Healthcare law amendment will increase public health inequality: expert

A healthcare expert has voiced opposition to the proposal to separate the salaries of public health personnel from the total public healthcare budget, warning that it could result in serious inequality in health care.  

On 12 July 2017, Winai Swasdiworn, former Secretary-General of the National Health Security Office (NHSO), publically warned of the danger in separating the salaries of public health personnel from the total budget for national universal healthcare, aka the ‘Gold Card Scheme’.

The separation is one of the proposals in the ongoing amendment of the 2002 National Health Security Act, which has been widely opposed by many civil society organisations.

Winai pointed out that currently the calculation of the average public healthcare budget per head includes the salaries of personnel in public hospitals throughout the country in order to ensure equal access to healthcare. Therefore, the separation of salaries could affect the management and services of public hospitals and clinics under the NHSO.

The purpose of including the salaries of health personnel in the total healthcare budget is to make sure that hospitals with few health professionals but many patients could hire extra staff to provide services.

In Isaan (northeastern Thailand), there is an insufficient number of health service centres in proportion to the population of the region, whereas in central Thailand the number of health centres is more than what is needed, Winai elaborated.

The former NHSO Secretary-General concluded that hospitals in Isaan will face severe problems, such as a shortage of health personnel and medicines, if the plan to separate the salaries of health staff from the total healthcare budget is put into effect.

In January, Public Health Minister Piyasakol Sakolsatayadorn set up a committee to reform the National Health Security Act, which will directly affect the functions of the NHSO.   

The committee was quickly formed after the junta-appointed National Legislative Assembly (NLA) proposed amendments on the grounds that the changes will improve the efficiency and sustainability of the national healthcare system. However, many civil society organisations have pointed out that the amendments will only put at risk the lives of the country’s most vulnerable people.

Winai Swasdiworn, former Secretary-General of the National Health Security Officer (NHSO)