Abstract
The study looks upon recent changes of the health personnel situation in public hospitals in Thailand. The study covers four professions-physicians, dentists, pharmacists, and nurses. More emphasis is placed on physicians and dentists, the two scarcest health professionals, and those that public hospitals have faced the most problem retaining. The recent years have seen increasing number of resignation, and many blame this on the 30 Baht Scheme. A recent study found, however, that resignations usually determined by joint factor such as work burdens, remuneration, and further training opportunities-all of which are similar to determining factor in the past. The state of economy is important, as it affects the relative compensation between the private and public sectors. Not many physicians cited political induced factors such as the 30 Baht Scheme or Article 41-42 of the National Security Act as the main factor. However, it would be prudent not to dismiss the possibility that dissatisfaction with the 30 Baht scheme might add some weight that tip the scale on their final decisions. The number of dentist training has increased at a slower pace than those of physicians and, in most cases, is resulting from founding a new dentistry department in a new university rather expanding the existing departments. In most dentistry departments, the number of graduates fluctuates significantly from year to year. The main reason is that many first-year dentistry students would reapply to a medical school and would withdraw from the dentistry department if they were admitted to the medical school. Pharmacists used to be considered a scarce health profession in which graduates were required to work for the MOPH after graduation. Such a requirement was abolished years ago and the public hospitals usually do not have problem filling the pharmacist position, although the legal requirement to have pharmacists working in drugstores could still not be enforced. Like other health professions, Bangkok and the Central Region has more pharmacists per capita than the rest of the country, but their distribution is better than those of physician and dentists. Nurses were also considered a scarce profession in which the graduates were required to work for the MOPH after graduation. Such a requirement was abolished even before the pharmacist case, partly because the government was not willing to hire all graduated nurses. Although some public hospitals still complain that they don’t have a sufficient number of nurses, the issue isn’t of great concern for the public or politicians. If we compare the number of health personnel with the standard that was set for the Primary Care Unit (PCU) in the 30 Baht scheme, we would find dentists to be the scarcest profession. In the Northeastern Region, even if all dentists are spread evenly throughout the region (which is currently not the case), there still would not have enough dentists to satisfy the standard requirement. While other professions could meet such a standard, it should be kept in mind that the standard itself is a bare minimum. Under such a condition, and given the situation that the 30 Baht Scheme has not successfully attracted private providers, to retain a sufficient number of personnel in public hospitals would be crucial to the success of the universal health coverage program in Thailand.
