A peek at how Thailand’s healthcare system has adapted to the Covid-19 situation

And as the end of the outbreak is still nowhere in sight, something new may need to be done to ease the situation of the country’s strained healthcare system. The National Health Security Office (NHSO) has, therefore, held a forum for its partners to share their views on the matter.

Entitled “National health security system in the face of Covid-19”, the brainstorming session was held on June 25. It also included a seminar on the role of each healthcare system’s division in the country’s fight to contain the outbreak.

Dr Tares Krassanairawiwong, director-general of the Department of Health Service Support (DHSS), shared his department’s experience in working behind the scenes to ensure every part of the healthcare system functions as effectively as possible while struggling to cope with the impact of Covid-19.

Since the start of the outbreak in Thailand, he said, DHSS has been enhancing the capacity of laboratories, which play a key role in testing Covid-19; reorganising the system for managing public healthcare facilities and medical supplies; and using social mechanisms such as health volunteers for Covid-19 control in each area.

And now that the country is struggling to deal with this new rapid wave of Covid-19, Bangkok has been running out of hospital beds to accommodate new patients, he said.

The DHSS has therefore come up with an idea to turn more than 71 hotels in the capital into temporary isolation facilities, which are actually capable of taking care of infected patients whose conditions are rated as yellow (with moderate symptoms) and green (with mild or no symptoms), he said.

These so-called “hospitels” have more than 10,000 beds for Covid-19 infected people, he said.

“We’ve also resolved to allow private parties to take part in handling Covid-19, especially in Bangkok [where the situation is most critical]. Five announcements have been issued to permit these private partners to support us in terms of pooling healthcare resources,” he said.

After Covid-19 was declared to be a medical emergency, all healthcare facilities, both private and state-run, have begun working together in taking care of Covid-19 patients under healthcare cooperation similar to the Universal Coverage for Emergency Patients (UCEP) system, which is practised under the Universal Coverage Scheme (USC), he said.

And to keep up with the changing situation, the NHSO is trying to make its funding for healthcare services provided by healthcare facilities in this same system as flexible and effective as possible, said Dr Jadej Thammatach-aree, NHSO secretary-general.

At the beginning of the outbreak, the overall capacity of laboratories in Thailand remained limited, which hindered the country’s ability to detect new cases of Covid-19, he said.

In response, the NHSO sought to divert the government’s central budget to fund the work of improving the capacity of these laboratories until the active case-finding strategy could be adopted to find new cases and provide necessary healthcare services at isolation units such as field hospitals, whose operations are also subsidised by the NHSO, he said.

Later when the government rolled out its mass Covid-19 vaccination drive to contain the outbreak, the NHSO began offering a new disbursement rate of 40 baht per vaccine injection service in a bid to accelerate and support the expansion of the national vaccination programme, he said.

At the same time, the NHSO also began implementing a new mechanism to boost public confidence in the government’s financial compensation programme for adverse events following vaccination, he said.

And most recently, the NHSO has started drafting rules on a new financial compensation programme for “Home Isolation/Community Isolation”, which will allow people to undergo Covid-19 isolation at home, he said.

“Covid-19 has taught us a lesson – the speed of responding to a crisis is the key to success,” he said.

In case of the financial compensation programme for Covid-19 vaccine recipients suffering adverse events, for instance, although the preliminary financial assistance being offered isn’t that much, it does improve public confidence in the government’s promise to take care of them in the event they suffer any unwanted consequences of vaccination, he said.

Covid-19 has, in a way, accelerated certain systems designed to support the development of the country’s healthcare system, which had not succeeded earlier, such as the telemedicine project, he said.

“On the one hand, Covid-19 came as a catalyst for change in several services, ideas, and organisational practices. It has been driven us to move forward to the new normal,” he said.

Watchari Nim-anong, president of Hua Pho sub-district local administration organisation in Suphan Buri’s Song Phi Nong district, meanwhile, offered a broader picture of how Local Administration Organisations (LAOs) can use the Community Health Fund to support its fight against public health problems at the local level, including Covid-19.

As many LAOs remain reluctant to use this budgetary mechanism simply because they are worried about the strict inspection by the Office of the Auditor General (OAG) of their spending, a great deal of money remains unused, she said.

“You should never worry about strict inspection by the OAG as long as you spend the given money for disease prevention and health promotion and for helping people,” she said.

The fund is allowed to be used in case of outbreaks and disasters such as for purchasing Covid-19 prevention equipment for local educational institutions, child-development centres, elderly care centres and healthcare facilities, she said.

Saree Aungsomwang, secretary-general of Thailand Consumers Council, said the council is focusing on three areas of the government’s provision of healthcare services during the Covid-19 crisis.

The three areas are ensuring treatment for Covid-19 patients remains totally free, redefining medical emergencies and improving the quality of healthcare services being offered, she said.

She also urged the government to improve clarity and transparency in its communication with the public about Covid-19, such as details on the procurement of Covid-19 jabs.

She also expressed concern over the possibility of Thailand joining the Comprehensive and Progressive Agreement for Trans-Pacific Partnership (CPTPP), which she said the government should put a hold on until it is proved that the country will truly benefit from the trade pact.