Large numbers of medical professionals are resigning from community hospitals due to the slashing of hardship allowances, the former head of the Rural Doctors Society has said.
Arak Wongworachart, the group's former president, said 146 doctors resigned in February and March combined.
Most of those who left were recipients of government grants and had yet to complete their years of commitment to rural hospitals, Dr Arak said.
"The resignations came within two months of the new policy being announced. This is a serious problem," he said.
Before the introduction of the hardship allowances in 2008, more than 600 rural doctors were resigning every year from community hospitals. That figure halved with the launch of the incentive scheme.
The original hardship allowance was based on each doctor's degree of isolation and working conditions. But as of Monday, it was replaced with a performance-related pay system.
Under the scheme many doctors will have their hardship allowance cut by half, with the remaining 50% being paid according to their performance.
Exceptions apply for those working in high-risk areas such as the far South, where allowances will remain unchanged.
Despite the 146 resignations, Public Health Minister Pradit Sintawanarong yesterday said the situation was normal, as between 300-400 rural doctors resign each year. "There is nothing to worry about," he said.
Niparat Sriprai, a junior doctor working in Ban Fang Hospital in Khon Kaen, submitted her resignation letter yesterday, despite having 11 years of tethered service left under the terms of her One Doctor, One District (Odod) scholarship.
Dr Niparat said she was leaving due to the loss of the hardship allowance.
"I joined the Odod programme because I truly wanted to be a rural doctor. But the new policy has forced me to leave the community hospital," she said. "It contradicts my ideology."
Dr Niparat said she will have to open a private clinic so she can earn enough money to pay back her scholarship fees.
The doctor added the performance scheme is likely to spark conflicts between medical staff who will have to compete to get higher scores.
Doctors might be tempted to rush through examinations and choose cases that will give them high scores, which is not good for patients, she said.
Wilaekha Kinnarate, a doctor who recently resigned from a community hospital in the Northeast, said her decision was also partly motivated by a desire to avoid a competitive workplace.
She said she has 10 years of commitment left under the Odod programme, but will now return to school to study a specialist subject that might later help her earn enough to pay off her scholarship fees.
The new policy is not fair for rural doctors, who inevitably have to make personal sacrifices, she said.
"While I was working in a community hospital, I couldn't take care of my family as I was too far away from them," she said.
Kriangsak Watcharanukulkiat, the president of the Rural Doctors Society, said most community hospitals are not yet able to implement a performance-based pay scheme as no appraisal criteria have been put in place.
The hospitals have not received a key performance index yet, he said.
Dr Kriangsak said the society remains opposed to the policy and will hold a meeting next Tuesday to consider its next move.
