Medical hub must work for Thais, not just tourists

The country's healthcare system still needs more doctors, nurses and better treatment for everyone, regardless of the ability to pay.

The plan to turn Thailand into a medical hub has been around for years. Although no government has yet produced any concrete action, Thailand continues to receive many foreign patients due to the good skills and service of physicians and other medical staff here.

The trend is welcome, for it suggests the services and capacity of the Thai medical sector is of international standard. But while the government concentrates on visa incentives to encourage foreigners to visit, there are other issues it should address to make the medical hub plan sustainable and beneficial for all Thais.

Many private hospitals here have earned an international reputation for providing world-class service. So it's ironic that many Thais are still struggling with bad service, inadequate medical equipment and a shortage of doctors, especially at public hospitals in the rural areas.

The government recently eased visa requirements for visitors from six Middle Eastern countries seeking medical treatment here. They no longer need to get a visa in advance. Public Health Minister Dr Pradit Sinthawanarong says this "privilege" is part of the campaign to become a regional medical hub.

Medical services provided to foreigners generate Bt120 billion a year for the Thai economy, but critics claim a connection between the shortage of doctors and nurses at public hospitals and the boom in private hospitals accommodating foreign patients.

Regardless, even without the goal of becoming a medical hub, Thailand needs to overhaul its medical training to produce more doctors and nurses for the entire system. It is estimated that 40,000 more doctors are needed to ensure quality healthcare, but only 2,500 graduate every year, according to the Private Hospital Association. Therefore, the booming business of private hospitals is not the only factor causing the shortage of personnel in the system.

According to a Health Ministry report, Thailand has 43,424 physicians working at public and private hospitals across the country. To provide adequate services, that figure needs to be doubled. The "2011 World Health Statistics" report by the World Health Organisation showed that in Thailand there are just three physicians for every 10,000 patients, compared to 18.3 in Singapore, 9.4 in Malaysia, 11.5 in the Philippines and 12.2 in Vietnam. In Norway, the United Kingdom and US, the ratios were 42, 27 and 24.

The medical training should engage the private sector in order to ease the financial burden on the government and create more flexibility in the system. This shortage of doctors has to be resolved to enhance the country's competitiveness ahead of the advent of the Asean Economic Community in 2015. The AEC will mean that, in the near future, doctors here will not only have to serve 67 million Thais but also more than 3 million foreigners, including migrant workers and tourists.

The medical hub plan should go along with a workable plan to create more qualified physicians to serve both local and foreign patients. Relaxation of the entry-visa rule is not a determining factor. Patients do not choose to receive medical treatment simply because of visa issues. They need good treatment and services, and pharmaceuticals they can trust. There are also certain regulations that make some pharmaceutical products unavailable in Thai hospitals, partly because of the government's policy to promote the use of locally made drugs. However, some local and foreign patients prefer to use pharmaceutical products they are familiar with.

At any rate, the overall plan and details to transform Thailand into a medical hub will have to evolve from thorough discussion among all parties involved - the Health Ministry, public and private hospital operators, concerned agencies and organisations and the public and patients themselves.

Regardless of the medical hub plan, the Thai healthcare system must be improved anyway, primarily for the best interest of Thais.

Thailand has made progress by providing access to all Thais to healthcare. But more has to be done to ensure that the people also get good service. The medical hub plan, if realised, should also support that aim.