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

[Issangeorge]

I have always felt the health care system in Canada was good. However I must admit it is pretty hard to beat a system like Thailand's, where all Thais are covered, including drugs prescribed by the hospital. After seeing the Thai system the Americans should be ashamed of themselves.

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[wilcopops]

I have always felt the health care system in Canada was good. However I must admit it is pretty hard to beat a system like Thailand's, where all Thais are covered, including drugs prescribed by the hospital. After seeing the Thai system the Americans should be ashamed of themselves.

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the Thai system is quite different from the UK system...all Thais (or just about - you need various IDs etc) are covered.....but what with? A system that is poorly trained and rickety, devoid of ethics and with no comeback.

You hear a lot of criticism of the UK NHS and rightly so - because it has systems, monitoring and checks and balances to make sure that poor practices are stamped on before they get out of hand.....all NHS employees can be held accountable - and some are - for any negligent behaviour. The Thai system has NO SUCH SAFEGUARDS, and the services available to "everyone" are permanently under pressure from elitist private hospitals who poach both staff and finances.

[AnotherOneAmerican]

I have always felt the health care system in Canada was good. However I must admit it is pretty hard to beat a system like Thailand's, where all Thais are covered, including drugs prescribed by the hospital. After seeing the Thai system the Americans should be ashamed of themselves.

Sent from my i-mobile IQ 6 using Thaivisa Connect Thailand mobile app

the Thai system is quite different from the UK system...all Thais (or just about - you need various IDs etc) are covered.....but what with? A system that is poorly trained and rickety, devoid of ethics and with no comeback.

You hear a lot of criticism of the UK NHS and rightly so - because it has systems, monitoring and checks and balances to make sure that poor practices are stamped on before they get out of hand.....all NHS employees can be held accountable - and some are - for any negligent behaviour. The Thai system has NO SUCH SAFEGUARDS, and the services available to "everyone" are permanently under pressure from elitist private hospitals who poach both staff and finances.

Dunno about that, Dr. Death killed loads (up to 250), not many checks and balances worked with him.

http://en.wikipedia.org/wiki/Harold_Shipman

Not to mention Thai doctors tend to have several jobs in different hospitals.

No need for elitist private hospitals to poach, doctor will work for both.

Edited June 29, 2014 by AnotherOneAmerican

[wilcopops]

I have always felt the health care system in Canada was good. However I must admit it is pretty hard to beat a system like Thailand's, where all Thais are covered, including drugs prescribed by the hospital. After seeing the Thai system the Americans should be ashamed of themselves.

Sent from my i-mobile IQ 6 using Thaivisa Connect Thailand mobile app

the Thai system is quite different from the UK system...all Thais (or just about - you need various IDs etc) are covered.....but what with? A system that is poorly trained and rickety, devoid of ethics and with no comeback.

You hear a lot of criticism of the UK NHS and rightly so - because it has systems, monitoring and checks and balances to make sure that poor practices are stamped on before they get out of hand.....all NHS employees can be held accountable - and some are - for any negligent behaviour. The Thai system has NO SUCH SAFEGUARDS, and the services available to "everyone" are permanently under pressure from elitist private hospitals who poach both staff and finances.

Dunno about that, Dr. Death killed loads (up to 250), not many checks and balances worked with him.

http://en.wikipedia.org/wiki/Harold_Shipman

Not to mention Thai doctors tend to have several jobs in different hospitals.

No need for elitist private hospitals to poach, doctor will work for both.

not true - doctors who train in Thailand - and that is the preferred system here are obliged to work for the government health system for only 2 years....after that many are lost to high pay jobs like plastic surgery or private hospitals....the ones who stay in government hospitals...well WHY???

In UK,all doctors are obliged to work for the NHS.

You might also begin to look at the health system for what it is....it isn't just doctors - it is the entire system.....the support staff, training!!! the legal obligations the autonomy of the doctors and checks and balances too and able all the culture of ethics.

I think that citing the Shipman case is particularly facile - as serial killers are not a product of the health system itself - and at some point he was caught - by the same logic we can say that the Thai version hasn't even been discovered!

[cheeryble]

"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.

rhythmworx be very careful too know what your stats mean.

Example hospital mortality can be hugely skewed by national traditions of dying at home.

They die anyway, but for the hospital it sounds like blazing success.

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[Issangeorge]

Wilcopops you say "

not true - doctors who train in Thailand - and that is the preferred system here are obliged to work for the government health system for only 2 years....after that many are lost to high pay jobs like plastic surgery or private hospitals....the ones who stay in government hospitals...well WHY???" Any private hospital I have been in, the doctors all worked in the government hospitals also. Mind you these have been up country hospitals Bangkok hospitals might be different.

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[Sheryl]

In Bangkok also, the top specialists usually hold faculty positions at government teaching hospitals.

As to "why" - believe it or not, many doctors have a sincere commitment to trying to help people and are attracted to what allows them to have the largest impact, which = working in a government hospital since these are the source of health care for the vast majority of Thai people (and sole source for many).

And it is easy enough to make up for the low salary through a bit of private practice on the side. Which is exactly what most of them do.

[Thai at Heart]

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.

Brits complain about everything. Its part of our DNA. The NHS is a wonder. I went with my uncle the other day for his check up. He has Alzheimer's.

Having just been through watching and nursing my father in law through late stage Alzheimer's in Thailand , I know my uncle will be infinitely better off in the UK.

[Thai at Heart]

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.

Public and media moaning is an effective tool to exposing problems and improving quality in public services.

Thailand should try it.

[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.

Public and media moaning is an effective tool to exposing problems and improving quality in public services.

Thailand should try it.

Things can be improved everywhere, no question.... even in the excited united states, not everything is perfect... (although they think it is! )

I have been impressed with my local Thai government hospital .... very efficient.... and as one visitor said to me, when i was in there for a week, the comment was, "not much different from a UK hospital"

Thankfully I've not had to use the NHS in over 40 years.... I lived in Canada, where it's not perfect either....

[citizen33]

not true - doctors who train in Thailand - and that is the preferred system here are obliged to work for the government health system for only 2 years....after that many are lost to high pay jobs like plastic surgery or private hospitals....the ones who stay in government hospitals...well WHY???

In UK,all doctors are obliged to work for the NHS.

You might also begin to look at the health system for what it is....it isn't just doctors - it is the entire system.....the support staff, training!!! the legal obligations the autonomy of the doctors and checks and balances too and able all the culture of ethics.

I think that citing the Shipman case is particularly facile - as serial killers are not a product of the health system itself - and at some point he was caught - by the same logic we can say that the Thai version hasn't even been discovered!

I have to say that I find a couple of things about Wilcopops' posts puzzling. First why compare Thai healthcare with the UK NHS? The Thai system is obviously at a different stage of development, is based on three public health insurance funds and a plurality of providers rather than a (still) largely integrated tax-funded service, and could more fairly be compared with the systems of other middle-income countries. Second, although there is a lot of positive evidence of improvement in the Thai system since the early 2000s, Wilicopops makes damning assertions without any supporting research evidence whatsoever. In the vernacular, and without meaning any offence, perhaps it is time to put up or shut up? Yes, you will find some studies that show a brain drain from the public to the private sector and (in the past) some 'policy confusion', but the outcomes achieved and the increase in access to healthcare for poorer people (especially the near-poor) look impressive. Where is the evidence of failure?

I am a strong supporter of the NHS, as are many of the people who have tried to improve Thai healthcare. The NHS is a great institution, but like all health care systems it has had some setbacks. The critics of the NHS (whom I believe to be misguided) would probably not point to Shipman, but rather to Mid-Staffs (the Francis Reports), the Keogh Review and the hospitals subsequently placed into special measures. There have been some unfortunate incidents but overall the NHS delivers very acceptable results at a lower cost than most rival systems. This also applies to the Thai health care system at the middle/lower income level, particularly in terms of the benefits of 'closed-end' funding mechanisms that are attracting a lot of interest from other ASEAN+3 countries.

P.S. On the 'why' question Sheryl gave most of the answers above. Others are accelerated progression through the civil service grades and (limited) incentive payments for rural service. Incidentally many of the senior officials at the MoPH and NHSO served their time as rural doctors, but are doing pretty well now.

Edited June 30, 2014 by citizen33

[rsokolowski]

The commonwealth fund is a leftist American organization that works for universal healthcare (aka socialized medicine). From their website "

Mission

The mission of The Commonwealth Fund is to promote a high-performing health care system that achieves better access, improved quality, and greater efficiency, particularly for society's most vulnerable, including low-income people, the uninsured, minority Americans, young children, and elderly adults."

[citizen33]

Yes, funded by philanthropy from the Harkness, Picker and Macgregor families who made their money in the private sector - I suppose they must have been closet reds all along!

[razorramone]

My sister has been waiting 2 months for a head scan in the UK, after experiencing blurred vision and constant headaches. It could be something life threatening and she is wasting valuable time. Cost: free.

Last week I spent too much time on the internet reading about arthritis, and I stupidly convinced myself I had it. So I rushed to phayathai 2 and within three hours I had blood test results and a dvd of various xrays assuring me I was fine. Cost: a few hours overtime.

I know which I prefer.

[Issangeorge]

My sister has been waiting 2 months for a head scan in the UK, after experiencing blurred vision and constant headaches. It could be something life threatening and she is wasting valuable time. Cost: free.

Last week I spent too much time on the internet reading about arthritis, and I stupidly convinced myself I had it. So I rushed to phayathai 2 and within three hours I had blood test results and a dvd of various xrays assuring me I was fine. Cost: a few hours overtime.

I know which I prefer.

You are one of the lucky ones who can work a few hours overtime and thus can afford medical care. The solution for the countries that have a national health service is to get the waiting times down. One thing in Thailand I find different from Canada and saves a lot of time, is that a lot of individual doctor's offices have ultrasound machines and blood testing machines that can do simple tests, in Canada I asked my GP once why she didn't have an ultrasound machine. Her answer was she wouldn't know how to read it.

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Edited July 1, 2014 by Issangeorge

[citizen33]

Agree that getting waiting times down is the answer. The four UK countries all have slightly different NHS waiting times policies. England has made pretty good progress in recent years, with a legal right to a maximum wait of 18 weeks GP referral to treatment, and less for urgent conditions.

www.nhs.uk/choiceintheNHS/Rightsandpledges/Waitingtimes/Pages/Guide%20to%20waiting%20times.aspx

In the case of Razorramone's sister, the issue may be whether her condition is seen as urgent. It may be worth her writing to her clinical commissioning group to complain, .Is the two months from GP referral or from consultant outpatient consultation, I wonder?

There is in fact a low-cost way around NHS waiting lists, though you have to join up before you get sick. It comes about because some of the old friendly societies are still in existence.

See, for example: www.benenden.co.uk/

[liddelljohn]

In thailand i can see a GP at 10 minutes notice ,, in UK it takes me and my family 3 weeks to get a GP appointment !!!!!

In UK my diabetes went undiagnosed for 4 years even with 14 medical checks on NHS in thailand it was spotted 1st time and treated properly,, in Uk my cancer issues were missed on 6 occaisions in thailand they were spotted immediately and sorted quickly ..

NHS = NO HOPE SYSTEM but still better than USA health care unless you are wealthy .

[Thai at Heart]

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.

Public and media moaning is an effective tool to exposing problems and improving quality in public services.

Thailand should try it.

Things can be improved everywhere, no question.... even in the excited united states, not everything is perfect... (although they think it is! )

I have been impressed with my local Thai government hospital .... very efficient.... and as one visitor said to me, when i was in there for a week, the comment was, "not much different from a UK hospital"

Thankfully I've not had to use the NHS in over 40 years.... I lived in Canada, where it's not perfect either....

I don't disagree. But the nature of something as enormous as the NHS is that mistakes will happen and need to be exposed and improved. Thank god for that.