A former public health minister has called on rural doctors and the Public Health Ministry to hold talks to iron out their differences over the pay-for-performance (P4P) scheme.
Mongkol Na Songkhla blasted both parties for "losing their minds" by prolonging the stalemate. He said the protest by the Rural Doctors Society (RDS), which is refusing to talk to the ministry, was inappropriate.
Doctors have railed against the scheme since it was announced last month. They argue that it cuts pay for rural doctors and will lead to a mass exodus of medical professionals from rural areas. The P4P scheme, which came into effect at the start of this month, cuts hardship allowances by half, though it allocates an additional allowance based on individual performance.
The original hardship allowance was based on each doctor's degree of isolation and working conditions. The RDS has refused to join any meeting with the Public Health Ministry.
Arak Wongworachart, an RDS leader,said the society would stage another demonstration at the ministry on Wednesday. He called on civil society groups and patient networks to join them.
But Dr Mongkol said it is unlikely a solution will be reached through protest and intimidation. He urged the RDS to open discussions with the ministry about a way out of the problem.
Dr Mongkol said that while he agrees with the P4P concept, Public Health Minister Pradit Sinthawanarong has implemented the scheme poorly.
He said the concept should have gone through a public hearing before being brought into effect. "I think that both parties are losing their minds which makes it hard to find harmony in this situation," Dr Mongkol said.
He suggested ministry executives suspend the scheme temporarily to allow for talks with the RDS. He said certain aspects of rural doctors'job, such as improving the health of rural residents or preventing the spread of disease, cannot be measured on paper.
But performance-based evaluations could boost efficiency in the medical industry if they are applied correctly.
Dr Mongkol expressed concern in a Facebook posting recently that the rift would cause a decline in health servicestandards. "The longer the conflict is made to linger, the more effect it will have on patients," he said.
Public Health permanent secretary Narong Sahamethapat insisted performancebased appraisals are needed.
He said the scheme is a key tool for the ministry to encourage doctors to join its new public health service plan, and would help solve the prolonged doctor shortage.
The scheme divides the public health sector into 12 regions. Hospitals within each region share doctors and specialists.
Doctors can gain extra performance points by serving hospitals other than the one where they are stationed. This motivates doctors to expand their services and share knowledge, he said.
The plan will also give patients access to a wider range of medical services, he added. The ministry's inspector-generals will promote the advantages of the P4P scheme to doctors and rural residents,since the RDS has refused to cooperate.
Meanwhile, the Government Pharmaceutical Organisation (GPO), networks of people living with HIV/Aids, and people suffering from heart disease, cancer and kidney failure say they plan to join the RDS protest on Wednesday.
Apiwat Kwangkaew, from the Thai Network of People with HIV/Aids, said the decision to join the protest was prompted by Dr Pradit's comments about a corruption investigation into the GPO.
The Department of Special Investigation is investigating the GPO over alleged corruption in a vaccine plant project.
Source: Bangkok Post April 19, 2013
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