Factional undercurrents cause Health Ministry waves
Rural Doctor Club 'progressives' at loggerheads with conservatives
Despite the respect the Ministry of Public Health has garnered over its handling of the Covid-19 pandemic, the protest at Khon Kaen Hospital last month against the abrupt transfer of its director Dr Chanchai Chanworachaikul has unveiled undercurrents beneath the surface of the ministry.
Frontline health personnel are dubbed Nak Rob Sua Kao, which means "warriors in white gowns". Many of them serve under the Public Health Ministry.
Dr Chanchai was accused by ministry executives of taking bribes from pharmaceutical companies. His boss, Dr Sukhum Kanchanapimai, the ministry's permanent secretary, moved him to an inactive post pending an investigation.
However, Dr Chanchai refused to lay low. He reportedly filed legal action against Dr Sukhum for alleged unfair treatment.
Dr Chanchai said the bribery accusation is groundless.
"Anyone can donate money to the hospital, and I did not even know the pharmaceutical companies donated to the hospital's fund," he said, as quoted by local media.
The case shed light on the unusual relationship between state hospitals and pharmaceutical companies. The ministry spent billions of baht annually purchasing medicine. In short, state hospitals are a major market for these companies.
Rumours have been circulating saying pharmaceutical companies usually allocate 5% to give to hospitals. The allocation can go to medical personnel or as a donation to the hospital.
In the case of Dr Chanchai, the ministry accused him of receiving money via a donation to Khon Kaen Hospital's Fund.
The fund was set up as a point to receive public donations and the money received is meant to help run the hospital's internal affairs. Sometimes, there is no receipt provided for donations.
The Public Health Ministry is aware of the 5% allocation by the pharmaceutical companies. Last year, it officially warned state hospitals not to accept gifts from these companies.
Apart from launching a probe into Dr Chanchai, the ministry has also launched an investigation into the donation funds of 186 state hospitals, accusing them of taking money from pharmaceutical companies.
The probe into the hospitals started on Monday and the ministry is giving investigators one month to complete it.
At Khon Kaen Hospital, the ministry sent Dr Kriangsak Watcharanukulkiat, the president of Rural Doctor Club (RDC), to sit as acting hospital director, replacing Dr Chanchai.
Dr Kriangsak's arrival ignited a mass protest from some medical staff in state hospitals across the kingdom. Some state hospital personnel staged a campaign to demand justice for Dr Chanchai.
For those unfamiliar with the internal politics within the Public Health Ministry, the protest and the arrival of the new director is a war waged between two camps at the ministry: conservative doctors and the RDC progressive doctors.
The RDC has received credit for reforming Thai health care in the past decade. The group is the architect behind the highly acclaimed 30-baht Universal Healthcare scheme and community health volunteering.
The RDC has gained more power in budgeting and policymaking. RDC doctors have been appointed as heads of policy-making bodies in the ministry, including the National Health Commission Office and the National Health Security Office, which oversees the country's medical welfare budget.
But Dr Kriangsak has also been targeted because of his close links with Health Minister Anutin Charnvirakul. There is a rumour saying Dr Kriangsak wanted to work at Khon Kaen Hospital before he retires. Khon Kaen is considered a high-profile hospital.
Dr Kriangsak received the cold shoulder at Khon Kaen Hospital. Officials intentionally leaked a memo calling on them to welcome the new director. The memo was ignored.
Dr Kriangsak on Monday told a press conference he agreed to decline the offer to serve as acting director at Khon Kaen Hospital, saying it will finally end the internal ministry conflict.
But in fact, Mr Anutin wanted the conflict to end quickly because of the investigation into the 186 hospitals.