THE BOARD of the National Health Security Office (NHSO) has approved an increased Bt12.39-billion budget for the centralised procurement of medical supplies for fiscal year 2018.

Public Health Minister Piyasakol Sakolsatayadornm, who is also the board’s chairman, said yesterday the budget would increase by Bt1.9 billion from the ongoing 2017 fiscal year.

The next fiscal year starts on October 1.

“We have increased the budget because we have expanded the medicines, vaccines and supplies for the centralised procurement, in line with the government policy to provide comprehensive medical care,” Piyasakol said. The NHSO operates the universal healthcare scheme, which covers about 48 million people in Thailand and offers most medical services for free.

While the NHSO has allowed hospitals to procure most medical supplies on their own, it has operated a centralised procurement system for items that are best bought in bulk, which increases negotiating power during the procurement process and requires centralised storage and distribution for efficiency.

For example, the centralised procurement system covers orphan medicines to treat rare medical conditions, antidotes, vaccines, anti-retroviral drugs, stents, artificial knees and supplies for continuous ambulatory peritoneal dialysis (CAPD).

Piyasakol said he would review the figures before forwarding them to the Cabinet for approval.

After the Cabinet gives the green light, the Government Pharmaceutical Organisation (GPO) will procure medical supplies for the universal healthcare scheme.

Although the process is efficient and saves money, the NHSO board looks set to lose its power to make decisions on procurement soon and it has been pointed out that the NHSO is not legally entitled to handle the process. The NHSO has in the past evaded legal restrictions by assigning the GPO to make procurements.

The country’s pending National Health Security Bill does not give the NHSO procurement power either.

It is very likely that starting in 2018, or when the bill becomes law, the Public Health Ministry will be in charge of centralised procurement instead.

In a related development, the Kidney Patient Association of Thailand yesterday urged Piyasakol to oppose the Office of Auditor-General’s suggestion that the NHSO should review some services for kidney patients covered by the universal healthcare scheme.

At present, 52,976 patients with chronic kidney failure have exercised their right to medical treatment under the scheme.

People using CAPD services are not required to pay, but those opting for hemodialysis must pay Bt500 for each treatment.

“We are worried about the suggestion from the Office of Auditor-General. Without medical services offered by the universal healthcare scheme, a huge number of patients will suffer more,” the association’s vice president Somkuan Ketthong, who is himself a kidney patient, said.

NHSO deputy secretary-general Dr Prachaksvich Lebnak received a letter on the association’s concerns from Somkuan.

The association plans to lodge a complaint with the National Human Rights Commission and the Office of the Ombudsman.