A group of medical associations led by the Medical Council of Thailand has backed the public health minister's pay-for-performance (P4P) scheme.
About 200 rural doctors tear up pictures of Public Health Minister Dr Pradit Sintawanarong outside Pheu Thai Party headquarters yesterday in protest against the ministry’s introduction of a performance-based payment system. They claim the move will lead to pay cuts for doctors. APICHART JINAKUL
The group, which also includes the Dental Council, Thailand Nursing and Midwifery Council and Pharmacy Council, said yesterday it believes the new approach will bring fairness and efficiency to the public health system.
Somsak Lolekha, president of the Medical Council which regulates the practice of medicine throughout the country, said the scheme would bring balance to hospitals and the medical professions.
He suggested the scheme be applied in a flexible manner, adaptable to the local contexts of different hospitals.
The public health minister put the P4P scheme into practice on April 1. The scheme, to run for a year in its first phase, demands hardship allowances given to doctors working in rural areas be cut in half with the rest paid according to their performance. The scheme is opposed by rural doctors.
Dr Somsak said a performance-based assessment system will encourage medical personnel to work harder. The result will benefit the public.
He said some rural doctors transfer complex cases to larger hospitals even though they have the ability to deal with them. He believes the P4P scheme will prompt them to take on more cases.
Udon Thani Hospital director Manas Kanoksil said the large number of transfer cases has resulted in treatment being delayed.
More than 50,000 appendectomy cases have been transferred from district-level hospitals to provincial-level hospitals or excellence centres.
The large number was partly a result of a lawsuit in 2002 in which the Public Health Ministry was ordered to pay 600,000 baht compensation to the family of a woman who died following an operation to remove an inflamed appendix at a hospital in Nakhon Si Thammarat.
Having their performance assessed will prompt doctors to pay attention to their work, Dr Manas said.
A member of the Rural Doctors Society, Arak Wongworachart, insisted they are already working hard.
According to the National Health Security Office's workload survey last year, each doctor working in rural areas had to treat 48 patients a month, while those working in provincial hospitals took care of 26 patients on average.
The rural doctors group yesterday held another protest against Public Health Minister Pradit Sintawanarong for introducing the P4P scheme.
More than 600 society members tore up pictures of Dr Pradit with the word P4P written on them during their protest yesterday.
Kriangsak Watcharanukulkiat, the Rural Doctors Society president, handed a protest letter to the Pheu Thai Party's executive committee through its spokesman Prompong Nopparit.
"We've supported the 30-baht health-care scheme created by former prime minister Thaksin Shinawatra," Dr Kriangsak said. "But Dr Pradit is going to ruin the scheme."
The rural doctors' next move is to seek permission from the Senate president to gather signatures to oust Dr Pradit.
The group argued the P4P scheme would result in rural doctors quitting because there are not enough incentives for them to stay on. This would result in poorer health-care services for people in rural areas.
About the author
Writer: Paritta Wangkiat & Aekarach Sattaburuth