The entire year 2023 was a year of change in the public health field after the COVID-19 outbreak. and general elections The Ministry of Public Health transitioned from “Anutin” to “Dr. Chonnan” and moved forward with the policy of one ID card for treatment everywhere. At the same time, there were still complaints from medical personnel who resigned from the system. Not including the problem of decentralization, the Subdistrict Health Promotion Hospital is still a ghost child. Including mental health problems that have an increasing tendency to become a social problem. The Active ranks the top 5 public health news stories of 2023 as follows:
1. “Doctor Chonnan” controls the Ministry of Public Health. amidst hope
After the election on 14 May 2023, it took more than 3 months to form a government led by the Pheu Thai Party. Settha Thaweesin Be the Prime Minister While the public health sector Keep an eye on the chair of the Minister of Public Health. The place formerly belonged to Anutin Charnvirakul from the Bhumjaithai Party, which over the past four years has faced the COVID-19 outbreak and has been questioned about vaccine procurement. Anutin himself is not a person in the medical profession. The arrival of Dr. Chonnan Srikaew, the new Minister of Public Health. Therefore, there is hope for dismantling the public health system and developing it for the better.
But 3 months have passed, amidst the 10 issues of the Quick Win policy, the public health community has still not seen any movement in solving systematic problems. to solve the public health system problem in a sustainable way At the same time, many questions are also raised, especially the many policies that seem to have been implemented and passed. Focus on public relations Some policies against vaccinating HPV to prevent cervical cancer have been announced as exceeding targets. Even though it’s something that needs to be done.
While the policies set many goals The target was smoothly adjusted down, such as 1 province, 1 nursing home. From the original saying that all provinces would be covered, it was reduced to at least 1 in the health zone, which has 13 districts. As for saying that a hospital would be built in Bangkok. In the end, existing hospitals in the area were used as service units. People still do not feel the change in the health system.
while structural problems in public health For example, promoting disease prevention that will not make people more sick from chronic non-communicable diseases. There are still no clear food safety measures in place. Upgrading community hospitals and primary care units that say they will find all the doctors is counter to the reality. The question of where to find doctors has become viewed as a perverse policy by those in the academic community.
2. One ID card to maintain everywhere. Establish a National Health System Development Board Reducing inequality with 3 funds, making no progress
From the policy of 30 baht to treat all diseases which was successful during the Thaksin Shinawatra government as Prime Minister was extended as a policy One ID card to protect you everywhere. During the era of the government of Settha Thaweesin of the Pheu Thai Party, the public sector accepted that it was a good policy. But to truly reach the point of healing everywhere Not focused on public relations Must face many challenges and requires participation from all sectors to reflect opinions
Although there is currently a pilot planned in 4 provinces: Phrae, Roi Et, Phetchaburi and Narathiwat, it will be officially launched on January 10, 2024, but it is still just the beginning. which must be learned and lessons learned Especially connecting health information in different service units. which is still a great obstacle While the other side is still concerned that this policy will make the National Health Insurance Fund must bear the burden of increased expenses until it may affect sustainability If not managed well
While the benefits and services of the Golden Patent develop forward But health rights in social security Seems to have holes and be inferior. This is the source of the question of how to reduce inequality with the 3 health funds, gold cards, civil servants, and social security.
Even though this government has set up the National Health System Health Development Committee The first meeting was held on October 24, 2023, with the Prime Minister as chairman and Prae Thongthan Shinawatra as vice chairman. But we still haven’t seen any results or ways to reduce health disparities from all 3 funds.
3. Problem of lack of manpower Medical personnel still can’t fix it.
From the drama of intern doctors resigning from the system because they can’t stand the excessive workload, old problems that have not yet been resolved and have persisted year-over-year, in 2023 there are efforts to solve the problem of manpower and medical personnel. Seriously, both the Ministry of Public Health and the Medical Council There were many meetings. But it still seems like The complaints of doctors in the system still haven’t subsided. The method of working in rice farming is still the same as before. Loading work is on duty for almost 48 hours, many times more than ordinary workers.
Ministry of Public Health Try to solve this problem both immediately and in the long term. Not only the medical group But it also includes nurses and other professional personnel. Only nurses have already filled more than 50% of the positions. Public health academics are constantly adding more positions.
The long-term part is to produce more doctors. which academics think may not be solving the problem directly The main problem of this matter is the distribution of personnel Today, it is concentrated in the private health care system, which offers better compensation and less workload.
Personnel problem solving In addition to building morale and encouragement, you may need to think further into reforming the entire health system. which still takes a long time And a lot of courage Before walking to that point
4. Decentralize the power of public health hospitals that are still ghosts.
It has already been 1 year since the transfer of Subdistrict Health Promoting Hospitals from the Ministry of Public Health. to stay with the Provincial Administrative Organization (PAO) amid the hope that this transfer It will make providing better health services to the people. But the opposite is true. From the echo of the Subdistrict Health Promotion Hospital that was transferred to some places Found difficulties in financial regulations. Problem of insufficient personnel
Decentralization and it’s a good idea. But the decentralization of public health to local areas is not yet ready. It turned out to be more harmful. This matter is still controversial because in some areas Subdistrict Health Promoting Hospital transferred to can provide more services to the people than when under the Ministry of Public Health But in the first phase of transferring, HSRI’s research found more problems.
This issue is a concern for civil society in health. Because it directly affects the health services of people in rural areas due to Subdistrict Health Promotion Hospital is the front line where villagers have the easiest access. And it was even more confusing when the village health volunteers, who are community primary health workers, did not transfer their duties to the Provincial Administrative Organization but remained with the Ministry of Public Health as before. Therefore, health operations which are under different agencies. even more complicated
The transfer of Subdistrict Health Promotion Hospitals was voluntary for the first time in 2023. There were 3,264 Subdistrict Health Promotion Hospitals that voluntarily transferred, but in 2024 there were only 921 Subdistrict Health Promotion Hospitals that voluntarily transferred. Many times more than before It reflects the uncertainty of people working in the area.
5. Increased mental health and drug problems Will the public health system be able to handle it?
Problems of violence in some parts of society Coming from mental health problems and mental health problems resulting from drug use Previously, the world faced an epidemic that caused the public health system to be caught off guard. But nowadays there are more and more patients with psychiatric diseases. Meanwhile, the number of psychiatrists who will be providing care cannot be produced in time and there are not enough numbers to meet demand.
The problem of overflowing psychiatric patients in hospitals Not having access to the public health system It became a pain point for many people after the Department of Mental Health released figures showing that 1.5 million Thai people aged 15 years and over are suffering from depression, while psychiatric patients have increased almost twice in the past 6 years.
In terms of drug problems, which is another group of psychiatric patients. The more patients in this group enter the system, the more After having a policy that addicts are patients Support is not easy. Even though there is a policy of 1 province, 1 mini-thanyarak This requires additional personnel and is worried that it will affect the care of patients with other diseases.
At the same time, doctors accepted that it was a psychiatric disease. It’s like a chronic disease that can’t be cured. Must see a doctor continuously That causes the patient to come out of treatment and not be completely cured. More than half return to taking drugs again. It has become a recurring problem.
Mental health and drug problems are therefore not problems that can be relied upon by the public health system as the destination. alone But the entire society has an important role to play in helping solve this problem.
2023-12-28 10:37:45
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