‘Medical hub’ ambition requires thorough thinking

[webfact]

OPINION

‘Medical hub’ ambition requires thorough thinking

By The Nation

 

Govt’s Plan must not come at the expense of local patients and standards in the public health system

 

BANGKOK: -- State-supported healthcare is always controversial, as it can never be universally agreed on how much or to what extent the poor should be assisted.

 

The government’s plan to turn the country into a medical hub for foreign tourists will not make things any easier. While there is a clear line between how much the poor and the rich can afford when they seek medical treatment, thus making “medical tourism” something that seemingly doesn’t affect the former, the government's ambition requires thorough thinking.

 

The very first thing that can happen if Thailand becomes a full-blown medical hub is further migration of health personnel to the private sector. Professionals follow the money and doctors, nurses and physicians are no exceptions. The situation is already worrying; only the best-known state hospitals are able to afford to keep qualified human resources, and it could get really bad when the private sector starts headhunting.

 

Medical tourism is not new. In fact, a lot of foreigners come to Thailand with a priority of, say, seeking dental services while doing some sightseeing or enjoying a break as a secondary factor.

 

Thailand, Singapore and India account for some 90 per cent of Asia’s medical tourism market. The current government must have seen the trend, and thus an opportunity to make more money.

 

Immigration rules can also be relaxed for potential “patients” from overseas while medical services that are in demand stand to get more or less state support.

 

On the one hand, Thailand’s ability to attract “medical tourists” is something the country can be proud of, and its “Land of Smiles” reputation will undoubtedly help the ambitious plan when it is carried out.

 

On the other hand, that Thailand can provide cheap but quality healthcare adds insult to injury, as it mocks the fact that a lot of Thai nationals still get substandard medical care, and state-supported healthcare still has significant room for improvement.

 

Many state employees, meanwhile, are reluctant to quit their low-paying jobs because one of the major fringe benefits is that they can get medical fees reimbursed for immediate family members. That can only mean one thing: the healthcare sector in this country is far from perfect.

 

The government needs to think it through, and a lot of safeguards must be put in place to make sure that the “medical hub” ambition does not succeed at the expense of the poor or Thai people in general. The best brains can be easily sucked to where big money is. It has happened to all professions, but we must be extra careful when it comes to key social services like

healthcare. We don’t need to look further than the Thai education system, whose dismal state is a direct result of the fact that fewer and fewer good teachers have wanted to work in the public sector, with more and more having sought employment in 

private institutions that pay better salaries.

 

Medical investment is increasingly geared toward the rich. Many private hospitals already look intimidating for poor people to walk into, although the facilities cater mainly to Thais.

 

Imagine what could happen when the healthcare sector gets a bigger licence to cash in on foreign patients. However, squeaky clean lobbies or hotel-like waiting rooms are not what we should be worried about.

 

What the government should focus on is the question how many qualified health personnel will be left to serve the Thai public, if the balance is upset and medics begin to think that serving rich foreign patients is the way to go.

 

Source: http://www.nationmultimedia.com/detail/opinion/30320906

 

-- © Copyright The Nation 2017-07-17

[blackcab]

The answer is really simple:

 

If Thailand is critically short of medical professionals then allow qualified doctors and nurses from other countries to work in Thailand without requiring them to speak or write Thai.

 

As the patients would almost all be non-Thai then fluency in English (or possibly Chinese/Arabic, etc) should be sufficient.

[Samui Bodoh]

1 hour ago, webfact said:

BANGKOK: -- State-supported healthcare is always controversial, as it can never be universally agreed on how much or to what extent the poor should be assisted.

 

Why not set the standard that the poor can receive the same level of health care as an army general?

 

That could be universally agreed to.

 

[jaywalker]

1 hour ago, webfact said:

requires thorough thinking

......I think this is where it all starts to fall apart.

[maewang99]

everything is our future world involves higher levels of human resources. 

the MRO hub (aviation repair).... no exception to the same requirement as with doctors and nurses. 

we can name them all.  so, here we go again.. it all, even the alcoholism stuff... leads back to only one thing....... education.  and using misdirection with words such as "education reform" when you know in your heart of hearts it has always meant school decentralization... not so that the children are not brought up to be Thai patriots... but because centralized management of schools in a country as large as Thailand... just doesn't work.... and that there is nothing that the people are more concerned with than the welfare and education of their children. the synergy begins there... not with "better teachers".... but with better schools, involved parents and neighbors totally engaged in that effort. 

not fingerprint machines... to encourage the top rank to show up at the school on time.  there should be another management approach. 

   

 

Edited July 16, 2017 by maewang99

[Bill Miller]

My dad had his kidney operation at a VA hospital by a world ranked surgeon, who was also a professor at Yale New Haven University Hospital. 

Not a unique situation, the point being that not all medical people are going to "follow the money" and abandon the poor.

The folks I have dealt with at provincial hospitals have been pretty first rate.

They could use a little infrastructure support, and maybe some facilities management, which is a glaring short coming in Thai culture. "My" hospital, for instance, has numerous fans, including several industrial strength evaporative cooling types, yet folks are waiting for hours in stifling heat, fanning themselves with whatever is at hand, sweat rolling down their faces, because the damned fans are not turned on, and the "swamp cooler's" water reservoirs are empty.

How about a little paint once a decade or so?

The farangs are not going to suck the medical resources dry... they are already being neglected.

[SOUTHERNSTAR]

These medical tourist can drive by the government hospitals where normal people stand inline for hours to get seen by a doctor thats over worked and under paid and then this tourist can check in at a world class hospital which bought all the good doctors. Yup this is sustainable isnt it?

[Bob12345]

4 hours ago, blackcab said:

The answer is really simple:

 

If Thailand is critically short of medical professionals then allow qualified doctors and nurses from other countries to work in Thailand without requiring them to speak or write Thai.

 

As the patients would almost all be non-Thai then fluency in English (or possibly Chinese/Arabic, etc) should be sufficient.

Or just hire translators.

 

In my wifes hospital they have Chinese, Russian, Dutch, French, German, and whatever more translators on hand.

Works out nicely especially with the Chinese translator who doesn't mind yelling at the patient so the doctor doesn't have to.

[Emster23]

"Make the pie higher!" as Geo Bush2 once said. There's your answer

[yellowboat]

The current government has driven most of those people away in the last three years.   You cannot trust Thailand.  Malaysia might be a better option.  Less hassles.  Immigration there is a government department not a cash cow. 

[maewang99]

I gotta stay away from this website.  I'm too much of a western person to not think about stuff... and then my comments are usually negative.

I don't like leaving bad comments.  I live here. 

but it's some kind of catch 22.. unless I just avoid this website 100%. but the problem is... even then.... I still can't avoid seeing stuff in real life everyday that I would never see anywhere else that I know of. there are some other places somewhere like this.... I guess ... but not that I have ever been to.

and it doesn't help to laugh it off either... not really.  no wonder folks get drunk.   

Edited July 17, 2017 by maewang99

[Beats56]

3 hours ago, jaywalker said:

......I think this is where it all starts to fall apart.

I smell rubber burning... 

They are schooled not to think only listen

 

[YetAnother]

5 hours ago, webfact said:

further migration of health personnel to the private sector.

will continue to happen for sure; unfortunately spending too much time in hospitals as a patient, the staff quality that is actually experienced by patients is already very different public versus private; excess use of interns with no immediate supervision is common in the public side; quite frankly, the private side doctors and nurses seem happier, likely due to lesser workloads than the public  

[Bob12345]

1 hour ago, YetAnother said:

will continue to happen for sure; unfortunately spending too much time in hospitals as a patient, the staff quality that is actually experienced by patients is already very different public versus private; excess use of interns with no immediate supervision is common in the public side; quite frankly, the private side doctors and nurses seem happier, likely due to lesser workloads than the public  

Absolutely agree there.

My wife works in a private hospital but has done her specialization in a public hospital plus she did some time working upcountry to pay back the government for her education. So she has seen both sides and has many friends in the same field (several hundred as she spend 6 years with them in university and keeps in contact regularly).

 

Basically working conditions in the private sector are much, much better. Less stress, better environment (AC running all day long, modern equipment, politer patients, no reason to turn down requests from patients as they pay for it so why deny them an extra scan if they insist), more status, better staff (the nurses work harder in general), etc. The gap between private and public is actually widening: in the past your family could get freebies when you worked for a public hospital but that stopped a couple of years ago (my wife's parents were covered under a different healthcare plan because she worked for a hospital giving them free access to better medicine). And see the recent problems with nurses being hired as temporary staff to not give them full pay in the public sector, that wont be good for morale.

 

The main reason some of her friends still work in public hospitals normally boils down to the following 4 motivations, from most likely to least likely:
1. they want to work close to their parents' place or home town and there is no private hospital with open positions there (think outside of BKK)  -> this is the most often mentioned reason for staying in the public sector

2. they signed a contract forcing them to stay at a public hospital (in exchange for a specialization or for their "free" education; if you do a 3 year specialization you typically need to stay another 6 years working in the public sector to "repay")

3. they want to have a teaching position which is only available in the public sector

4. they want to do something for the country / their community; ideological motivation (least mentioned reasoning)

[Khun Paul]

The whole situation is doomed to failure as THINKING is not a Thai trait  at ALL !!!!!!!!!!!!!!!!!

[WhizBang]

21 hours ago, Samui Bodoh said:

 

Why not set the standard that the poor can receive the same level of health care as an army general?

 

That could be universally agreed to.

 

 

Would that include obtaining medical services in Sweden (or was it Switzerland) at state expense, as Prawit did?

 

[WhizBang]

For foreigners, the Thai way of NOT accepting responsibility when something or someone f**ks up, is a major obstacle.  Thai doctors and hospitals must be prepared to take responsibility and correct (that means pay for, and maybe have to pay additional compensation too)  any and all issues that may arise, especially if there is incompetence involved.

 

Until that happens, this HUB will die on the vine.