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Bangkok needs improving access to primary care
Bangkok needs improving access to primary care
Dr Jadej Thammatacharee
Secretary-General of National Health Security Office (NHSO)
Primary care is essential to people’s health as it is an entry point to the health system while providing access to medical care, preventing diseases, and sustaining good health.
Despite Thailand’s extensive primary care units, there are still gaps in urban areas, especially in Bangkok where people’s access to primary care is lower than in the provinces (outside Bangkok)
Our recent survey shows that residents of Bangkok have limited access to primary care. Many of them are not aware of the availability of primary care units. They mainly depend on pharmacies or prefer to visit big hospitals when they are ill.
Bangkok’s traffic and distance to primary care units are part of the reasons. Despite the availability of primary care units, their numbers are not enough to serve the needs of people. Many are run by private owners as single entities and may not link to the public health system.
It’s also common for Thais to prefer big hospitals because they believe they can get the best services and doctors.
The situation in the capital is different from provincial areas where strong networks of state-own primary care units exist, thanks to Public Health Ministry’s effort to expand health facilities across the country in the past four decades.
The staff of these health units has established trust with local communities, whose members help promote access to primary care and collaborate with health workers and volunteers.
The lack of access to primary care is manifested during the COVID-19 pandemic when the Bangkok patients can’t immediately access care and must wait for getting beds in big hospitals.
The National Health Security Office (NHSO) is aware of the limited access to primary care in Bangkok. We have supported relevant authorities, health organizations, and local communities to expand health coverage.
One of our solutions is to increase the number of primary care units by establishing partnerships with private clinics, which can provide free services to Bangkok residents and claim the medical fees from the NHSO.
We have currently partnered with around 200 private- and state clinics located across the capital. But a larger number of clinics are in need.
We estimate that the capital needs at least 500 primary care units to serve its two million population — this number doesn’t count domestic migrants whose home addresses are not registered in Bangkok.
In the past years, we have had some success in expanding primary care access, especially health promotion and disease prevention.
For example, we have partnered with dental clinics which agree to provide services such as teeth scaling and fluoride varnish to the beneficiaries of the Universal Coverage Scheme (UCS), the government’s healthcare scheme overseen by the NHSO.
Our beneficiaries don’t need to pay medical fees at the clinic because we cover the cost after we receive the claim from dental clinic operators.
We have also partnered with pharmacies in the capital, of which pharmacists provide UCS beneficiaries with first aid and advice on medication. For us, these pharmacies are considered primary care units because local people easily access them. Regarding the challenge of the travel distance to primary care units, we are planning to initiate a new rule that allows residents to request primary care services at health units regardless of their hospital registration.
Currently, people’s access to healthcare services is tied to health units. An individual can enter the health system only through a health unit he/she is registered with, mostly based on his/her home address.
If an individual wants to get health services from another hospital, he/she must get inter-hospital transfer approval from a doctor at his/her registered health unit.
This rule intends to reduce the crowd at big hospitals as well as ensure access to the health system in different locations. But it may not be applicable for today when people often move to or resettle in new places.
They should be able to make choices for health units, based on their convenience. We’re working on a strategy to make this happen.
The good news for Bangkok people is that, access to primary care is one of the highlighted policies by the newly elected governor Chadchart Sittipunt.
His policies include extending after-hour clinics and introducing health mobile vehicles. These are the activities that the NHSO can support, especially in the area of finding the right financial mechanism to make the policies reality.
Our role is to support health initiatives and services that expand health coverage for all. We are ready to answer the governor’s call while developing new policies to fill the healthcare gaps.
Dr Jadej Thammatacharee
Secretary-General of National Health Security Office (NHSO)
Primary care is essential to people’s health as it is an entry point to the health system while providing access to medical care, preventing diseases, and sustaining good health.
Despite Thailand’s extensive primary care units, there are still gaps in urban areas, especially in Bangkok where people’s access to primary care is lower than in the provinces (outside Bangkok)
Our recent survey shows that residents of Bangkok have limited access to primary care. Many of them are not aware of the availability of primary care units. They mainly depend on pharmacies or prefer to visit big hospitals when they are ill.
Bangkok’s traffic and distance to primary care units are part of the reasons. Despite the availability of primary care units, their numbers are not enough to serve the needs of people. Many are run by private owners as single entities and may not link to the public health system.
It’s also common for Thais to prefer big hospitals because they believe they can get the best services and doctors.
The situation in the capital is different from provincial areas where strong networks of state-own primary care units exist, thanks to Public Health Ministry’s effort to expand health facilities across the country in the past four decades.
The staff of these health units has established trust with local communities, whose members help promote access to primary care and collaborate with health workers and volunteers.
The lack of access to primary care is manifested during the COVID-19 pandemic when the Bangkok patients can’t immediately access care and must wait for getting beds in big hospitals.
The National Health Security Office (NHSO) is aware of the limited access to primary care in Bangkok. We have supported relevant authorities, health organizations, and local communities to expand health coverage.
One of our solutions is to increase the number of primary care units by establishing partnerships with private clinics, which can provide free services to Bangkok residents and claim the medical fees from the NHSO.
We have currently partnered with around 200 private- and state clinics located across the capital. But a larger number of clinics are in need.
We estimate that the capital needs at least 500 primary care units to serve its two million population — this number doesn’t count domestic migrants whose home addresses are not registered in Bangkok.
In the past years, we have had some success in expanding primary care access, especially health promotion and disease prevention.
For example, we have partnered with dental clinics which agree to provide services such as teeth scaling and fluoride varnish to the beneficiaries of the Universal Coverage Scheme (UCS), the government’s healthcare scheme overseen by the NHSO.
Our beneficiaries don’t need to pay medical fees at the clinic because we cover the cost after we receive the claim from dental clinic operators.
We have also partnered with pharmacies in the capital, of which pharmacists provide UCS beneficiaries with first aid and advice on medication. For us, these pharmacies are considered primary care units because local people easily access them. Regarding the challenge of the travel distance to primary care units, we are planning to initiate a new rule that allows residents to request primary care services at health units regardless of their hospital registration.
Currently, people’s access to healthcare services is tied to health units. An individual can enter the health system only through a health unit he/she is registered with, mostly based on his/her home address.
If an individual wants to get health services from another hospital, he/she must get inter-hospital transfer approval from a doctor at his/her registered health unit.
This rule intends to reduce the crowd at big hospitals as well as ensure access to the health system in different locations. But it may not be applicable for today when people often move to or resettle in new places.
They should be able to make choices for health units, based on their convenience. We’re working on a strategy to make this happen.
The good news for Bangkok people is that, access to primary care is one of the highlighted policies by the newly elected governor Chadchart Sittipunt.
His policies include extending after-hour clinics and introducing health mobile vehicles. These are the activities that the NHSO can support, especially in the area of finding the right financial mechanism to make the policies reality.
Our role is to support health initiatives and services that expand health coverage for all. We are ready to answer the governor’s call while developing new policies to fill the healthcare gaps.
