Rural doctors vow to oppose allowance cuts

Rural doctors vow to oppose allowance cuts

Weekly protests will call for Pradit to step down

SOCIAL & LIFESTYLE

Rural doctors will stage rallies every week to protest against a new Public Health Ministry policy to cut their hardship allowance and base payments on performance.

The doctors will gather at the ministry or Government House once a week to demand the policy be revoked and Public Health Minister Pradit Sintawanarong step down.

Vachira Bothpiboon, a former president of the Rural Doctors Society, said yesterday about 160 representatives of doctors and dentists nationwide would meet today to decide their next move.

The hardship allowance is based on the degree of isolation of the area in which the doctors work and the conditions they work under.

Isolated areas come under three classifications _ normal suburban areas; isolation level 1, or remote areas; and isolation level 2, or border or high-risk areas.

Physicians stationed in areas classified as normal are currently entitled to an allowance of 10,000-30,000 baht a month, depending on their years of experience.

Doctors in level 1 areas are entitled to 20,000-60,000 baht a month, while those working in level 2 areas receive 30,000-70,000 baht.

Under the new policy, suburban areas will be reclassified as "urban" areas for which the allowance will be cut by about half.

Remote and border areas will be reclassified as "specific" area 1 and 2, for which the allowance will also be cut in half.

The other half of the old allowance will be performance-related.The allowance for those working in high-risk areas such as the far South remains unchanged under the move.

Narong Sahamethapat, permanent secretary for public health, said the ministry would set targets for rural doctors and the scores they achieve will be used for performance appraisal.

The higher the score, the higher the payment, he said.

"The total budget for public health personnel will remain unchanged at 91 billion baht a year. We are just adjusting the way we allocate the payment," he said.

Dr Narong believes the new policy will reduce the income gap among doctors because several parts of the country are no longer considered isolated.

He said the new policy should encourage doctors to work harder to improve health care for the public.

But Rural Doctors Society president, Kriangsak Watcharanukulkiat, says the new payment policy would undermine the public health system.

"Several studies in foreign countries has proven that paying doctors based on performance harms public health systems," he said.

Doctors are likely to focus on treatments that can boost their scores, Mr Kriangsak said.

The new system will force many doctors into private hospitals because they can earn more from the same workload. "The existing hardship allowance is the best incentive to encourage doctors to work in rural areas," Mr Kriangsak said.

"The Public Health Ministry must not combine a hardship allowance with a performance-based payment. It's a separate issue."

Mr Kriangsak said the society will hand letters to the director of the Comptroller-General's Department and the Budget Bureau outlining their opposition to the ministry's move this afternoon.

The letters would also urge the two agencies which supervise the state budget not to approve the policy change.

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