Eliminating the Persistent Healthcare Ghoul
Tanao Sri Hospital, a remote community hospital in Ratchaburi province near the Thai-Myanmar border, recently made headlines for using a frog-hunting head torch in place of a dental lamp due to a lack of proper equipment. This photo sparked outrage online, leading the Ministry of Public Health to finally approve a budget for new equipment. Yet, this isn't just Tanao Sri's story—financial strain and poor working conditions are rampant across many state-run hospitals in Thailand, experts say.
The drop in healthcare service revenue from 60 billion baht to 40.6 billion baht in the current fiscal year—representing a 9.5% fall—has left at least four major hospitals nationwide in critical condition, requiring immediate financial aid to stay operational. The problems extend beyond finances, however, as rural hospitals like Bueng Kan in the northeastern province grapple with overwhelming workloads, poor work-life balance, organizational injustice, uncompetitive salaries, and heavy bureaucratic red tape.
According to Chutinart Chinudomporn, coordinator of the Thai Frontline Physician Union, many doctors work up to 100 hours per week, more than double the 45-hour limit stipulated under the labor law, largely due to high patient volumes under Thailand's 30-baht universal healthcare scheme. In the northeastern province of Bueng Kan, 18 intern doctors recently submitted their resignations from Bueng Kan Hospital due to these hostile work conditions.
Moreover, nurses face similar challenges, as many move to private hospitals or change career paths due to unlivable wages in state hospitals. This is because workers at state hospitals, which are run as a government agency, are not protected under standard labor laws but are subject to civil service laws instead. Nurses Connect's co-founder, Suwimol Namkanisorn, advocates for fair pay and flexible employment models to retain nurses and support staff.
The severity of the issue is evident in the Medical Council of Thailand's recent survey, which found that 84.8% of the 2,431 intern doctors at state hospitals who took part were dissatisfied with their conditions. Alarmingly, 3.5% indicated plans to resign even before their work starts, citing poor working environments, among other factors.
The challenges facing Thailand's state hospitals require immediate attention. Targeted government funding, budget reforms, and revisions to healthcare financing are necessary to prevent chronic equipment shortages and infrastructure decay. In addition, enhancing working environments, implementing better remuneration, career development programs, and mental health support for healthcare workers will help retain staff, while technological solutions and improving the training and incentives provided to young doctors can address the regional shortage of healthcare professionals.
Ultimately, structural reforms in social security and healthcare policy, such as integrating a national healthcare strategy and addressing external economic threats, will ensure the long-term viability and sustainability of the public healthcare system. A coordinated approach focusing on immediate financial aid, systemic reforms, workforce retention strategies, and broader economic stabilization is essential to address the intertwined challenges faced by Thailand's state hospitals and safeguard their ability to deliver essential healthcare services to the country's citizens.
The failing financial situation of state-run hospitals in Thailand, such as the significant drop in revenue leaving four major hospitals in critical condition, raises concerns about the future of healthcare-and-wellness services. It is not just about the lack of medical-equipment, but also the mental-health and workplace-wellness of healthcare professionals, with many doctors and nurses working excessive hours and facing poor working conditions, leading to dissatisfaction and high resignation rates as seen in the case of Bueng Kan Hospital.
