2 weeks Ago
The resignation of six medical interns from a rural Bueng Kan provincial hospital this month has again raised concerns about systematic problems in state hospitals. While the Ministry of Public Health tried to allay public fears, saying the interns just wanted to relocate and further pursue higher education, others see the interns' actions as the tip of the iceberg of a much larger problem that includes doctors overloaded with patients, as was the case of Dr Natthakarn Chomphan who worked at Mae Sot Hospital in Tak province. Dr Natthakarn recently resigned after working at rural state hospitals along the Thai-Myanmar border for 21 years.
The high number of patients and subsequent increase in workload that she had to deal with were compounded by an influx of Myanmar migrants and refugees. In her case, the ratio of doctors per patient was 1:8,000 at her small state hospital. The World Health Organisation (WHO) standard requires the optimal rate of doctors per patient to be 1:1,000.
The general rate of doctors at state hospitals in Thailand is 1:2,000. Another case that has drawn public attention is that of Dr Napassorn Veerayuthvilai, a young doctor who resigned after starting her first job at Ratchaburi Provincial Hospital in June 2023. Dr Napassorn said she had to work 120 hours a week and worked shifts as long as 32 hours.
The WHO standard says that a doctor's work shift should not exceed 16 hours per shift. For years, experts and lawmakers have urged the Ministry of Public Health to tackle such problems, but it has moved slowly. There have been attempts, such as an initiative to encourage more local medical students, but they have only scratched the surface of the staff shortage problem, which of course stands to affect the quality of health care.
More recently, the Ministry of Public Health has been rewriting a law to move personnel out of the Office of Civil Service Commission bureaucracy in the hope that it will create work promotions and budget disbursement programmes that fit the work style of medical professionals. Will this be enough? Only time will tell. However, the bottom line is the ministry needs to create enough incentives to keep medical personnel working for the state instead of going to the private sector.
As part of that, it must make the environment and workplace attractive for doctors and other medical staff. A lack of welfare and benefits for state medical personnel also drives people to leave. Many state doctors also complain about delayed allowances and overtime payments.
Some doctors have reportedly had to borrow money because payments had been delayed for six months. The ministry must address these issues and improve the facilities and work environment. The government must invest more in developing dormitories with good facilities, such as gyms, and recreation rooms for medical staff to stay and rest.
Most of all, politicians who try to woo voters with medical benefits must be reasonable and not burden medical personnel too much..
