Experts at a National Health Commission (NHC) seminar said on Monday that there might be an oversupply of doctors within the next 10 years, and called for a well-planned road map to solve problems. They also suggested that multidiscipline health promotion teams should be set up and measures taken to shift people’s attitudes to encourage them to proactively take care of their own health before seeking doctors’ attention.

NHC deputy secretary-general Dr Weerasak Putthasri said global changes would make the country’s healthcare human resources and service management more complicated and challenging in the next 20 years. He said a well-planned road map to support the ageing society should be in place and the inequity in health service access should be resolved.

Although Thailand exceeded the World Health Organisations recommended doctor ratio, the public perceived there was a shortage, which actually stemmed from the ineffectiveness in current management and staff distribution, Weerasak said. Despite the growth in numbers, doctors still were disproportionately based in big cities and large hospitals, leaving rural areas with not enough doctors, he said. “Policies and measures should be intensified to create equity between urban and rural communities. Healthcare personnel should understand the local context and speak the same language as the people there while being able to work in teams.

“The healthcare workforce isn’t just doctors and nurses, but also those working in health promotion and rehabilitation. They also have to work with local bodies in line with the Public Health Ministry’s Family Doctor Team and District Health Promotion policies,” he said.

Dr Thinnakorn Noree, a secretary of the National Health Workforce Committee’s sub-panel that is tasked with formulating labour planning recommendations for 2017-2026, said the sub-panel had set up 15 working teams to study human resources in nine professions: doctors, nurses, dentists, pharmacists, medical technicians, physical therapists, public health professionals, Thai traditional healers and veterinarians.

“If the current manpower promotion continues, only a few professions will fall short in numbers, while some fields would be oversupplied in the next 10 years.

“Thailand in the past four decades has been trying to solve the doctor-nurse shortage by boosting quantity and this could lead to a new problem of having too many practitioners in some fields. For example, 69 universities are producing 14,000 to 15,000 graduates in the public health field per year,” he said. “The problem is manpower distribution, because there are more doctors in big hospitals than those in district-level facilities, while some provinces have too many doctors and some have not enough,” he said.

An efficient healthcare system in the next decade would boost people’s ability to care for themselves and strengthen primary health services, Thinnakorn said. Graduates should be taught to respond to people’s lifestyles, social context and health systems as well as be equipped with other necessary skills such as IT, he added.

Dr Krisada Sawaengdee, a senior researcher on healthcare labour policy, said people crowded big hospitals and sought medical attention even when it was not necessary, giving the impression of a shortage, although academic reports showed otherwise. The distribution of services in the form of near-home Family Doctor clinics for people to seek basic treatment would help solve the problem, he said.

As vice president of the Thailand Nursing Council, Krisada said the nursing shortage was due to the inability to keep nurses in the healthcare system, ineffective manpower distribution and the assignment of nurses to other tasks that affected their main duties.

According to Dr Prasitchai Mangchit, director of Saraburi’s Kaeng Khoi Hospital, people should proactively take care of their own health while communities, agencies and universities should provide accurate health information. He agreed that the issue of staff distribution must be solved.

The experts’ comments were made during an NHC-hosted seminar on the healthcare workforce on Monday at the NHC’s head office in Nonthaburi province.