“There are 886 state hospitals across the country and some 50 of them have critical cash-flow problems,” Public Health Ministry permanent secretary Dr Sopon Mekthon said yesterday, relying on information as of the end of March.

He said 44 of the financially hit hospitals were community- or district-level facilities, while six were larger hospitals.

Sopon said the financial problems at some of these hospitals could be blamed on poor budget management.

“But in some cases, small hospitals are struggling because they just can’t compete against the several larger hospitals nearby. This is the situation for many hospitals in Sing Buri and Ratchaburi provinces.”

Another key cause for the crisis is the universal healthcare scheme’s per-head budget allocation.

“When a hospital is in a remote area, it will not have many patients. So if it is allocated a budget based exactly on the number of patients it treats, it will be financially ruined,” he said.

He said he had raised the issue with the National Health Security Office, which manages the universal healthcare scheme.

“We have been talking about allocating a bigger per-head budget for hospitals in remote zones,” Sopon disclosed. “We may have to scrap the flat rate for all.”

He reckoned that relevant authorities were also considering whether to separate the budget for the universal healthcare scheme’s medical services and the budget for the salaries of medical staff implementing the scheme.

“But we have not yet reached any conclusion,” he said.