Pradit urges doctors to enter pay talks

Cabinet okays changes amid rural medic protest

The cabinet has approved in principle a 3-billion baht performance-based payment scheme despite rural doctors staging a protest rally yesterday.

Almost 1,000 doctors and dentists from across the country gathered at Government House to protest against a new public health policy to cut their hardship allowance and base payments on performance.

The protesters demanded the policy, proposed by the National Health Security Office (NHSO), be revoked and Public Health Minister Pradit Sintawanarong and permanent secretary for public health Narong Sahamethanpat step down.

The protesters wore black as they burned an effigy of the minister and laid wreaths in protest.

Dr Pradit insisted the government would not revoke the hardship allowance payment.

However, he said many areas are no longer isolated and rural doctors should receive an allowance based on workload and performance.

Dr Pradit called on the rural doctors to enter talks with the Public Health Ministry on Friday to resolve the dispute. The result of the meeting will be submitted to a mobile cabinet meeting for consideration on Sunday.

Kriangsak Watcharanukulkiat, president of the Rural Doctors Society, said doctors were unhappy with Mr Pradit's performance.

The changes to the hardship allowance were the final straw. Doctors will protest every week until Mr Pradit steps down, he said.

The protesters who gathered yesterday had dispersed by 2.30pm.

The hardship allowance is currently based on the degree of isolation of the area in which the doctors work and the conditions under which they work.

Isolated areas come under three classifications _ normal suburban areas; isolation level 1, or remote areas; and isolation level 2, or border or high-risk areas. Physicians stationed in areas classified as normal are currently entitled to an allowance of 10,000-30,000 baht a month, depending on their years of experience.

Doctors in level 1 areas are entitled to 20,000-60,000 baht a month, while those working in level 2 areas receive 30,000-70,000 baht.

But from next month, most doctors who receive hardship allowances will have their rates cut in half.

The ministry has opted to pay the allowance based on doctors' performance.

The allowance for those working in high-risk areas such as the far South, however, will remain unchanged.

Dr Kriangsak said the new system will force many doctors into private hospitals where they can earn more for doing the same amount of work.

Rural doctors will also wear black to work to show their disapproval of the minister, he said.

Meanwhile, the cabinet yesterday approved a budget of 191.6 billion baht to finance the 30-baht universal healthcare scheme for the 2014 fiscal year, which begins in October.

Lt Sunisa Lertpakawat, deputy government spokeswoman, said the budget would provide health coverage to about 48 million people. The per capita subsidy for patients under the scheme will be raised to 2,955.91 baht in 2014, Lt Sunisa said. The current subsidy is 2,755.60 baht. Of the budget, 1.9 billion baht has been set aside for the management of the NHSO, which oversees the universal healthcare scheme, she said.

Members of the Government Pension Fund, Health Professional Associates Thailand and the Bangkok Mass Transit Authority union also protested outside Government House yesterday, blocking Phitsanulok Road.

About the author

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Writer: Pradit Ruangdit
Position: Reporter