Imposition of quotas on foreign doctors seen in most AEC countries
The Thai healthcare sector is preparing for the challenges of a freer flow of doctors within the Asean Economic Community, which will become effective in 2015.
Medical doctors are one of the seven professions to benefit from relaxation of the movement of labour within the region. Other healthcare professions to be included are nurses and dentists.
“According to the Asean Charter, we’re supposed to give national treatment to all other Asean countries,” said Dr Tanatip Suppradit, adviser to the secretary-general of the Medical Council of Thailand. “For example, if you are Thai, you are required to take the exam to qualify as a practitioner of medicine in the country [you want to move to], which will also apply to foreigners from other Asean countries who want to practice medicine in Thailand.
“The exam [for Thailand-bound doctors] has three parts, including a final part on using the Thai language to communicate with patients. In other words, we do not discriminate against other Asean nationals, but we need to maintain the same standards applied to Thai medical doctors.”
Dr Somsak Lohlekha, former chairman of the Medical Council and currently a subcommittee head, said: “I think most Asean countries will impose quotas on foreign doctors working in their countries. For example, there are now only dozens of Thai doctors in Malaysia, while up to 30 per cent of doctors in Singapore are foreigners but only a few Thai doctors work permanently in the island republic. Singapore only issues temporary permits of up to four years for specialists currently in shortage in the country.”
He pointed out that professional movements within Asean were not the only issue. There is also some concern regarding doctors from India, especially as Thailand is negotiating with that country on a comprehensive economic-cooperation agreement covering a freer flow of some professional workers, including doctors.
“India has a large number of doctors and as many as 300 medical schools, but the most competent tend to go to work in the US. Lately, the Indian government has expressed interest during negotiations with Thailand that practitioners of traditional Indian medicine and yoga should be allowed to work in Thailand, similar to the practitioners of Chinese medicine such as acupuncture,” Somsak said.
“I think Thai doctors can compete with others in Asean countries. Compared with Singapore and Malaysia, we have more doctors because of our larger population. For example, Singapore only has dozens of specialists in children’s ailments but we have several hundreds.
“Overall, there are more than 30,000 practising doctors in Thailand, so we are quite strong in terms of the number of doctors and their competencies in various specialist fields of modern medicine.
“Vietnam is still in an early stage of development, while Myanmar is just opening up. Indonesia is not ahead of us, while the most able doctors in the Philippines are now working overseas.
“We are also service-minded, which proves to be a key asset in the medical-tourism sector, while our prices are competitive and in some cases lower than those in other countries.
“Besides, we have other attractions such as shopping malls to draw visitors from overseas, especially the Middle East, who have faced difficulties in getting visas to Western countries after the September 11  terrorist attacks.
“Thailand is also the medical-treatment destination for many expatriates working in countries in the region such as Cambodia, Laos and Myanmar, as well as China, because of our reputation in terms of quality.”
Dr Boon Vanasin, head of the Thonburi Hospital Group, said: “We are now operating the international-patients divisions of two major hospitals in China’s capital, Beijing. We are also involved in two joint-venture hospital projects in Nanjing and Hangzhou.
“Of the 10,000 hospitals in China, about 500 want to upgrade to international standards. They have the money but they don’t have the management skills. Each of the two joint-venture projects in China is quite large, each costing about Bt20 billion with 1,000 beds.
“In Vietnam and Myanmar, land is very expensive, so it is not yet feasible to launch private hospital projects. Unlike Thailand, whose gross domestic product is many times larger, these countries do not have enough middle-class patients at this stage, as each hospital needs at least 100,000 patients with annual income of US$5,000 [Bt150,000] or more each.”