Former minister pushes for changes in state hospitals

Former Public Health minister Dr Mongkol Na Songkla wants the Public Health Ministry to speed up the process of turning community hospitals into public organisations because many of them are buckling under inflexible management and massive workloads. These are some of the factors why so many medical workers are dropping out state hospitals, he said.

During his term, Mongkol initiated the plan to turn state hospitals into public organisations - especially Patong Hospital in Phuket. However, he said, his proposal was turned down by the Cabinet under the reasoning that it would reduce the authority of the Public Health Ministry, the Office of the Public Sector Development Commission and the Office of the Civil Service Commission.

But, Mongkol said, state agencies would not totally lose their authority to control and manage state hospitals. Instead they would become supportive missions instead of control missions, he explained, adding that the permanent secretary of the Public Health Ministry would still play a key role as a board member of the public organisation. by enforce hospital to implement the important health promotion policy which benefit to patient and people in community into the hospital's implementation plan.

The Office of the Public Sector Development Commission is responsible for auditing and monitoring the quality of hospital management. He said at present there are fifty community hospitals nationwide ready to operate as public hospitals, including Nakhon Si Thammarat's Tung Song Hospital, Nakhon Ratchasima's Pakchong Hospital, the Rayong provincial hospital, Phuket's provincial hospital, Chiang Mai's Mae Rim Hospital and Songkhla's Hat Yai Hospital. "Medical workers, including hospital directors, have the skill to run hospitals as public organisations and effectively manage them," he said.

Over the past thirtyfive years, most community hospitals in Thailand have been given basic governmental support in finances and manpower, while the number of patients has been increasing every year. The current number of medical workers and devices available in community hospitals are not adequate to serve the rising number of patients. However, if they were turned into the public organisations, then they could use the funds allocated to them by the National Health Security Office to purchase medical instruments and hire more doctors, he said.

If state hospitals were left as they are, many would go bankrupt and suffer an exodus of doctors and medical workers like Patong Hospital did recently, he warned.

He said operating hospitals as public organisations would give them more flexibility because they would not have to keep asking state agencies for permission to either hire new staff or purchase medical devices, adding that this method of management had already proved successful at Samut Sakhon's Banphaeo Hospital.

As for the severe crisis faced by Patong Hospital, Mongkol believes that if the ministry turned it into a public organisation, problems would be resolved within a month because they could start raising funds by seeking donations. At present, government regulations prohibit state hospitals from seeking public contributions.