Thai health ministry vows sweeping reform
Thailand’s Public Health Ministry yesterday vowed to go ahead with its ambitious plan to restructure the country’s public health system, which will take effect by October 1. The plan calls for reform of the structure of health-related agencies and decentralisation of the ministry’s authority to local bodies.
The massive overhaul is aimed at improving the public health system and making it more efficient, the ministry’s permanent secretary Dr Narong Sahametha said.
The new structure would bring all five independent health agencies – the National Health Security Office, Thai Health Promotion Foundation, Emergency Medical Institute, Health System Research Institute and National Health Commission Office – under the management of the National Health Authority’s National Health Policy Commission, which has been established to oversee the country’s health policy.
At the same time, the Public Health Ministry’s powers would be decentralised to local agencies. To facilitate this, all health agencies under the ministry are now drawing up plans to reform their own organisations.
The National Health Policy Commission will be chaired by the prime minister and managed by ministers with related portfolios. All health agencies including the Public Health Ministry and the independent health organisations will have to propose their projects and budgets directly to the new commission.
The new commission would then select health-related projects that are in sync with the country’s health policy direction for submission to the Cabinet for final approval.
Currently, the five independent health agencies propose their projects directly to the Cabinet for budgetary approval. This has led to duplication of projects, which wastes money.
The Public Health Ministry will divide its management into two parts comprising central agencies and 12 Health Area-Based Services.
The central agencies will act as a back office to support the area-based services.
The latter, to be overseen by ministry inspectors, will comprise central hospitals, general hospitals, community hospitals and health-promotion hospitals.
Authority will be transferred from the permanent secretary to the inspectors to manage the public-health system and services in local areas. The inspectors will be able to move or transfer any local health officials, without having to wait for a decision from the permanent secretary. They will also have authority to manage the local areas’ budgets.
Narong has given agencies under the Public Health Ministry three months to come up with plans for restructuring their organisations, before the overall plan to reform the public-health system is implemented by October 1.
Those health-related agencies that are not ready to implement this plan will be given one year to adjust to the coming changes.
“They must come up with action plans to reform themselves. They must give a precise timeframe for reform to enable the country’s public-health system to become stronger,” Narong told more than 200 health officials at the ministry yesterday.
The ministry is expected to spend about five years reforming the health system.
In the next step, it will allow local administration organisations to co-manage the public-health system and services in local areas.
The Public Health Ministry is also revising its method for paying additional allowances to medical workers across the country.
The new allowance rates will be based on the amount of work done – the so-called pay-for-performance principle. It will take effect on Monday, April 1.
Currently, the rates are based on the remoteness of the worker’s location and the number of years they have worked.
The Cabinet on Tuesday approved the new pay plan in principle, pending its further study of the plan. It will give its final approval for the new allowance system at a two-day mobile Cabinet meeting in Chachoengsao province this weekend.