

[rubl]

The critics and the Public Health Minister should heed what Deputy Government Spokeswoman Sunisa Lertpakawat just said. "no matter if it was white or red masks, in the social media and in the real world everyone had a constitutional right to express political opinions, as long as they conformed to the law."

[Thait Spot]

What's a lady to do when the populism is all spent and the account is in the red?

The honeymoon's over, the wet patch beckons.

[bigbamboo]

'Criticise and ye shall be sued.'

What a way to run a country!

[jambodave]

Thailand,Hub of libel cases,So much for free speech

[creekside]

Personally, I respect Public Health Minister Pradit Sinthawanarong (on the left) for his bravery by agreeing to go out and discuss the P4P issue with protesters. Additionally, as a double hand amputee, he must be intimately familiar with health care issues.

[slapout]

My way, the highway or the road to the court way. What a way to suspress opposition, questions, and criiial remarks.

I guess next a burp after a meal should be accompanied by a compliment, 'First rate meal, my lord".

[chainarong]

Quiet frankly Frank these PTP dinosaurs are a thing of the past, it's time to hand the baton to the next generation of Shinawatra's???, they can't take criticism, they are defensive in their manor and don't like being corrected , if the good minister is correct all he has to do is say, I told you so , if he is wrong , he must except the critic's to have a field day, err how is it going Minister???

[A Member]

'Criticise and ye shall be sued.'

What a way to run a country!

We all know what losing face can mean here but the words libel and defamation appears to be on everyone's lips and criticise has been removed from the dictionary

[Animal68]

I don't understand. He made it so that the doctors have to work to get paid. That is what P4P stands for right. You perform a good job and you get a good wage, you perform a bad job and you get a bad wage. Additionally, he sought out to find out if there was something going on and discovered something was indeed going on and he ended it..... ... ..

I realize there might be a few flaws in his system, but it does appear that he wants to have the right things happen.

So the rural Doctors are saying it might push them to work in private hospitals. Don't private hospitals get paid more money, after all they can set prices higher, deliver higher level of services, etc. and charge for them in the same manner. How is this bad? Is it bad because they don't get paid more? So in that instance those that produce less or perform worse have to go to the area of employment which satisfies that level of work..... This still means that the people who get the service get a better service. So I am really confused.

[khunken]

His P4P plan is to reduce the extra pay that doctors get for agreeing to work in rural hospitals. It is basically a disastrous scheme for people in the countryside as medical staff don't want to work there unless some incentive is provided.

In addition he has been instrumental in removing the GPO director with what looks very like trumped up charges.

All in all he is another arrogant prick like Plodprasop who cannot accept any criticism.

[Bagwan]

I don't understand. He made it so that the doctors have to work to get paid. That is what P4P stands for right. You perform a good job and you get a good wage, you perform a bad job and you get a bad wage. Additionally, he sought out to find out if there was something going on and discovered something was indeed going on and he ended it..... ... ..

I realize there might be a few flaws in his system, but it does appear that he wants to have the right things happen.

So the rural Doctors are saying it might push them to work in private hospitals. Don't private hospitals get paid more money, after all they can set prices higher, deliver higher level of services, etc. and charge for them in the same manner. How is this bad? Is it bad because they don't get paid more? So in that instance those that produce less or perform worse have to go to the area of employment which satisfies that level of work..... This still means that the people who get the service get a better service. So I am really confused.

Care to consider the effect on the rural poor? Can they afford private hospitals? There are doctors who do not want to be involved in the rip off activities of the privates and have their contracts cancelled because they don't generate enough income. From what I have seen of Government hospitals up country the staff deserve truckloads of money and medals.

[Animal68]

I don't understand. He made it so that the doctors have to work to get paid. That is what P4P stands for right. You perform a good job and you get a good wage, you perform a bad job and you get a bad wage. Additionally, he sought out to find out if there was something going on and discovered something was indeed going on and he ended it..... ... ..

I realize there might be a few flaws in his system, but it does appear that he wants to have the right things happen.

So the rural Doctors are saying it might push them to work in private hospitals. Don't private hospitals get paid more money, after all they can set prices higher, deliver higher level of services, etc. and charge for them in the same manner. How is this bad? Is it bad because they don't get paid more? So in that instance those that produce less or perform worse have to go to the area of employment which satisfies that level of work..... This still means that the people who get the service get a better service. So I am really confused.

Care to consider the effect on the rural poor? Can they afford private hospitals? There are doctors who do not want to be involved in the rip off activities of the privates and have their contracts cancelled because they don't generate enough income. From what I have seen of Government hospitals up country the staff deserve truckloads of money and medals.

I would think they would be happier with better doctors who are working hard to get the job done right. I might be wrong though, maybe they would prefer a doctor that is lazy and simply diagnoses something to avoid working so hard. Performance doesn't mean productivity only, it means quality too. I guess having a competitive environment in your opinion means having a higher cost to the rural poor, not a better service for the same cost. Having doctors compete is not a bad thing. It keeps healthcare relevant to the needs of those that use it. Creating a pay for performance method of rewarding individuals allows competition to reach higher levels. It is just a little thing I learned in Human Resources, Organizational Behavior, and Leadership classes I took to get at least 3 of those degrees I hold. Maybe the next degree will help me get clarification on this?

As far as the trumped up charges mentioned before, I think the jury is out on that!

[SOTIRIOS]

....he is doing only good...if he says so himself....

[rubl]

"But this policy was strongly opposed by a large group of medical workers at rural hospitals and the Rural Doctors' Society, as they claimed the new system would push doctors to work at private hospitals."

Whereas P4P might be a good idea assuming the basic salary offers a reasonable startingpoint, the fear of medical personal moving to private hospitals is a real one. Without a safety net government hospitals may 'empty' of personel threatening the 'nationl health service' provided by the 30Baht scheme. Even PM Yingluck came out to say private hospitals should help any emergencies. What about non-emergencies? Pay your 30Baht, sit here and wait your turn which may or may not be today?

[MikeOboe57]

I don't understand. He made it so that the doctors have to work to get paid. That is what P4P stands for right. You perform a good job and you get a good wage, you perform a bad job and you get a bad wage. Additionally, he sought out to find out if there was something going on and discovered something was indeed going on and he ended it..... ... ..

I realize there might be a few flaws in his system, but it does appear that he wants to have the right things happen.

So the rural Doctors are saying it might push them to work in private hospitals. Don't private hospitals get paid more money, after all they can set prices higher, deliver higher level of services, etc. and charge for them in the same manner. How is this bad? Is it bad because they don't get paid more? So in that instance those that produce less or perform worse have to go to the area of employment which satisfies that level of work..... This still means that the people who get the service get a better service. So I am really confused.

It is actually quite simple. Doctors who volunteered to work in Nakhon Nowhere got extra money for all the drawbacks that come with living far away from any major city.

Now the more patients they "treat" per hour the more money they will find on their bank account at the end of the month. Difficult in a lonely countryside hospital.

On the other hand it has its advantages. A patient, that is correctly diagnosed in 15 minutes, successfully medicated and healed, is not coming back - a lost costumer. But do a crappy 3 minute examination with a faulty diagnose and useless medication and you can be sure that the patient is coming back for another round, as he has little choice otherwise.

[GentlemanJim]

I don't understand. He made it so that the doctors have to work to get paid. That is what P4P stands for right. You perform a good job and you get a good wage, you perform a bad job and you get a bad wage. Additionally, he sought out to find out if there was something going on and discovered something was indeed going on and he ended it..... ... ..

I realize there might be a few flaws in his system, but it does appear that he wants to have the right things happen.

So the rural Doctors are saying it might push them to work in private hospitals. Don't private hospitals get paid more money, after all they can set prices higher, deliver higher level of services, etc. and charge for them in the same manner. How is this bad? Is it bad because they don't get paid more? So in that instance those that produce less or perform worse have to go to the area of employment which satisfies that level of work..... This still means that the people who get the service get a better service. So I am really confused.

Care to consider the effect on the rural poor? Can they afford private hospitals? There are doctors who do not want to be involved in the rip off activities of the privates and have their contracts cancelled because they don't generate enough income. From what I have seen of Government hospitals up country the staff deserve truckloads of money and medals.

I would think they would be happier with better doctors who are working hard to get the job done right. I might be wrong though, maybe they would prefer a doctor that is lazy and simply diagnoses something to avoid working so hard. Performance doesn't mean productivity only, it means quality too. I guess having a competitive environment in your opinion means having a higher cost to the rural poor, not a better service for the same cost. Having doctors compete is not a bad thing. It keeps healthcare relevant to the needs of those that use it. Creating a pay for performance method of rewarding individuals allows competition to reach higher levels. It is just a little thing I learned in Human Resources, Organizational Behavior, and Leadership classes I took to get at least 3 of those degrees I hold. Maybe the next degree will help me get clarification on this?

As far as the trumped up charges mentioned before, I think the jury is out on that!

It is absolutely nothing to do with lazy Doctors. Would you like to work in Bangkok or Nakhon si aminthemiddleofnowhere? Answer Bangkok! How do I get you to work in Nakhon Si Aminthemiddleofnowhere....I need to give you some extra money to go and put up with the squalid place. Same principle the world over. This is NOTHING to do with quality as you mention, but is in fact everything to do with productivity. Now with P4P lets say a Doctor in Bangkok sees 50 patients a day as that is the max he can do, the same goes for the Doctor in Nakhon Si Aminthemiddleofnowhere. They both get the same pay, and now there is no allowance for putting up with working in squalor, so the Doctor will naturally want to go and work in Bangkok, and it is highly likely that in his clinic in the middle of nowhere, he won't even see 50 patients a day because there are not as many people in Bangkok etc etc etc. Net result they get a massive pay cut because they are paid on the number of patients they treat under the new system.

Does it seem like a good idea now?

edited to add

Mike LMAO

I can't believe we type at the same time and use 'Nakhon nowhere/aminthemiddleofnowhere ' at the same time. Double spooky!!

Edited May 28, 2013 by GentlemanJim

[winstonc]

get a room you two,,hahahahaha,,,,ive never seen an empty hospital in the sticks theres always sick people ,,,just excuses