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NHSO chief bows out after ‘rollercoaster ride’ to advance every Thai’s healthcare right
NationalApr 02. 2021
By Dr Sakchai Kanjanawatana
Outgoing Secretary-General of the National Health Security Office (NHSO)
If someone asked me to describe my last four years as Secretary-General of the National Health Security Office (NHSO), I would say it was “like riding a rollercoaster”.
Not only did we need to work restlessly to improve the benefit packages and financing model for the Universal Coverage Scheme (UCS), one of the Thai government’s healthcare schemes covering nearly 49 million people. We also faced one of the worst health crises in history, the Covid-19 pandemic that has disrupted healthcare services, the economy, and the whole society.
As a leader of the NHSO, I must thank my staff and people in our networks who, despite this most challenging time, have kept working hard and never lost sight of our core value: to ensure every Thai’s right to healthcare.
This value is based on the concept that all humans are born equal. Their dignity must be respected. Therefore, they must have the right to access affordable healthcare services without begging for mercy or charity from others. It is the government’s role, and the NHSO’s, to make this happen.
But it cannot be achieved without creating the right ecosystem comprised of an effective health financing model, multi-sectoral collaboration, and transparency.
Let me start with the effective health financing model.
In the past four years, the NHSO convinced central government to increase the UCS capitation budget by 24 per cent.
When I was elected as secretary-general in 2017, the UCS capitation budget was around Bt3,110 per head per year. It was increased to Bt3,853 in the 2021 fiscal year. The overall NHSO budget was also increased from Bt152 billion to Bt202 billion in the same period.
Thanks to the central government, which prioritises the people’s health, the increased budget allowed us to add new items to the UCS benefits package. These include free automated peritoneal dialysis provided to people with kidney disease, expansion of the free flu shots programme, a new medication for hepatitis C patients, and treatment for children with hearing loss.
The availability of UCS funding has also allowed us to manage and control the spread of Covid-19 effectively. We can provide free coronavirus testing and treatment, personal protective equipment, and compensation for health workers at the frontline.
Multi-sectoral collaboration is another essential component of an ecosystem that has led to achievements in many areas.
NHSO has initiated many collaborative projects with partners and networks of health professionals, patients, and civil society. One of these is the Community Health Fund, in which the NHSO works closely with local administrative organisations across the country to run health promotion and disease prevention programmes.
Over 20,000 projects were launched last year with several activities, including Covid-19 health literacy training for village health volunteers and local communities, distributing free face masks and hand gel to people at the community level.
Early this year, we piloted a programme involving private clinics providing physical therapy to UCS patients with stroke, traumatic brain and spinal cord injury, under a collaboration with public and private health providers.
We also work with pharmacists across Thailand to deliver medicines, first aid, and health consultations for patients in local communities, so they do not need to travel far to hospitals.
Collaborating with a wide variety of networks, we have been able to reach out to vulnerable populations, including the elderly, monks, ethnic people, and prisoners in recent years. The Thai health system cannot be inclusive without ensuring healthcare access for vulnerable people who are left out due to disadvantaged backgrounds and discrimination.
Finally, the ability of the NHSO to expand health financing and multi-sectoral collaboration depends largely on ensuring transparency – a key to build trust between NHSO and multi-stakeholders.
We organise public hearings annually and run a series of focus group interviews with all stakeholders to hear their ideas for improving UCS.
Amid travel restrictions caused by the pandemic, we managed to hold virtual public consultations via social media platforms, mobile application, and a hotline. UCS beneficiaries can direct messages and concerns towards us and review the scheme’s spending on the NHSO website and annual report.
This open environment is reflected in the “A” rating granted to the NHSO by the National Anti-Corruption Commission. We also won the Ministry of Finance’s 2020 award for the best working capital management and outstanding organisational performance. The award recognises Thai governmental organisations that uphold transparency and accountability.
Despite many challenges, the NHSO has achieved many things. But, of course, this is not an ending point.
Though my term ended at the end of March, I am confident that the remaining NHSO staff and their new leader, Dr Jadej Thammathataree, will continue their journey to ensure every Thai’s healthcare right.
And not just because this is the NHSO’s core value, but because it also restores value to their life – which was my own deep feeling during my rollercoaster years with the NHSO.