Panita Kaewkhongchan holds a photograph of her mother as she stands outside Nonthaburi Provincial Court in this file photo. On September 16 the court ruled that the Public Health Ministry must pay Panita Bt600,000 in compensation after her mother died fol

The Nonthaburi Provincial Court's ruling on September 16 last year came as justice for Panita Kaewkhongchan after the Public Health Ministry was ordered to pay Bt600,000 in compensation for the loss of her mother following treatment at a state hospital in the South.

At Nakhon Si Thammarat's Ron Phibun Hospital, however, for Dr Peera Khongthong, its director, and his younger female colleague, Dr Suthiporn Kraimak, the decision came as an unwelcome surprise.

Weeks after the court's ruling the pair went to a Nakhon Si Thammarat police station to acknowledge its subpoena without knowing they would be detained.

It took Peera about an hour to find someone with the Bt100,000 bail to get him out and about another three hours to find a further Bt200,000 to bail out Suthiporn.

"See how naive Thai medical doctors are when it comes to legal matters," said Dr Cherdchoo Siripanitch, a member of the Medical Council. "Had the pair been aware of what they were going to encounter they would at least have prepared their bail money."

Panita used the Nonthaburi court's ruling to convince the regional prosecutor to accept her criminal lawsuit against the two doctors after the provincial prosecutor had decided not to accept it, said Cherdchoo.

The Peera and Suthiporn case was what prompted the Health Ministry to offer a helping hand and at the same time deal with the increase in legal threats filed by patients.

"We need to help doctors deal with unfamiliar legal issues," explained Dr Manit Peeratantikanont, the public health deputy permanent secretary.

The ministry recently hired 12 lawyers to serve state hospitals nationwide. "This is intended to help only those doctors who are innocent, not just anyone having a problem with a legal complaint," said the health official. "Court battles [between doctors and patients] do more harm than good to both sides."

On a case-by-case basis, the 12 specialists, he said, are to represent doctors in handling court procedures so the medical professionals can focus on their patients.

The number of lawsuits filed against state doctors is on the increase, said Manit. Sometimes doctors were sued simply because of a misunderstanding, he said, adding that under the new scheme such a conflict could be settled out of court.

"We need to settle certain cases out of court," he said. "But if it really is the doctor's fault, of course we can accept the truth."

Apart from the provision of legal services, the ministry is issuing step-by-step guidelines so that doctors know what to expect when faced with a legal complaint. It has also set up a reconciliation committee to find a long-term solution to the problem.

The idea to set up a special fund to help victims of medical errors, which has long been discussed among doctors, is expected to be given prominence on the reconciliation committee's agenda.

The financial compensation mechanism under the Bt30 healthcare scheme has improved considerably since the compensation rate was raised by more than twice the old rate, said Manit.

However, he said the scheme covered only about 80 per cent of the Kingdom's population.

Cherdchoo sees the ministry's approach as trying to tackle the consequences, rather than the causes, of the problem. Rather than improve public understanding that not everyone seeing a doctor will get well, the government has raised patients' expectation too high by saying the Bt30 scheme "cures all".

"What makes doctors happy is to see their patients get well. What upsets them utterly is losing a patient."

These days not only have doctors such as Peera and Suthiporn had to overcome the death of their patients, but they also have to fight criminal charges that brand them as "reckless and causing someone to die".

Arthit Khwankhom

The Nation