So you think your Thai healthcare is good? "NHS is world's best healthcare system"

[wilcopops]

Here's food for thought for those who blindly believe that just because a hospital has a fish-tank and Le cornier furniture it must be good.

Take aloof at this article which takes you beyond any amateur's assessment of how good a system is.

http://www.theguardian.com/society/2014/jun/17/nhs-health?CMP=EMCSOCEML657

"NHS is world's best healthcare system"

[CaptHaddock]

The study only compared healthcare systems in 11 rich countries. So, the comparison is not "the world." However, to an American the NHS looks very good indeed. I know the Brits like to complain about it. If they ever experienced American medicine they would not complain so much about the NHS.

[citizen33]

Thailand has only just moved from lower to upper middle income status, and Thai public healthcare cannot compete with the systems of most developed Western nations. Nevertheless, in its class it has had very good results, to the extent that it is a global leader in terms of universal coverage in less affluent nations. This is an area where past governments did quite well, and I very much hope that similar policies will be maintained, though I have some worries.

http://uhcforward.org/sites/uhcforward.org/files/book018.pdf

http://ghlc.lshtm.ac.uk/files/2011/10/Policy-Briefing-No5-Thailand.pdf

http://scholar.harvard.edu/files/hendren/files/the_great_equalizer_vaejv130318.pdf

Incidentally, although the Thai system is very different from the NHS, that latter system, as well as European and Canadian social health insurance systems, have had some influence on Thai policy making.

Edited June 19, 2014 by citizen33

[Costas2008]

Thai healthcare is excellent, if you have the money to pay for it, as a foreigner.

The same applies for the Thais with money.

Poor, people suffer from the inadequacy of the Thai hospitals in rural areas like Issan.

Inexperienced doctors and luck of proper medical equipment, has a great affect on them.

Also the "Mai Ben Rai" culture, even to human life, is a big downside to Thai healthcare.

We can't compare the big city hospitals and healthcare they offer with the small rural hospitals.

So at the end, it's a two tier system.

Edited June 19, 2014 by Costas2008

[wilcopops]

Thai healthcare is a lottery....even at the top end it can be DREADFUL. Poorly trained doctors with no accountability with support staff with little or no appropriate training and absolutely no comeback in the event of in appropriate treatment.

If you are sick - GO HOME!

Edited June 19, 2014 by wilcopops

[citizen33]

Of course the gap between the leading Bangkok private hospitals and the average rural community hospital is huge. However, as has been said on this forum many times, the university hospitals, military hospitals and many of the MoPH provincial hospitals are quite good. So somebody living in Isaan might get perfectly adequate treatment at a larger hospital, and in the case of the leading university hospital, Srinakarin in Khon Kaen, would find standards comparable to those of the big Bangkok hospitals, albeit without the plush 'hotel' services. The thing to avoid in Isaan is smaller private hospitals for life threatening conditions.

[samuijimmy]

Wow.... no one watching Sky News....? constant problems with NHS almost in the news weekly .....

not even worth the time to read the article .... It certainly is not the best.

[sustento]

Wow.... no one watching Sky News....? constant problems with NHS almost in the news weekly .....

not even worth the time to read the article .... It certainly is not the best.

Sky News is there to do what all news outlets do. Drum up custom by dramatising stuff. The Commonwealth Fund is slightly more credible.

http://www.commonwealthfund.org/publications/fund-reports/2014/jun/mirror-mirror

PS I use the NHS. It's excellent.

Edited June 19, 2014 by sustento

[rhythmworx]

NHS is definitely not the worlds best healthcare system, it not even the UK's best.

Why do people pay for BUPA when the NHS is free?

Exactly.....

The guardian is not even worth using as emergency bog roll.

Edited June 19, 2014 by rhythmworx

[sustento]

NHS is definitely not the worlds best healthcare system, it not even the UK's best.

Why do people pay for BUPA when the NHS is free?

Exactly.....

The guardian is not even worth using as emergency bog roll.

The report wasn't written by the Guardian - it was written by the Commonwealth Fund - a highly respected private independent American organisation that promotes better healthcare. It has no incentives to promote any healthcare organisation over any other

http://www.commonwealthfund.org/publications/fund-reports/2014/apr/2014-state-scorecard

http://www.commonwealthfund.org/about-us

Still don't let your prejudices get in the way of independent research.

[wilcopops]

Wow.... no one watching Sky News....? constant problems with NHS almost in the news weekly .....

not even worth the time to read the article .... It certainly is not the best.

So you're suggesting Sky News is a better source than Commonwealth Fund? Do you even know who they are?

[wilcopops]

NHS is definitely not the worlds best healthcare system, it not even the UK's best.

Why do people pay for BUPA when the NHS is free?

Exactly.....

The guardian is not even worth using as emergency bog roll.

I think you need a reality check...especially with BUPA in UK..... What do you think they do if one of their patients by as an emergency?????? Edited June 19, 2014 by wilcopops

[wilcopops]

It fairly clear that there a some hugely uninformed opinions on this thread....largely laypeople who mistake a colour TV and nice furniture for a good SYSTEM. If you think you can judge a medical system by your own personal experience as a layman then you are thoroughly mistaken and should take time either to read the article or find out about the commonwealth fund. The way to really learn is listen to the experts.

Edited June 19, 2014 by wilcopops

[wilcopops]

Of course the gap between the leading Bangkok private hospitals and the average rural community hospital is huge. However, as has been said on this forum many times, the university hospitals, military hospitals and many of the MoPH provincial hospitals are quite good. So somebody living in Isaan might get perfectly adequate treatment at a larger hospital, and in the case of the leading university hospital, Srinakarin in Khon Kaen, would find standards comparable to those of the big Bangkok hospitals, albeit without the plush 'hotel' services. The thing to avoid in Isaan is smaller private hospitals for life threatening conditions.

So.... A flawed system then.

[rhythmworx]

"The only serious black mark against the NHS was its poor record on keeping people alive. On a composite "healthy lives" score, which includes deaths among infants and patients who would have survived had they received timely and effective healthcare, the UK came 10th."

Correct me if I'm wrong but isn't the purpose of a hospital to keep people alive?

"short waiting times".

Clearly you haven't been in an NHS hospital in the past 10 years.

Edited June 19, 2014 by rhythmworx

[wilcopops]

Of course the gap between the leading Bangkok private hospitals and the average rural community hospital is huge. However, as has been said on this forum many times, the university hospitals, military hospitals and many of the MoPH provincial hospitals are quite good. So somebody living in Isaan might get perfectly adequate treatment at a larger hospital, and in the case of the leading university hospital, Srinakarin in Khon Kaen, would find standards comparable to those of the big Bangkok hospitals, albeit without the plush 'hotel' services. The thing to avoid in Isaan is smaller private hospitals for life threatening conditions.

"The gap" as you put it, is not the main problem. The main proiblems are the poor training of staff from consultants down to cleaners, the lack of ethics and accountability. The inequities caused by the big private hospital are of course a drain on thevsytstem, which rather than care for the Thai people, concentrates on the super rich and medical tourism. Obligations on doctors to work in the Thai national system are minimal and there is no GP system or even a centralised ambulance system No uniform standards of treatment and no boidy to check the services offered nor not offered by hospitals. Again many people are beguiled by "flashy-looking" facilities and often leave hospital feeling they have had great treatment, when in reality they have had an inappropriate possibly more costly procedure abdvwill never be aware that abmuch better outcome should have been achieved.

BTW don't be fooled by doctors who claim to have trained in the states. They seldom were allowed to practice and actually only spend a few months on "observation" courses on a particular subject. At the end they get an impressive certificate.

Edited June 19, 2014 by wilcopops

[sustento]

"The only serious black mark against the NHS was its poor record on keeping people alive. On a composite "healthy lives" score, which includes deaths among infants and patients who would have survived had they received timely and effective healthcare, the UK came 10th."

Correct me if I'm wrong but isn't the purpose of a hospital to keep people alive?

"short waiting times".

Clearly you haven't been in an NHS hospital in the past 10 years.

I was in one three weeks ago. It was excellent.

[wilcopops]

"The only serious black mark against the NHS was its poor record on keeping people alive. On a composite "healthy lives" score, which includes deaths among infants and patients who would have survived had they received timely and effective healthcare, the UK came 10th."

Correct me if I'm wrong but isn't the purpose of a hospital to keep people alive?

"short waiting times".

Clearly you haven't been in an NHS hospital in the past 10 years.

I think you should rethink your criteria for what a healthcare service is and maybe broaden your view.

[samuijimmy]

"The only serious black mark against the NHS was its poor record on keeping people alive. On a composite "healthy lives" score, which includes deaths among infants and patients who would have survived had they received timely and effective healthcare, the UK came 10th."

Correct me if I'm wrong but isn't the purpose of a hospital to keep people alive?

"short waiting times".

Clearly you haven't been in an NHS hospital in the past 10 years.

Not to mention discharging people in the middle of the night with no one to help, some times without their meds too... .... . and today's news on Sky, falsifying patient records .... Staffordshire district seems to be pretty bad ... that is often mentioned ....

I have yet to find a problem with my local Thai public hospital.... often thought other countries could learn something about hospital efficiency .... I really don't have a problem with the hospital visits here....

(That should get the Thai bashers going)

[chiang mai]

Removed - already covered.

Edited June 20, 2014 by chiang mai

[citizen33]

Of course the gap between the leading Bangkok private hospitals and the average rural community hospital is huge. However, as has been said on this forum many times, the university hospitals, military hospitals and many of the MoPH provincial hospitals are quite good. So somebody living in Isaan might get perfectly adequate treatment at a larger hospital, and in the case of the leading university hospital, Srinakarin in Khon Kaen, would find standards comparable to those of the big Bangkok hospitals, albeit without the plush 'hotel' services. The thing to avoid in Isaan is smaller private hospitals for life threatening conditions.

"The gap" as you put it, is not the main problem. The main proiblems are the poor training of staff from consultants down to cleaners, the lack of ethics and accountability. The inequities caused by the big private hospital are of course a drain on thevsytstem, which rather than care for the Thai people, concentrates on the super rich and medical tourism. Obligations on doctors to work in the Thai national system are minimal and there is no GP system or even a centralised ambulance system No uniform standards of treatment and no boidy to check the services offered nor not offered by hospitals. Again many people are beguiled by "flashy-looking" facilities and often leave hospital feeling they have had great treatment, when in reality they have had an inappropriate possibly more costly procedure abdvwill never be aware that abmuch better outcome should have been achieve

BTW don't be fooled by doctors who claim to have trained in the states. They seldom were allowed to practice and actually only spend a few months on "observation" courses on a particular subject. At the end they get an impressive certificate.

I have acknowledged that Thai healthcare needs further development, but stick to my point that it compares well with systems in other middle-income countries. I posted some links earlier in the thread that point to research evidence, and if you believe these to be wrong perhaps you can direct us towards peer reviewed publications that contradict this.

Many commentators believe the gap is precisely the main problem, and one which successive policy initiatives have failed to diminish. Training could be improved, but many at consultant level have had pretty good training. With regard to overseas qualified medics who cannot practice in Thailand, are you perhaps getting confused with foreign physicians working for the large international private hospitals, who have limited roles as 'coordinators' and the like? The system does not have GPs, but it does have primary care gate keeping via the CUP, which is important for cost containment. Steps towards integrating ambulance services have been started with the EMIT Thailand. There is again some way to go, and this is also true of accreditation for private hospitals, HTA, and various quality initiatives in the public sector such as KPIs overseen by the NHSO regional offices and PHOs, and some use of P4P in health promotion and disease prevention. The encouraging thing though is that there are things happening in all these areas.

The private system is a drain on the public system. One thing you might be interested to learn however, is if you take the largest six Thai international hospitals they treat more Thais than they do foreigners (even combining medical tourists, expats and unplanned treatments of overseas visitors).

I agree completely with your sentiments regarding the worth of the NHS. Many who have played key roles in reforming Thai healthcare are admirers of the world's first full-scale UHC system - which contrary to what you might read on this forum has been a great inspiration to many.

Edited June 20, 2014 by citizen33

[Sheryl]

....BTW don't be fooled by doctors who claim to have trained in the states. They seldom were allowed to practice and actually only spend a few months on "observation" courses on a particular subject. At the end they get an impressive certificate.

There are quite a few doctors in Thailand (largely Bangkok) who completed full residencies/fellowships in the US during which time they were most definitely "allowed to practice" and not a few of these obtained US Board certification in their area of specialization.

It is quite easy to differentiate from a CV between a short-term course and an actual residency or fellowhsip. The latter last 1-3 years.

[wilcopops]

....BTW don't be fooled by doctors who claim to have trained in the states. They seldom were allowed to practice and actually only spend a few months on "observation" courses on a particular subject. At the end they get an impressive certificate.

There are quite a few doctors in Thailand (largely Bangkok) who completed full residencies/fellowships in the US during which time they were most definitely "allowed to practice" and not a few of these obtained US Board certification in their area of specialization.

It is quite easy to differentiate from a CV between a short-term course and an actual residency or fellowhsip. The latter last 1-3 years.

Very misleading - there are VERY FEW doctors in Thai;and who trained in the US as doctors....most have tangential or spurious qualifications.....and no they DIDN"T practice as doctors in the US.

[Sheryl]

Sorry but to my certain knowledge untrue. It is an easy enough thing to verify. Board certification in the US can be verified online. Doctors who practiced privstely in the US will have an internet footprint listing them at prior place of employment. Etc

[wilcopops]

Sorry but to my certain knowledge untrue. It is an easy enough thing to verify. Board certification in the US can be verified online. Doctors who practiced privstely in the US will have an internet footprint listing them at prior place of employment. Etc

Un fortunately you are so wrong on this - check the figures and find out what practice means. I'm particularly uncomfortable with some who has "moderator" by their avatar posting ill-informed and misleading comments on a thread they imply they have expertise in.

Edited June 27, 2014 by wilcopops

[AnotherOneAmerican]

Of course the gap between the leading Bangkok private hospitals and the average rural community hospital is huge. However, as has been said on this forum many times, the university hospitals, military hospitals and many of the MoPH provincial hospitals are quite good. So somebody living in Isaan might get perfectly adequate treatment at a larger hospital, and in the case of the leading university hospital, Srinakarin in Khon Kaen, would find standards comparable to those of the big Bangkok hospitals, albeit without the plush 'hotel' services. The thing to avoid in Isaan is smaller private hospitals for life threatening conditions.

"The gap" as you put it, is not the main problem. The main proiblems are the poor training of staff from consultants down to cleaners, the lack of ethics and accountability. The inequities caused by the big private hospital are of course a drain on thevsytstem, which rather than care for the Thai people, concentrates on the super rich and medical tourism. Obligations on doctors to work in the Thai national system are minimal and there is no GP system or even a centralised ambulance system No uniform standards of treatment and no boidy to check the services offered nor not offered by hospitals. Again many people are beguiled by "flashy-looking" facilities and often leave hospital feeling they have had great treatment, when in reality they have had an inappropriate possibly more costly procedure abdvwill never be aware that abmuch better outcome should have been achieved.

BTW don't be fooled by doctors who claim to have trained in the states. They seldom were allowed to practice and actually only spend a few months on "observation" courses on a particular subject. At the end they get an impressive certificate.

My ageing aunt was found collapsed on the farm in Nakon Nowhere December last year.

She was diagnosed with a failing liver, and some related problems, by the local hospital.

As there were no immediate family members there to transport her to and from hospital, we moved her to stay with me in CM.

Soon had her signed on with my local hospital NakornPing near Mae Rim, seen immediately.

Referred to the liver specialist in Suan Dok (aka Maharat) and seen the next morning.

Over the last 5 months, she received constant attention, monitoring and medication with weekly hospital appointments.

Once she was strong enough, ending with a 7 day stay in hospital and an operation to put a drain in her liver.

Originally expected to die, she is now almost ready to return home, next hospital appointment due in 6 months.

Lots of queues, most appointments taking all day.

I can't fault the hospitals, doctors or nurses. Don't really care where they trained. Didn't ask.

First class service all the way at no cost to the family except our time.

Much better than the service in my home country.

And this was for an elderly village woman who has no money and no assets.

[wilcopops]

Of course the gap between the leading Bangkok private hospitals and the average rural community hospital is huge. However, as has been said on this forum many times, the university hospitals, military hospitals and many of the MoPH provincial hospitals are quite good. So somebody living in Isaan might get perfectly adequate treatment at a larger hospital, and in the case of the leading university hospital, Srinakarin in Khon Kaen, would find standards comparable to those of the big Bangkok hospitals, albeit without the plush 'hotel' services. The thing to avoid in Isaan is smaller private hospitals for life threatening conditions.

"The gap" as you put it, is not the main problem. The main proiblems are the poor training of staff from consultants down to cleaners, the lack of ethics and accountability. The inequities caused by the big private hospital are of course a drain on thevsytstem, which rather than care for the Thai people, concentrates on the super rich and medical tourism. Obligations on doctors to work in the Thai national system are minimal and there is no GP system or even a centralised ambulance system No uniform standards of treatment and no boidy to check the services offered nor not offered by hospitals. Again many people are beguiled by "flashy-looking" facilities and often leave hospital feeling they have had great treatment, when in reality they have had an inappropriate possibly more costly procedure abdvwill never be aware that abmuch better outcome should have been achieved.

BTW don't be fooled by doctors who claim to have trained in the states. They seldom were allowed to practice and actually only spend a few months on "observation" courses on a particular subject. At the end they get an impressive certificate.

My ageing aunt was found collapsed on the farm in Nakon Nowhere December last year.

She was diagnosed with a failing liver, and some related problems, by the local hospital.

As there were no immediate family members there to transport her to and from hospital, we moved her to stay with me in CM.

Soon had her signed on with my local hospital NakornPing near Mae Rim, seen immediately.

Referred to the liver specialist in Suan Dok (aka Maharat) and seen the next morning.

Over the last 5 months, she received constant attention, monitoring and medication with weekly hospital appointments.

Once she was strong enough, ending with a 7 day stay in hospital and an operation to put a drain in her liver.

Originally expected to die, she is now almost ready to return home, next hospital appointment due in 6 months.

Lots of queues, most appointments taking all day.

I can't fault the hospitals, doctors or nurses. Don't really care where they trained. Didn't ask.

First class service all the way at no cost to the family except our time.

Much better than the service in my home country.

And this was for an elderly village woman who has no money and no assets.

as an assessment of the Thai healthcare system this has no value whatsoever. I would have thought that was obvious.

[AnotherOneAmerican]

as an assessment of the Thai healthcare system this has no value whatsoever. I would have thought that was obvious.

Thread title "So you think your Thai healthcare is good?"

My answer is a most definite yes!

My aunt, myself, a kid with dengue, a cousin with dengue, another kid bitten by a cobra, a couple of nieces having babies that I visited in rural government hospitals.

All I have seen so far is good treatment, free of charge. That's seven major medical events spread over 4 government hospitals and 1 semi-private.

In what way is my assessment valueless?

Edited June 27, 2014 by AnotherOneAmerican

[cheeryble]

NHS is definitely not the worlds best healthcare system, it not even the UK's best.

Why do people pay for BUPA when the NHS is free?

Exactly.....

The guardian is not even worth using as emergency bog roll.

Why do they pay for BUPA?

Because the NHS is a compromise and that compromise saves a lot of money it seems.

The compromise is waits.....only sometimes!.....for non-urgent treatment such as in "emergency" .

You need a stitch in your finger well just occasionally you'll wait a bit. You got anything serious and you'll be swept through to essential treatment.

BUPA has mostly the same docs as NHS by the way.

I had to wait a long time for monitoring at the Maudsley, but when it came I was under the care of perhaps the most illustrious mental hospital in the world. That's back many decades I hear things have changed and my hernia OP was a model of efficiency and timeliness.

For me it's a good compromise....in the US health costs are disabling the country and making masses of people worry at the time they don't need to worry.

God bless the NHS

ps the Daily Mail constantly groaning about over-management in the NHS all high salaries.

Well there's an optimum number of managers, and someone who knows says if anything they don't have enough.

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[cheeryble]

Just read my post above it was confusing where I said it was possible for waits in "emergency"

Of course I meant waits for non-urgent cases presenting at emergency admission.

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