Thai teen’s death illuminates state hospital woes

[webfact]

EDITORIAL:

Teen’s death illuminates state hospital woes

By The Nation

 

Whether the boy died of a ‘rare’ ailment or from waiting too long, changes are needed 

BANGKOK: -- The death of a teenage patient at a provincial hospital last week has triggered public uproar, including drama on the social media, and at the same time highlighted severe problems in the country’s public health system, particularly at state-run hospitals.

 

The 15-year-old boy succumbed last Thursday to aortic rupture after being admitted to a hospital in Phetchaburi with abdominal pain. His stricken family took to the social media to complain that he’d been left to wait for hours before finally 

receiving treatment, and by then it was too late. 

 

The claim of inadequate hospital care ignited public outrage directed at medical personnel at the hospital. Hospital administrators denied the charge of negligence, saying that, rather than being “abandoned”, the patient had to wait for the results of his CT scan from a Bangkok hospital. They explained that he died instantly when a main blood vessel in his chest burst.

 

Senior local public health official Dr Prajak Wattanakul said the youth’s condition was rare, afflicting only about five people per one million, and even rarer for a teenager. “It’s normally found in adults aged 40 to 70,” he said.

 

This is primarily a conflict between state-hospital medical staff – who complain about a shortage of personnel and inadequate equipment – and patients and their families who complain about long waits and unsatisfactory service. 

 

Patience is precisely what patients need at state hospitals, where services and medicine are mostly free thanks to the universal healthcare programme. In exchange for these benefits, people seeking treatment and their loved ones in attendance must cope with nurses irritated by their heavy workload and with long waits due to the large number of people in need of care. 

 

On the other side of the coin, most nurses will also be feeling the grief over this latest drama. Many have expressed their feelings on the social networks. More than one nurse has been coldly asked by a weary waiting family member whether their loved one too was being “left to die” like the Phetchaburi teen. How disheartening this is for the nurses, how damaging to their work morale, can only be imagined. One nurse in Chon Buri said the brutal workload at state-run hospitals routinely drives nurses to private hospitals, where the salary is higher and work conditions are better.

 

From the hospital’s point of view, the teenager’s death resulted from a rare ailment. But from his family’s perspective, he died after having waited too long. The question is whether a patient with the same symptoms would die if being treated at a private hospital, where the fees are higher but the equipment and personnel are more adequate.

 

This case highlights the problems of staff shortage, insufficient equipment and inadequate service at government-run hospitals. Medical personnel must be more careful in screening patients and trying to determine which ones have serious, life-threatening symptoms and which require immediate treatment. The longer that patients with severe symptoms have to wait and the more likely it is they will succumb to their ailments.

 

It’s time for those involved to think of overhauling the state hospital system, with the goal of improving service, quality and efficiency. Medical personnel at state hospitals deserve better pay. Their workload is much heavier, and yet they’re expected to provide top-notch service. Improved welfare benefits and other incentives can also help keep hardworking medical personnel at state hospitals.

 

Source: http://www.nationmultimedia.com/detail/opinion/30321922

 

-- © Copyright The Nation 2017-07-27

[Deli]

Chasing teenage singers and short pants has higher priority than saving lives.

[YetAnother]

3 hours ago, webfact said:

The question is whether a patient with the same symptoms would die if being treated at a private hospital, where the fees are higher but the equipment and personnel are more adequate.

based on my not insubstantial experience in both public and private hospitals as an inpatient, the differences between the two are pretty wide in favor of the private; happier workers, including the administrative personnel make a Huge difference

Edited July 27, 2017 by YetAnother

[Confuscious]

Anybody who has been to a State hospital knows where the MAIN problem is.

The State hospitals are "run" be old, angry Thai woman who thinks that they own the world and can do with anyone as they please.
Even when rules are setup to prevent this kind of situation, these old, angry nurses knows very well that you will need to meet ALL the requirements they want before you are able to speak to anyone else.
Give their job to a computer (ticketing machine) and get rid of them.
That will speed up the waiting queue by 80%.

[maewang99]

there's one caution on private versus pubic.... even though some of the caregivers are the same folks at each...

patient exposure... a busy practice... keeps the caregivers experienced.

I know of some pretty horrid results at top of the line private hospitals... where there sometimes is even a dearth of patients....leading to dangerous situations.... as well as simple but important stuff such as not even correctly taking a patient's vitals before seeing a doctor for basic care.... at the fancy private hospital.. not the public one.   

 

Edited July 27, 2017 by maewang99

[colinneil]

30 minutes ago, Confuscious said:

Anybody who has been to a State hospital knows where the MAIN problem is.

The State hospitals are "run" be old, angry Thai woman who thinks that they own the world and can do with anyone as they please.
Even when rules are setup to prevent this kind of situation, these old, angry nurses knows very well that you will need to meet ALL the requirements they want before you are able to speak to anyone else.
Give their job to a computer (ticketing machine) and get rid of them.
That will speed up the waiting queue by 80%.

You sir are talking nonsense.

I have more experience with state hospitals here than most people.

Spent 7 months in Khonkaen hospital, many very fit/sexy young nurses.

Very well mannered, very good at caring for patients, yes a few older nurses.

One in particular older nurse, an absolute bitch, i complained about her several times, nothing ever done about it, but she has since been sacked from the hospital, due to many complaints from Thais.

[Confuscious]

2 minutes ago, colinneil said:

You sir are talking nonsense.

I have more experience with state hospitals here than most people.

Spent 7 months in Khonkaen hospital, many very fit/sexy young nurses.

Very well mannered, very good at caring for patients, yes a few older nurses.

One in particular older nurse, an absolute bitch, i complained about her several times, nothing ever done about it, but she has since been sacked from the hospital, due to many complaints from Thais.

You "sir" just confirmed my post.

Quoting:

"One in particular older nurse, an absolute bitch, i complained about her several times, nothing ever done about it, but she has since been sacked from the hospital, due to many complaints from Thais."

[colinneil]

Just now, Confuscious said:

You "sir" just confirmed my post.

Quoting:

"One in particular older nurse, an absolute bitch, i complained about her several times, nothing ever done about it, but she has since been sacked from the hospital, due to many complaints from Thais."

 Yes one nurse, only one, not many like you impied

[Jonnapat]

Problem is the vast difference there appears to be in state run hospitals.

On the credit side I've had major surgery 9 years ago at Siriraj hospital with multiple follow ups and can only say that the treatment I receive is first class and very affordable.

Guess it's the luck of the draw.

[quadperfect]

Subs,planes,tanks and guns are far more important to national well being than a fully staffed highly competent state hospital.

People die every day.

Sounds like this instance the poor boy did not have much time .

For sure more needs to be done for the people of thailand now than for the defence of thailand for some unknown future threat.

I know beating a old horse here but seriuosly you will not ever see me in a state run hospital while i am still alive.

[billd766]

29 minutes ago, quadperfect said:

Subs,planes,tanks and guns are far more important to national well being than a fully staffed highly competent state hospital.

People die every day.

Sounds like this instance the poor boy did not have much time .

For sure more needs to be done for the people of thailand now than for the defence of thailand for some unknown future threat.

I know beating a old horse here but seriuosly you will not ever see me in a state run hospital while i am still alive.

 

You could equally say that the 500 billion? baht poured into the rice scheme was more important than a fully staffed highly competent state hospital.

 

In fact the 500 billion? baht is more than the annual budget for the Ministry of Health, yet the previous PTP government chose to waste money on that.

 

I prefer to use the state run hospital over the private hospitals. My wife went private for one night and checked out the next day as it was too expensive at over 10,000 baht per 24 hours. She had to wait until the doctor treating her turned up from the state hospital where he also works 1km down the road. He turned up at 2:30 in the afternoon.

 

One of the medicines she was prescribed was Tylenol 500 mg at 18 baht per tablet. On the way home I went to the local pharmacy and bought a bottle of 100 Tylenol tablets for 100 baht.

[barefootbangkok]

7 hours ago, Confuscious said:

Anybody who has been to a State hospital knows where the MAIN problem is.

The State hospitals are "run" be old, angry Thai woman who thinks that they own the world and can do with anyone as they please.
Even when rules are setup to prevent this kind of situation, these old, angry nurses knows very well that you will need to meet ALL the requirements they want before you are able to speak to anyone else.
Give their job to a computer (ticketing machine) and get rid of them.
That will speed up the waiting queue by 80%.

Yes the angrier the nurse, the more personal power, in direct contradiction to traditional standards of being quiet and submissive. When my father in law died, it was a bossy lady nurse who refused to put him in the Critical Care Unit despite the fact that he was in a coma. The next day when he was brain dead, an older cranky female doctor placed him in CCU. 

[robblok]

9 hours ago, YetAnother said:

based on my not insubstantial experience in both public and private hospitals as an inpatient, the differences between the two are pretty wide in favor of the private; happier workers, including the administrative personnel make a Huge difference

Of course, however nobody want / or can fund it. No recent goverment has substantially increased the health budget. Free healthcare.. is just not free. The tax base is not big enough. Mind you I am against the increased military spending but even if that amount had been added to the health budget it would not have helped much. The cost of the rice program is about twice the anual health budget.. that would have made a far bigger dent if the money had been allocated there. But it certainly would not have bought as many votes as the rice program and one has to keep adding money to the health budget year after year. 

 

I said it before.. just ad 1% to the VAT and mandate it that it goes to healthcare on top of the current budget. That is a way to finance it and then everyone is paying for it. (too bad for us foreigners). But at least its a solution to the problem instead of just complaining. 

[Grubster]

9 hours ago, YetAnother said:

based on my not insubstantial experience in both public and private hospitals as an inpatient, the differences between the two are pretty wide in favor of the private; happier workers, including the administrative personnel make a Huge difference

Yes there is no comparison between the two, I have instructed my wife to bypass the large government hospital and drive the extra 1 1/2 hours to the private hospital, if I die so be it but I do not want to wake up in a shit hole. I think these government hospitals are underfunded but if I were a poor person I would be very happy to have them available. They are much better than most of the rest of SE Asian nations have. I doubt the kid in this story would have survived in any hospital in the world.

[robblok]

8 minutes ago, Grubster said:

Yes there is no comparison between the two, I have instructed my wife to bypass the large government hospital and drive the extra 1 1/2 hours to the private hospital, if I die so be it but I do not want to wake up in a shit hole. I think these government hospitals are underfunded but if I were a poor person I would be very happy to have them available. They are much better than most of the rest of SE Asian nations have. I doubt the kid in this story would have survived in any hospital in the world.

Mistakes are made everywhere, and this was a rare case. I think you are right in your assessment. When I can i go to private hospitals, once I been to a government hospital for a nose operation. It was actually not that bad. 

[Grubster]

5 hours ago, billd766 said:

 

You could equally say that the 500 billion? baht poured into the rice scheme was more important than a fully staffed highly competent state hospital.

 

In fact the 500 billion? baht is more than the annual budget for the Ministry of Health, yet the previous PTP government chose to waste money on that.

 

I prefer to use the state run hospital over the private hospitals. My wife went private for one night and checked out the next day as it was too expensive at over 10,000 baht per 24 hours. She had to wait until the doctor treating her turned up from the state hospital where he also works 1km down the road. He turned up at 2:30 in the afternoon.

 

One of the medicines she was prescribed was Tylenol 500 mg at 18 baht per tablet. On the way home I went to the local pharmacy and bought a bottle of 100 Tylenol tablets for 100 baht.

Giving money to rice farmers is not a waste of money, all that money gets spent back into the economy. Money spent on arms in foreign countries is gone and will not benefit one single Thai person except the ones getting the large kickbacks.

  Yes Private Dr's are required to work in government hospitals also and I think that is a good thing. They have a much better system here than in the US I would say.

[YetAnother]

pity this had to happen; thailand's hospital woes are no secret; just no real ruler will to address them

[robblok]

19 minutes ago, YetAnother said:

pity this had to happen; thailand's hospital woes are no secret; just no real ruler will to address them

No they won't i like my suggestion.. raise vat by 1% and make sure it can only be spend on healthcare (and of course that the current budget can't be slashed). You can't spend more money on healthcare without either drastically cutting somewhere else.. or getting more money. I like the VAT one then everyone is paying, and as inflation rises so does the health budget. win win (except for foreigners we are screwed then just paying and not receiving.. but I can live with that)

[barefootbangkok]

7 hours ago, Jonnapat said:

Problem is the vast difference there appears to be in state run hospitals.

On the credit side I've had major surgery 9 years ago at Siriraj hospital with multiple follow ups and can only say that the treatment I receive is first class and very affordable.

Guess it's the luck of the draw.

Government hospitals in the major cities like Bangkok, Chiang Mai and Pattaya have a higher standard than those in the country.  A major problem is that if a Thai person is born in an outside province, they cannot get free health care outside of their own province unless they can change their tabien ban or home registration. If the government hospital in their province is bad, that is the luck of the draw, as another poster stated.

[balo]

This was a rare case , it could have happened anywhere ,

In government hospitals you wait until it's your turn  . In Norway, one of the richest countries in the world  we had some cases about patients dying in the waiting room . Because government hospitals offer free health care.  Sometimes it's just too late.  

[billd766]

17 hours ago, Grubster said:

Giving money to rice farmers is not a waste of money, all that money gets spent back into the economy. Money spent on arms in foreign countries is gone and will not benefit one single Thai person except the ones getting the large kickbacks.

  Yes Private Dr's are required to work in government hospitals also and I think that is a good thing. They have a much better system here than in the US I would say.

 

I didn't say that giving money to the rice farmers was a waste, just that this particular scheme was a waste.

 

If the money had been spent on the health service it would also be spent back into the economy of Thailand.

 

Not all private doctors HAVE to work at government hospitals. Mainly it is the younger ones just starting out.

 

The only link I have found about that is here but the study dates back to 2009.

 

http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/281627-1095698140167/THLHealthWorkforce.pdf

 

This is from page 9

 

(2) Compulsory strategies

Compulsory public service:

All PCWs and nurses trained by colleges under the

MOPH are required to obtain a government scholarship and to sign a contract for

compulsory public service for 4-8 years after graduation. Due to a zero growth civil

servant policy, this approach was terminated in 2001. In the case of doctors, this

approach was initiated to address a critical shortage of doctors in rural areas. Since 1972,

all doctors have been compelled to serve in rural public hospitals for 3 years. If they

breach their contract, they are required to pay a fine of USD 3,000 (1997 price). This fine

was increased to USD 8,000 and 16,000 in 1971 and 1977, respectively.

 

 

[Grubster]

2 hours ago, billd766 said:

 

I didn't say that giving money to the rice farmers was a waste, just that this particular scheme was a waste.

 

If the money had been spent on the health service it would also be spent back into the economy of Thailand.

 

Not all private doctors HAVE to work at government hospitals. Mainly it is the younger ones just starting out.

 

The only link I have found about that is here but the study dates back to 2009.

 

http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/281627-1095698140167/THLHealthWorkforce.pdf

 

This is from page 9

 

(2) Compulsory strategies

Compulsory public service:

All PCWs and nurses trained by colleges under the

MOPH are required to obtain a government scholarship and to sign a contract for

compulsory public service for 4-8 years after graduation. Due to a zero growth civil

servant policy, this approach was terminated in 2001. In the case of doctors, this

approach was initiated to address a critical shortage of doctors in rural areas. Since 1972,

all doctors have been compelled to serve in rural public hospitals for 3 years. If they

breach their contract, they are required to pay a fine of USD 3,000 (1997 price). This fine

was increased to USD 8,000 and 16,000 in 1971 and 1977, respectively.

 

 

I think even this rice scheme was better for the people than the money spent on military dreams. We will never know who stole the most rice from it either as the Junta had total control after the coup and I'm sure they were totally honest as they are yet today. Even the money generated from the stolen rice most likely went back into the economy. They should have just given direct subsidies of so much per rai of land up to a certain top that I would agree.

   I never said ALL doctors had to serve in public hospitals.

[tryasimight]

On 7/27/2017 at 9:00 PM, Grubster said:

Yes there is no comparison between the two, I have instructed my wife to bypass the large government hospital and drive the extra 1 1/2 hours to the private hospital, if I die so be it but I do not want to wake up in a shit hole. I think these government hospitals are underfunded but if I were a poor person I would be very happy to have them available. They are much better than most of the rest of SE Asian nations have. I doubt the kid in this story would have survived in any hospital in the world.

Tell the missus not to drive at all and save the fuel money.