Rural doctors drop call for Pradit resignation
The Rural Doctors Society (RDS) and its allies have vowed to return to the streets in two weeks to campaign for their demands if this week’s talks with the government fail to bring about satisfactory results.
The RDS and health activists are scheduled to meet Public Health Minister Pradit Sinthawanarong and Prime Minister Yingluck Shinawatra tomorrow and Thursday to discuss the doctors’ demands.
The doctors and health activists had been campaigning for the dismissal of Dr Pradit and demanded his pay-for-performance scheme be scrapped.
They also accused the minister of planning to privatise the Government Pharmaceutical Organisation (GPO) and seeking to introduce a co-payment method requiring patients under the universal healthcare scheme to share medical expenses for their treatment.
The meeting will be mediated by Prime Minister’s secretary-general Suranand Vejjajiva and PM’s Office Minister Niwatthamrong Boonsongpaisan.
“There’s nothing difficult in the demands that the government cannot accept,” RDS president Kriangsak Watcharanukulkiatsaid.”Every demand must be accepted.”
The society had planned to rally in front of the prime minister’s residence in Lat Phrao on Thursday to express dissatisfaction against Dr Pradit and his pay-for-performance scheme, launched on April 1 to partially replace the hardship allowances provided to rural doctors.
The RDS called off the rally last week after Mr Suranand proposed talks to discuss the doctors’ demands.
Dr Kriangsak said the society had decided to drop their demands for Dr Pradit’s ouster from a list of demands to be tabled for discussion at the talks, but other demands would remain intact.
The GPO’s labour union, which is an ally of the society, wants the government to guarantee the agency will not be privatised and will remain free from political intervention.
Viroj Na Ranong, Thailand Development Research Institute’s director for health economics and agriculture research, said the conflict at the Public Health Ministry should end at a meeting table.
He says Dr Pradit’s business background might be useful in improving Thailand’s public health system.
“Dr Pradit has tried to increase efficiency in the public health system,” Mr Viroj said.”But ‘efficiency’ has different meanings for different groups of people.”
The researcher said, however, he did not think Dr Pradit’s pay-per performance scheme was fair for rural doctors, who deserve full hardship allowances as they are stationed in remote areas and have to work under tough conditions.
However, he said it could not be concluded at this stage that the scheme would result in an exodus of doctors from state to private hospitals, as the society has claimed.
Consumer Foundation secretary general Saree Aongsomwang, who will also join the talks, said she believes every demand would be considered by the government.
“The demands we are making are for a sustainable public health system and universal healthcare scheme,” she said.
“The government and Public Health Ministry will see how essential the demands are for equitable access to health services.”
Representatives at the meeting are expected to try to iron out solutions to the doctors and health activists’ demands when they meet again on Thursday.
Dr Kriangsak said if the outcome of the meetings is unsatisfactory, the RDS and its allies will resume their plans to stage a protest in the next two weeks.
On Saturday, Dr Pradit said in the weekly television programme Prime Minister Yingluck Meets the People that his policy aims to manage health expenditure, which has skyrocketed in recent years.
Health expenditure is now 15% of government spending, while the government’s investment budget has decreased.
The Public Health Ministry spends about 80 billion baht a year on public health staff, paying for salaries and academic and human resources development, according to Bureau of the Budget.
The ministry pays the the labour costs of more than 350,000 staff nationwide, and Dr Pradit is doubtful whether the money is resulting in good performance and efficient delivery of medical services.
“The government is not making an attempt to reduce staff income,” he said.
“But we have to adjust the payment methods [by combining hardship allowances with performance-based payments] to assure high service efficiency for people.”
He insisted the ministry has not considered applying a co-payment model in the case of the universal healthcare scheme.
He reiterated he also had no intention to privatise the GPO, but will improve the agency’s role.
First published in Bangkok Post, 3rd June 2013