Consumer Protection in Health Service and Primary Health Care Systems throughout Thailand and Going Global Department of Health Service Support Ministry of Public Health, Thailand
Department of Health Service Support By English Documentation Working Group, Department of Health Service Support in 2014
Foreword The Department of Health Service Support gathered and presented information about the missions and responsibilities of our internal organizations to disseminate to external organizations and interested individuals nationwide and worldwide. This information could be beneficial in terms of cooperation, coordination, and the protection for consumer rights on primary health care systems and health service systems. We have always focused on providing standard services in the protection for the right of people to access health care to enhance better health among the general public. The Department of Health Service Support would highly appreciate any suggestions or comments to make this document better. English Documentation Working Group, Department of Health Service Support September, 2014
Contents Page General Information 1 1. Vision 2 2. Missions 2 3. Core Value 2 4. Strategy Administration, Control and Regulation 2 5. Executives 3 6. Organizational Structure and Addresses 4 7. Functions of the units in the Department 13 Detail of the Missions of the Department 19 1. Primary Health Care Systems 21 21 1.1 Health Behaviors 24 1.2 Primary Health Care and Public Health 27 2. Health Service System 27 2.1 Standards for Health Education 30 2.2 Standards for Medical Engineering 34 2.3 Medical Professional Licensing Standards for 36 Sanatoriums and Health Service Enterprises 37 2.4 Standards for Sanatorium Buildings and Environment 37 3. Medical Hub 55 3.1 International Healthcare Center 3.2 The extension of stay in the Kingdom of Thailand 56 57 for 90 days for the Member States of the GCC in case their people travel to receive medical treatment 65 in Thailand 65 3.3 Develop a Medical Mediator System to handle disputes 3.4 The Operations of the Medical Hub Center between 66 1 Nov. 2012 – 31 Jan. 2014 67 4. His Majesty, the King’s Initiative Project 69 4.1 The Royal-Granted Suksala Project at the Border Patrol Police Schools Appendix List of Abbreviations Glossary of Terms
Department of Health Service Support General Information 1
Department of Health Service Support Department of Health Service Support Policy of Health System Development in Ministry of Public Health Performing as a “Health Regulator, Technology Assessment, Model Development, and Technical Support” to Healthcare Service Consumer Protection 1. Vision “The principal agency for healthcare service and primary health care systems” 2. Missions 1. Develop the policies and strategies of consumer protection in healthcare service and primary health care systems. 2. Control and monitor quality assurance standards, and develop mechanism of legal enforcement. 3. Control and protect consumer rights for healthcare services based on community participation. 4. Study, analyze, research, develop, evaluate, and transfer knowledge and technology of consumer protection in healthcare service and primary health care systems. 3. Core Value FIRST: F = Fact I = Integrity R = Respect S = Success T = Teamwork 4. Strategic Administration, Control and Regulation, Evaluation, and Follow-up to Achieve the Quality Standards 1. Health system development of the Department of Health Service Support is aimed to achieve consumer protection in healthcare service and primary health care systems. 2. The Department changes a role as a “Health Regulator in Quality Standards” to consumer protection organization in healthcare service and primary health care 2
Department of Health Service Support systems in terms of Health Promotion, Disease Prevention, Treatment and Rehabilitation all over the country. 3. The Department will carry on its functions to meet the desirable outcomes of consumer protection in healthcare service and primary health care systems, that is “Health Service System is standardized, and the general public is knowledgeable and capable of self-care and self-protection”. 5. Executives Director General Department of Health Service Support Sqn.Ldr.Boonruang Triruangworawat, M.D. Deputy Director General Department of Health Service Support Tares Krassanairawiwong, M.D. Thongchai Keeratihuttayakorn, M.D. Nattawuth Prasertsiripong, M.D. 3
Department of Health Service Support 6. Organizational Structure and Addresses Department of Health Service Support Sqn.Ldr.Boonruang Triruangworawat, M.D. Director General Add. : Department of Health Service Support, Building 7, Floor 8, Office of the Permanent Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 2810-11 Fax. : +66 2590 2828 Mobile : +6681 308 6968 Email : [email protected] Tares Krassanairawiwong, M.D. Thongchai Keeratihuttayakorn, M.D. Nattawuth Prasertsiripong, M.D. Deputy Director General Deputy Director General Deputy Director General Add. : Department of Health Add. : Department of Health Add. : Department of Health Service Support, Service Support, Service Support, Building 7, Floor 8, Office of Building 7, Floor 8, Office of Building 7, Floor 8, Office of the Permanent Secretary, the Permanent Secretary, the Permanent Secretary, Tiwanon Rd., Nonthaburi Tiwanon Rd., Nonthaburi Tiwanon Rd., Nonthaburi 11000, Thailand 11000, Thailand 11000, Thailand Tel. : +66 2590 2816-7 Tel. : +66 2590 2814 Tel. : +66 2590 2812-3 Fax. : +66 2590 2802 Fax. : +66 2590 2835 Fax. : +66 2590 2830 Mobile : +6681 808 3846 Mobile : +6681 895 2244 Mobile : +6681 476 4288 Email : [email protected] Email : [email protected] Email : [email protected] Website : www.hss.moph.go.th Call Center : +662 193 7999 4
Department of Health Service Support Internal Organization Structure Note : RHSS 1 responsible for Nan, Lampang, Chiang Mai, Chiang Rai, Mae Hong Son, Phrae, Lamphun and Phayao RHSS 2 responsible for Sukhothai, Phetchabun, Uttaradit, Tak and Pitsanulok RHSS 3 responsible for Nakhon Sawan, Kamphaeng Phet, Phichit, Uthai Thani and Chai Nat RHSS 4 responsible for Nakhon Nayok, Lop Buri, Saraburi, Pathum Thani, Phra Nakhon Si Ayutthaya, Sing Buri, Nonthaburi and Ang Thong RHSS 5 responsible for Samut Sakhon, Samut Songkhram, Suphan Buri, Nakhon Pathom, Ratchaburi, Kanchanaburi, Prachuap Khiri Khan and Phetchaburi RHSS 6 responsible for Trat, Chanthaburi, Chachoengsao, Prachin Buri, Samut Prakan, Rayong, Sa Kaeo and Chon Buri RHSS 7 responsible for Roi Et, Kalasin, Maha Sarakham and Khon Kaen RHSS 8 responsible for Nong Khai, Udon Thani, Loei, Nakhon Phanom, Bueng Kan, Nong Bua Lam Phu and Sakon Nakhon RHSS 9 responsible for Surin, Nakhon Ratchasima, Chaiyaphum and Buri Ram RHSS 10 responsible for Mukdahan, Amnat Charoen, Yasothon, Ubon Ratchathani and Si Sa Ket RHSS 11 responsible for Krabi, Phangnga, Phuket, Ranong, Chumphon, Nakhon Si Thammarat and Surat Thani RHSS 12 responsible for Trang, Phatthalung, Songkhla, Pattani, Yala, Narathiwat and Satun 5
Department of Health Service Support Organizations under the Department of Health Service Support 1. Units responsible to the Director General 1.1 Public Sector Development Add. : Department of Health Service Support, Group Building 7, Floor 5, Office of the Permanent Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 2842-3 , +66 2590 1688 Fax. : +66 2590 1688 Website : http://opdc.hss.moph.go.th Email : [email protected] 1.2 Internal Audit Group Add.: Medical Engineering Division Building, Soi Satharanasuk 8, Ministry of Public Health, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2149 5642-3 Fax. : +66 2149 5644 Website : http://audit.hss.moph.go.th Email : [email protected] 1.3 Anti-Corruption Center Add. : Department of Health Service Support, Building 5, Floor 5, Office of the Permanent Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 1675 Fax. : +66 2591 2832 Website : http://acc.hss.moph.go.th Email : [email protected] 6
Department of Health Service Support 2. Administration Cluster Add. : Department of Health Service Support, Building 5, Floor 5, Office of the Permanent 2.1 Bureau of Administration Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 1644 Fax. : +66 2590 2832 Website : http://ld.hss.moph.go.th Email : [email protected] 2.2 Law Division Add.: Medical Engineering Division Building, Soi Satharanasuk 8, Ministry of Public Health, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 2999 Ext.1271-1273 Fax. : +66 2149 5651 Website : http://law.hss.moph.go.th Email : 2.3 Finance Division Add. : Department of Health Service Support, Building 5, Floor 5, Office of the Permanent Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 2878 Fax. : +66 2591 1657 Website : http://fd.hss.moph.go.th Email : [email protected] 2.4 Human Resource Add. : Department of Health Service Support, Management Division Building 5, Floor 5, Office of the Permanent Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 1640 Fax. : +66 2590 2808 Website : http://hr.hss.moph.go.th Email : [email protected], [email protected] 7
Department of Health Service Support 3. Policy, Strategy, and Primary Health Care Cluster 3.1 Primary Health Care Add. : Department of Health Service Support, Division Building 5, Floor 4, Office of the Permanent Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 1531-2 Fax. : +66 2590 1530 Website : http://phc.moph.go.th, http://www.thaiphc.net Email : [email protected], [email protected] 3.2 Planning Division Add. : Department of Health Service Support, Building 7, Floor 5, Office of the Permanent Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 1674 Fax. : +66 2591 1684 Website : http://pmsn.hss.moph.go.th Email : [email protected] 3.3 International Health Division Add. : Department of Health Service Support, Building 7, Floor 5, Office of the Permanent Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 1680 Fax. : +66 2590 1677 Website : http://mdh.hss.moph.go.th Email : [email protected] 8
Department of Health Service Support 4. Standard quality regulating Cluster 4.1 Bureau of Sanatorium and Add. : Department of Health Service Support, Healing Arts Supply Building, Floor 4-5, Soi Satharanasuk 6, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 1331 Fax. : +66 2590 1332 Website : www.mrd.go.th Email : [email protected] 4.2 Health Education Division Add. : Department of Health Service Support, Building 4,6, Floor 5, Office of the Permanent Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 1661 Fax. : +66 2590 1672 Website : www.hed.go.th Email : [email protected] 4.3 Design and Construction Add. : Department of Health Service Support, Division Building 5, Floor 7-8 ,Office of the Permanent Secretary, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2590 1861-2 , +66 2590 1859 Fax. : +66 2590 1860 Website : http://dcd.hss.moph.go.th Email : 4.4 Medical Engineering Division Add.: Medical Engineering Division Building, Soi Satharanasuk 8, Ministry of Public Health, Tiwanon Rd., Nonthaburi 11000, Thailand Tel. : +66 2149 5656 , +66 2149 5680-91 Fax. : +66 2149 5657 Website : http://medi.moph.go.th Email : [email protected] 9
Department of Health Service Support 5. Regional Cluster ( Regional Health Service Support Office 1-12) 5.1 Regional Health Service Support Add : Medical Engineering Center 1, Office 1 : Chiang Mai Chiangmai 191/1 Moo 4, Tambon Don Kaew, Amphur Mae Rim, Chiangmai 50180, Thailand Tel.: +6653 112 220-1 Fax. : +6653 896 119-200 Website : http://do1.hss.moph.go.th Email : [email protected] 5.2 Regional Health Service Support Add : 516/41 Moo10 Phaholyothin Office 2 : Phitsanulok Road, Tambon Nakhonsawan Tok, Amphur Muang , Nakhonsawan 60000, Thailand Tel. : +6656 222 375 Fax. : +6656 222384 Website : http://do2.hss.moph.go.th Email : [email protected] 5.3 Regional Health Service Support Add : Medical Engineering Center 3, Office 3 : Nakhon Sawan Nakhonsawan 516/17 Amphur Muang Nakhonsawan 60000, Thailand Tel. : +6656 221 289 Fax. : +6656 221 984 Website : http://do3.hss.moph.go.th Email : [email protected] 5.4 Regional Health Service Support Add : 88/13 Soi Satharanasuk 8, Office 4 : Nonthaburi Ministry of Public Health Tiwanon Rd., Amphur Muang, Nonthaburi 11000, Thailand Tel. : +662 590 2999 Fax. : +662 590 2999 Website : http://do4.hss.moph.go.th Email : [email protected] 10
Department of Health Service Support 5. Regional Cluster ( Regional Health Service Support Office 1-12) 5.5 Regional Health Service Support Add : Medical Engineering Center 1, Office 5 : Ratchaburi Ratchaburi 407 Yudhidham Road, Tambon Na Muang, Amphur Muang Ratchaburi 70000, Thailand Tel. : +6632 321 863 Fax. : +6632 337 258 Website : http://do5.hss.moph.go.th Email : [email protected] 5.6 Regional Health Service Support Add : Central Public Health Training Office 6 : Chon Buri and Development Center, Cholburi Phraya Sajja Road, Tambon Samed, Amphur Maung, Cholburi 20000, Thailand Tel. : +6638 467 249 Fax. : +6638 467 251 Website : http://do6.hss.moph.go.th Email : [email protected] 5.7 Regional Health Service Support Add : Medical Engineering Center 2, Office 7 : Khon Kaen Khon Kaen 303/2 Mittraphap Road, Tambon Sila, Amphur Muang, Knon Kaen 40000, Thailand Tel. : +6643 243 738-9 Fax. : +6643 247 045 Website : http://do7.hss.moph.go.th Email : [email protected] 5.8 Regional Health Service Support Add : 89 Anamai Road, Tambon Nai Office 8 : Udon Thani Muang, Amphur Muang, Khon Kaen 40000, Thailand Tel. : +6643 224 605 Fax. : +6643 221 679 Website : www.esanphc.net/hss8 Email : [email protected] 11
Department of Health Service Support 5. Regional Cluster ( Regional Health Service Support Office 1-12) 5.9 Regional Health Service Support Add : Medical Engineering Center 4, Office 9 : Nakhon Ratchasima Nakhon Ratchasima Ratchasima – Chokchai Road Kilometer 7, Amphur Muang, Nakhon Ratchasima 30000, Thailand Tel. : +6644 212 179 Fax. : +6644 212 692 Website : http://do9.hss.moph.go.th Email : [email protected] 5.10 Regional Health Service Support Add : Medical Engineering Center 5, Office 10 : Ubon Ratchathani Ubol Ratchathani Phromthep Road, Tambon Nai Muang, Amphur Muang, Ubol Ratchathani 34000, Thailand Tel. : +6645 244 994, +6645 255 259 Fax. : +6645 246 004 Website : www.mec5.dyndns.org Email : [email protected] 5.11 Regional Health Service Support Add : Southern Public Health Training Office 11 : Nakhon Si Thammarat and Development Center, Nakhon Sri Thammarat Pattanakarn Khu Kwang Road, Tambon Nai Muang, Amphur Muang, Nakhon Sri Thammarat 80000, Thailand Tel. : +6675 446 005, +6675 446 354 Fax. : +6675 446 291 Website : www.nakhonphc.go.th Email : [email protected] 5.12 Regional Health Service Support Add : Medical Engineering Center 7, Office 12 : Songkhla Songkhla 171 Songkhla-Jana Road, Tambon Khao Roop Chang, Amphur Muang, Songkhla 90000, Thailand Tel. : +6674 336 087 Fax. : +6674 336 088 Website : http://medi.moph.go.th/center7 Email : [email protected] 12
Department of Health Service Support 7. Functions of the units in the Department 7.1 Public Sector Development Group Responsibilities: (1) Give suggestions to the Director-General of the Department of Health Service Support on policies and strategies of the internal administrative system in the Department. (2) Monitor operating system and service development including improving the organizational structure to elevate work efficiency of all units in the Department, as well as monitoring, following up, and evaluating the improvement results to achieve continuous administrative development. (3) Perform other duties as assigned. 7.2 Internal Audit Group Responsibilities: (1) Verify operational systems of the accuracy and reliability of financial and programmatic data, including maintain the bureaucratic property as prescribed in bureaucratic regulations and rules. (2) Analyze, study, and evaluate the efficiency of risk management activities, sufficiency of internal audit system, and cost-effectiveness of resources including providing consultations, recommendations, facilities, and training courses. (3) Perform other duties as assigned. 7.3 Anti-Corruption Center Responsibilities: (1) Revise the Department’s 4-Year Action Plan, and Annual Action Plan, adding strategic issues on prevention and suppression of corruption and abuse of misconduct. (2) Suggest and coordinate all internal units to set up the Unit’s Action plan in accordance with the Action Plan of the Department and the Ministry. (3) Coordinate, activate, and monitor all internal units to operate in consistence with the plans/projects specified in the Action Plan. (4) Accept the complaints; and then, coordinate, forward, and consistently follow up the final resolution of the units with responsibilities for corruption. (5) Follow up and prepare a report on the Department’s prevention and suppression of corruption. (6) Submit a report on the implementation of prevention and suppression of corruption. (7) Enhance good governance and create the Department’s transparency or prevention and suppression of corruption. (8) Protect ethics according to the Code of Ethics of Civil Servants. 13
Department of Health Service Support (9) Coordinate with related organizations about ethics protection. (10) Follow up, evaluate, and submit a report on ethics protection to the Director-General and the related organizations. 7.4 Bureau of Administration Responsibilities: (1) Monitor general administrative operation of all units under the Departments to comply with rules and regulations. (2) Develop all systems to support and achieve the mission operation of the Department. (3) Develop public relations system and disseminate information and knowledge of the Department. (4) Serve as an information and technology center of the Department (5) Support and coordinate in international affairs cooperation with other related international agencies. (6) Study, analyze, research and instruct knowledge and technology as the missions of the Department. (7) Develop the emergency response system for the Department. (8) Perform other duties as assigned. 7.5 Law Division Responsibilities: (1) Perform legal affairs according to laws and regulations on sanatoriums, healing arts, health enterprises and other related laws. (2) Improve both national and international laws and regulations in relation to the Department to meet internationality. (3) Coordinate in the legal affairs of the international health services. (4) Perform legal actions, including contracts, rules, medical dispute settlement, civil and criminal liabilities, administrative cases, and other cases in the Department’s responsibilities. (5) Operate disciplinary actions, appeals and grievances, as well as strengthen legal disciplines of government officials and employees in the Department. (6) Take action in terms of complaints and coordinate in medical dispute resolution. (7) Perform law enforcement to accommodate consumer protection in healthcare service. (8) Give advice in legal affairs and publicize related laws and regulations of the Department. (9) Perform other duties as assigned. 14
Department of Health Service Support 7.6 Finance Division Responsibilities: (1) Suggest and specify strategies in financial management, accountancy, budgeting, and procurement. (2) Operate financial management, accountancy, budgeting, and procurement. (3) Perform other duties as assigned. 7.7 Human Resource Management Division Responsibilities: (1) Establish the strategic plan on human resource management in compliance with the strategy of the Department. (2) Carry out human resource management of the Department. (3) Develop a personnel information system and personnel records of the Department. (4) Study, analyze, and develop the manpower system of the public sector. (5) Carry out knowledge management to increase competency, training, and development for the personnel of the Department. (6) Make a suggestion in a human resource and perform other duties as assigned. 7.8 Primary Health Care Division Responsibilities: (1) Develop models and the implementation of primary health care to improve public health. (2) Develop, promote, and support the participation of local administration organizations, community organizations, public health volunteers, private sector organizations, and the general public in providing health promotion activities, disease prevention, and personal health care. (3) Promote and develop volunteers and private sector organizations to enhance public health protection and achieve social development participation. (4) Cooperate and support the operation of the related organizations as assigned. 7.9 Planning Division Responsibilities: (1) Study, analyze, and establish information for the Department’s policies and strategies in national health services. (2) Coordinate and develop action plans as well as operational plans of the Department to avail the achievement of the ministerial goals and operational plans. (3) Follow up the activities, and evaluate the achievements in health services and primary health care of the Department. 15
Department of Health Service Support (4) Implement Royal Initiative Projects and other projects under the patronage of the royal family. (5) Supervise, monitor, and evaluate the Department’s policies and strategies, leading to implementation. (6) Develop knowledge management system and research management mechanism to be standardized. (7) Collaborate or support cooperation with other related agencies as assigned. 7.10 International Health Division Responsibilities: (1) Specify strategies for 'Thailand as a Medical Hub'. (2) Set up the policy proposal on 'Thailand as a Medical Hub'. (3) Study, analyze, conduct research and development on health innovation to enhance value-added sanatoriums of the country and to accommodate the national strategic plan. (4) Develop systems for following up and evaluating impacts from the policy operation and the establishment of the remedial measures. (5) Promote and develop joint healthcare services between the public sector and the private sector. (6) Represent Thailand, doing the main mission in the negotiations to be an international medical hub. (7) Perform as an information and technology center of an international medical hub. (8) Collaborate or support collaboration with other related agencies as assigned. 7.11 Bureau of Sanatoriums and Healing Arts Responsibilities: (1) Develop and establish standards for the healing arts, sanatoriums, and healthcare enterprises. (2) Control, monitor, and assure quality standards of the healing arts, sanatoriums, and healthcare enterprises. (3) Study, analyze, research, evaluate and transfer knowledge and technology of consumer protection in healthcare service. (4) Perform law enforcement involving the Department to avail achievement of the government and the general public. (5) Collaborate or support collaboration with other related agencies as assigned. 16
Department of Health Service Support 7.12 Health Education Division Responsibilities: (1) Develop systems, criteria, procedures of quality assurance for health education standard and health behavior development in health service systems. (2) Research and develop bodies of knowledge, innovation, and technology to develop the quality of health education and health behaviors. (3) Promote and strengthen the capability of people and networks to protect human rights in health service system. (4) Develop and mobilize the policy and strategy of national development in health behaviors. 7.13 Design and Construction Division Responsibilities: (1) Promote, support, control, and maintain the buildings of sanatoriums and other organizations in the Ministry to be professionally standardized according to the building control law and other related regulations. (2) Regulate, monitor, follow up, evaluate, and give technical and professional advice in architecture and engineering of buildings and connected buildings in sanatoriums to achieve professional standards in accordance with the building control law and other related regulations. (3) Analyze, research, and establish criteria and standards including developing bodies of knowledge in buildings and the surrounding areas of sanatoriums and other organizations in the Ministry to be professionally standardized according to the building control law and other related regulations. (4) Collaborate or support collaboration with related agencies as assigned. 7.14 Medical Engineering Division Responsibilities: (1) Establish standards for medical engineering, communication engineering, and safety engineering including specifying quality of medical equipments, and surveying, analyzing, studying, as well as collecting academic information, and documenting the manual of knowledge and innovation in medical engineering. (2) Develop management systems in medical engineering, communication engineering, and safety engineering, and also set up the information center in medical engineering and public health including improving, maintaining and developing the website system of the Division. (3) Control and implement standards for medical engineering to ensure the efficiency of officials and sanatoriums including operating the calibration and verification of medical equipment in accordance with international standards. (4) Make an assessment, an improvement, a repair, a transfer, and an adjustment, concerning the missions of the Division. 17
Department of Health Service Support (5) Set up the strategic plan and action plan of the Division in accordance with the Key Performance Indicator (KPI). (6) Collaborate on the operation of the Division in terms of finance, accountancy, procurement, correspondence, and human resources. 7.15 Regional Health Service Support Office 1-12 Responsibilities: (1) Promote and support the policy and strategy of consumer protection in healthcare service and primary health care systems. (2) Promote and support the mechanism of law enforcement as assigned and involved. (3) Promote, support, regulate, follow up, and assure the standard of health service and primary health care systems in the responsible areas. (4) Promote and support bodies of knowledge, technology, and innovations in health management to achieve health behavior development in the responsible areas. (5) Promote, support and collaborate in the health service center and primary health care systems both nationally and regionally in the responsible areas. (6) Study, analyze, research, develop and transfer knowledge, technology and innovations in health service and primary health care systems. (7) Perform other duties as legally assigned by the Department, the Minister, or the Cabinet. 18
Department of Health Service Support Detail of the Missions of the Department 19
Department of Health Service Support The Missions of the Department of Health Service Support are as follows : 1. Primary Health 1.1 Health Behaviors Care Systems 1.2 Primary Health Care and Public Health 2. Health Service 2.1 Standards for Health Education System 2.2 Standards for Medical Engineering 2.3 Medical Professional Licensing Standards for Sanatoriums and Health Service Enterprises 3. Medical Hub 2.4 Standards for Sanatorium Buildings and Environment 4. His Majesty, the King’s Initiative Projects 3.1 International Healthcare Centers 3.2 The extension of stay in the Kingdom of Thailand for 90 days for the Member States of the GCC 3.3 Develop a Medical Mediator System to handle disputes 3.4 The Operations of the Medical Hub Center 4.1 The Royal-Granted Suksala Project at the Border Patrol Police Schools 20
Department of Health Service Support 1. Primary Health Care Systems 1.1 Health Behaviors Developing health behaviors is a process in which learning, skills training, and environmental factors, together with the development of health literacy, are provided for individuals, families, and communities to achieve desirable health behaviors. It is aimed that the target groups of people will gain the ability and skills to access information and knowledge, to understand how to make an analysis, and to gain self-assessment as well as self-management. In addition, the people are expected to be able to guide others regarding personal, family, and community health. Procedures 1. Establish and mobilize development policies and strategies for health education including developing health behaviors. 2. Conduct research and develop bodies of knowledge, health education media and innovation as well as health behaviors to attain internationality and implementation. 3. Develop communication systems and offer warnings on health behaviors. 4. Develop potential and capabilities of the health education network, and foster operations on health behaviors by developing healthy habits and the knowledge of primary health care. The development is aimed at the two age groups. The first one includes school students aged 7-18 years so that they will possess health behaviors in compliance with the guidelines specified in the National Hygiene Principles. The other group covers the people aged 15 and over, with proper health behaviors. The focus is on diets, exercise, stress (emotional) management, smoking, and drinking behaviors. Developing health behaviors among children and the youth Applying strategies to enhance and foster health inculcation among school children, synchronizing with the National Hygiene Principles. The National Hygiene Principles consist of 10 basic health principles. Following the 10 hygiene principles enhances strong physical and mental health with competency in learning and working. Moreover, an individual’s immune system and well-being will be strengthened. The 10 National Hygiene Principles are as follows. Hygiene Principle 1 : Keep the body and utensils clean. Hygiene Principle 2 : Maintain strong teeth and correctly brush your teeth every day. Hygiene Principle 3 : Wash your hands before eating and after excretion. Hygiene Principle 4 : Eat cooked clean foods without hazardous substances. Avoid intake of excessive spicy foods and those with flashy colors. Hygiene Principle 5 : Abstain from smoking, alcohol, drug abuse, gambling, and sexual promiscuity. 21
Department of Health Service Support Hygiene Principle 6 : Build a warm family relationship. Hygiene Principle 7 : Prevent accidental disasters by being precautious. Hygiene Principle 8 : Exercise regularly and have an annual health check up. Hygiene Principle 9 : Always have a cheerful mind. Hygiene Principle 10 : Have public awareness and join social activities. To cultivate and reinforce health behaviors among children and the youth, complying with the National Hygiene Principles, is crucially important as healthy children will grow up to being healthy adults. The children will have proper physical development, good health, and well-being, which will positively affect their learning performance. Therefore, in order to promote children to have good knowledge, understanding, and attitudes as well as health behaviors in accordance with the National Hygiene Principles, schools are the important place because of their potential to provide needed experiences, skills, and surroundings for students to consistently formulate proper health behaviors until they finally become their health behaviors. Schools can provide stages of learning activities, reinforced by bodies of knowledge and learning media as follows. Step 1 : Set up a working team. - Setting up a committee /a working team to be responsible for the school’s health plan, participated by all related sectors. - Specifying a health plan, in accordance with the National Hygiene Principles, as one of the school policies. Step 2 : Conduct a study and data analysis. - The data include school contexts, health situations, and health risks of the students. Step 3 : Plan and design health learning activities. Budgets and facility allocations must be included. Step 4 : Operate learning activities in compliance with the National Hygiene Principles. The learning activities must be consistently operated, using a variety of methods and media. 4.1 Learning activities are directly operated in such curricular subjects as Health Education and Physical Education. In addition, they can be included in other related subjects. 4.2 Health activities can be offered as part of extra - curricular activities in tutorial classes or in the school activity periods. 4.3 Conduct surveillance on students’ health behaviors. 4.4 Appoint some students as hygiene principle leaders or establish the Hygiene Principle Club. Step 5 : Create the schools’ surroundings to facilitate compliance with the National Hygiene Principles. Step 6 : Evaluate and improve the operation. Step 7 : Extend health learning activities to families and communities. 22
Department of Health Service Support Students’ guardians and community members will have good understanding and recognition of the importance of health awareness. Developing health behaviors among people aged 15 and over Behavioral adaptation in health is the strategy used at a village level aiming at changing people’s lifestyle to reduce the risk of developing cancer, hypertension, heart and vascular diseases. It is aimed that people aged 15 years and over will adapt themselves and have the right health behaviors – regularly do at least 30 minutes of exercise for at least 3-5 times per week. Additionally, they should eat half a kilogram of vegetables and fruit every day, and reduce fat intake. The people are encouraged to handle or regulate their feelings and to remain emotionally happy. When the community participates in this campaign, healthy villages with behavioral adaptation are then originated. There are 7 steps leading to achieving healthy villages with behavioral adaptation and reducing the risk of developing diseases. Step 1 : Establish an operational team. The team is set up, comprising representatives who are local personnel from the Ministry of Public Health, the Ministry of Agriculture, and Local Administration Organizations, together with the community leaders and the public. This team jointly works and mobilizes the operation. Step 2 : Study basic data of the village. Investigation of relevant data is conducted and used in the operational plan. - Data on health status - Data on health behaviors - Data on contributing factors - Data on networking - Data on people’s needs Step 3 : Set up a development plan for the village. The plan covers the participation model of all community sectors. Step 4 : Carry out learning activities. - Publicize the activities to gain recognition. - Carry out learning activities, allowing participation from all people. - Participate in specifying social measures or joint agreements. - Designate factors to contribute to increasing health intelligence and health behavioral adaptation. Step 5 : Conduct surveillance on health behaviors. Surveillance on health behaviors is conducted as scheduled by means of data collection to enhance activity adaptation. Step 6 : Establish open forums to exchange ideas among the operational team members. This is aimed to enhance joint learning and to elevate development skills on development and mobilization of activities. Step 7 : Evaluate the development of the village. 23
Department of Health Service Support The village is evaluated in 4 aspects as follows. - The development management - The empirical outcomes such as places for vegetable plantation, places serving as a gymnasium. - The impacts on people; for example, the changed behaviors, disease situations, and the people’s satisfaction. Health Behavior Development Health Education Process Health Literacy Children and the Process o-f providing youth achieve health learning activities, behaviors specified in developing health skills, as hygiene principles well as other surrounding factors leading to health People aged 15 and behavior adaptation of over possess the individuals, families, and proper health behavior communities focusing on diets, exercise, stress management, smoking, and drinking behaviors 1.2 Primary Health Care and Public health 1. Primary health care and public health : The Department of Health Service Support accomplishes the following tasks. - Specify directions and goals to activate primary health care and public health in Thailand. - Serve as a core public sector and a linkage for overall primary health care and public health of the country. - Provide academic support and allocate necessary resources; for example, new models to execute primary health care in the urban and rural areas, the implementation of primary health care to confront or handle the recurrent disease and chronic diseases. The Department also takes care of the elderly society, managing health care by age groups, as well as disease control, and health disaster management. Additionally, the Department 24
Department of Health Service Support is responsible for the budget of non-profit organizations that provide health service, disease prevention, and health behavior development. - Provide academic knowledge, training courses, study visits, including the exchange of ideas and knowledge on primary health care and public health among national and international health personnel and volunteers. - Serve as a mentor in developing potential, promoting the participation of local administration organizations, community organizations, health volunteers, including the private and public sector organizations in health promotion activities. Moreover, the Department is functionally involved in disease prevention, self health care, health behavior adaptation, and mechanism development, as well as a surveillance system on the protection for the rights of people to access health care, and consumer rights for community health care. - Collect, develop, and provide service, including knowledge transfer, technology and innovation on primary health care and public health. The innovation derives from outstanding Village Health Volunteers all over the country. In terms of research, the Department of Health Service Support is initiative and creative in searching for cutting- edge development in primary health care and public health. - Support and encourage people and all networking sectors to establish standard systems of primary health care and public health based on the principle of “for the people and by the people”. This is done through Village Health Management and Sub-District Health Management, including the Network for Community-Based Disaster Preparedness. - Promote, monitor, and certify standards of all organizations that work on primary health care. - Promote and support people so that they recognize their rights and play a role in the public health protection so that personal health care and self-reliance can be achieved. 2. Village Health Volunteers (VHVs.) The Department of Health Service Support supports both Thai and foreign volunteers as follows. 1) Organizing systems and developing potential of village health volunteers. 2) The training course curriculum as well as the publication of the handbooks and guidelines on developing Village Health Volunteers (aiming at recruiting new volunteers and developing the existing volunteers to be more capable and standardized as specified in the core training curriculum). The Department takes a great role in the standard training for urban volunteers, together with the courses in Curriculum and Guidelines for Village Health Volunteers, Community - Based Health Managers, and Foreign Health Volunteers. 3) The role of Village Health Volunteers in health promotion, disease prevention and control, as well as the protection for the right of people to access health care, and consumer rights as identified in primary health care activities, including health care by age group etc. 25
Department of Health Service Support 4) The development of Village Health Volunteers to comply with the law is focused. The rules and regulations enforced and related to Village Health Volunteers are as follows. - The Ministerial Regulation on Village Health Volunteers B.E.2554. - The Ministerial Regulation on the Control of Medical Professional Licensing Systems Authorized by Ministries, Bangkok Metropolis, Pattaya City, Provincial Administration Organizations, Municipalities, Local Administration Organizations, and the Red Cross B.E.2539. - The Ministerial Regulation on the Control of Medical Professional Licensing Systems Authorized by Ministries, Bangkok Metropolis, Pattaya City, Provincial Administration Organizations, Municipalities, Local Administration Organizations and the Red Cross (Edition 2) B.E.2556. - The Ministerial Regulation on the Control of Medical Professional Licensing Systems Authorized by Ministries, Bangkok Metropolis, Pattaya City, Provincial Administration Organizations, Municipalities, Local Administration Organizations or the Red Cross (Edition 3) B.E.2556. - The Ministerial Regulation on Financial Supports for Medical Treatment. - The Ministerial Regulation on Honorarium Payment for Village Health Volunteers B.E.2552. - The Ministerial Regulation on I.D. Cards of Village Health Volunteers. - The Ministerial Regulation on the Royal Thai Decoration : The Most Admirable Order of the Direkgunabhorn 2534 ; The Proposal for the Royal Graciousness on The Royal Thai Decoration : The Most Admirable Order of the Direkgunabhorn Act B.E.2538 Article 6, 8, 9, and 10 ; and The Proposal for the Royal Graciousness on The Royal Thai Decoration : The Most Admirable Order of the Direkgunabhorn Act (Edition 2) B.E.2549. 5) Provide benefits, welfare, and morale building for Village Health Volunteers such as position comparison for Village Health Volunteers ; Village Health Volunteer Foundation ; help, supports, and donation from the public. Foster upgrading basic education of Village Health Volunteers by unit transfer based on knowledge and working experiences that suits the courses offered in basic education for Village Health Volunteers as specified in the Non - Formal Basic Education Act B.E.2551. Allocate quotas for Village Health Volunteers and their children to study in the educational institutions organized by the Ministry of Public Health ; Day of Village Health Volunteers ; honoring Village Health Volunteers; badges of honor ; awards for outstanding Village Health Volunteers. Set up criteria, qualifications, and procedures in the Proposal for the Royal Graciousness on The Royal Thai Decoration for Village Health Volunteers ; honorariums for Village Health Volunteers, and financial supports for medical treatments for Village Health Volunteers etc. 6) Construct structures of Village Health Volunteers and their supporting networks such as the Village Health Volunteers Club ; names of the presidents of the national and provincial clubs including those in Bangkok; the name lists of all the provincial chiefs responsible for public health care all over the country. 26
Department of Health Service Support 7) Provide database on Village Health Volunteers ; their performances ; and outstanding Village Health Volunteers of all branches ; including those who receive the Royal Thai Decoration. 8) Offer curriculums, training courses, and study visits on the System of Village Health Volunteers (VHVs.), as well as on the Development of Village Health Volunteers to personnel and all volunteers at national and international levels. 2. Health Service System In terms of health service, the Department of Health Service Support is the key organization dealing with consumer protection. Health Standards of the Ministry of Public Health have been established and documented so that organizations under the Office of Permanent Secretary can be used as guidelines for health service promotion and a random examination on health service. It is aimed that patients, people, and society will all get services as identified by the Ministerial Standards. The Ministerial Standards 1. Standards for Health Education 2. Standards for Medical Engineering 3. Standards for Medical Licensure, Sanatoriums, and Health Centers 4. Standards for Buildings and Environment 2.1 Standards for Health Education “Health Education” is an essential foundation for the well - being of all age groups and genders of the people in the country in acquiring quality service. As a result, health education operation is a process to enhance and manage health learning, which affects health promotion and proper health adaptation so that people can take care of themselves, their families, and the communities. Health education is one of the health care services, which is the State’s mission. According to The Constitution of the Kingdom of Thailand B.E.2550, it is specified that health services shall be appropriate and standardized. Moreover, it is identified as Strategy 4 in the National Health Development Plan Edition 11 (B.E.2555-2559); i.e., promote health service systems to achieve standards at all levels. Therefore, the Department of Health Service Support takes health education as its mission on protecting the people in terms of health service. Standards for health education are an important tool for continuously improving the quality of health services and health education of the government sector at all levels. They are used as a framework to review and improve the service systems and the quality management systems to achieve a learning process and participation. The goals are to develop desirable health behaviors of all age groups and to foster health literacy among people, aiming at good health of the public. 27
Department of Health Service Support Standards for health education are systematic standards that cover organizational management. These standards generate the efficient and effective operational process, operational outcomes, health education, and desirable health behavior development concerning patients, communities, and service quality development. Compositions of Health Education Standards The structure of health education standards is set up as an operational framework, categorized into 3 levels, based on potential and types of health service providers. 1. Center hospitals/general hospitals. - 41 criteria needed for the operation. 2. Community hospitals. - 41 criteria needed for the operation. 3. District health promotion hospitals, community health centers, village health centers. - 31 criteria needed for the operation. The operational components can be classified into 4 sections and 10 factors as follows. Section 1 : Organizational Management Factor 1 : Directions and guidelines that reflect the organization’s values in operating health education. They can be adjusted to suit the situation of health problems so that the proper guidelines can be set up and behavioral adaptation in health can be efficiently achieved. Factor 2 : Resources for health education and health behavior development. This is aimed to enhance opportunities for all organizations to properly and sufficiently carry out health education and health behavior development. Additionally, it is aimed to efficiently support the operation on people’s behavioral adaptation in health in the areas for which each organization is responsible. Factor 3 : Information system on health education and development of health behaviors. The information system is managed to get the most benefit from its usage. Data is systematically and accurately collected and organized. They are up-to-date, reliable, and referential, with a data linkage within the health service network. There are 3 types of the database. 3.1 Database on health behaviors. 3.2 Database on health education media. 3.3 Database on the network of health education and development of health behaviors. Section 2 : Operational Process Factor 4 : Health education and an operational plan on development of health behaviors. This factor serves as a tool to monitor and evaluate the success of the operation; hence, it is a tool that maximizes the benefits of the project and resource management. 28
Department of Health Service Support Factor 5 : Health education and health behavior activities. The activities are provided so that the target groups will learn and develop needed health skills and fulfill the missing part. In addition, surrounding factors which enhance desirable health behaviors are developed both in the public and community health service organizations, aiming at people-centered learning with people’s full participation in the learning operation and activities. Factor 6 : Health education and health behavior supports. The personnel are assisted, supported, monitored, and evaluated so that their performances are most efficient and correct in accordance with the goals of the organization and the needs of the target groups. Factor 7 : Health education and health behavior evaluation. The evaluation serves as a tool in the operational plans and projects, monitoring the performances in accordance with the objectives of the plans and projects. Consequently, health education outcomes and situations are clearly known. Section 3 : Service Development Process Factor 8 : Surveillance on health behaviors. This factor covers the process of a study and an analysis including surveillance on health behaviors which cause health problems. It is beneficial for operating health education and health behavior development in order to keep pace with the situations of the ongoing or changing health problems. Factor 9 : Research in health education and health behaviors. This factor represents a process to find out answers to the health education operation, and then they are implemented in the health service systems related to people’s health behaviors. Section 4 : Operation Outcomes Factor 10 : The outcomes of health education and health behavior operations. The outcomes of health education and health behavior operations are classified into 3 aspects as follows. 10.1 The outcomes for service receivers. 10.2 The outcomes for the communities. 10.3 The outcomes for service quality development. Criteria for rankings on health service standards. The evaluation is categorized into 3 classes. Class 1: Fair - Achieving Factors 3, 4, 5, and 7 Class 2: Good - Achieving Factors 1, 2, 3, 4, 5, 6, and 7 Class 3: Very Good - Achieving all the 10 Factors 29
Department of Health Service Support 2.2 Standards for Medical Engineering According to the policy of the Department of Health Service Support, the Ministry of Public Health, it is identified that the Medical Engineering Division is responsible for supporting and fostering public hospitals and sanatoriums at all levels. It is aimed to establish administrative systems and ensure that the service is rendered with safety, efficiency, and high quality to the service receivers at all hospitals and sanatoriums all over the country. Even though the Medical Engineering Division does not have the tasks to give direct service to the people, indirectly, the Division plays an important role in supporting the development mechanism of quality service of hospitals or sanatoriums. For example, the Division systematically establishes the medical engineering system, enhancing the cleanest, most convenient, and safest environment of hospitals and sanatoriums. All the maintenance systems of the medical appliances and equipment are accurately, precisely, and efficiently organized with 24-hour availability. Therefore, to develop the medical engineering systems in hospitals and sanatoriums all over the country, responding to the policies of the Department of Health Service Support, the Medical Engineering Division has improved the previous medical engineering standards, used from 2010 to 2012. The standards become more complete, covering the main medical engineering activities such as systemization, maintenance, medical equipment calibration, and safety engineering. Any hospitals and sanatoriums which can achieve all these standards will be standardized, rendering quality assurance to patients, relatives, visitors, communities, and the surrounding areas. The most important thing is that these hospitals and sanatoriums can be further developed to achieve international standards and ask for evaluation and quality accreditation from the Medical Engineering Division. Evaluation Criteria Standard evaluation criteria include 4 factors : systemization, maintenance, medical equipment calibration, and safety engineering. These criteria are the same as the international ones and in consistent with health service standards set by the Ministry of Public Health. Criteria and directions to consider health service standards of the hospitals comprise 5 levels as follows. Level 1 is the level where medical engineering standards and monitoring procedure do not exist. No direction in the operation is depicted. Level 2 is the level where the organization begins to follow the medical engineering standards, but still does not cover all aspects. Moreover, the operation is reactive. Level 3 is the level where the operation conforms to the medical engineering standards, and the monitoring procedure is systemized. The operation is both proactive and reactive. Procedures are identified with services being systematically rendered. 30
Department of Health Service Support Level 4 is the level where the operation is done better than the requirements (Class 3). Services are continuously developed to achieve standards, emphasizing more on quality. This class is outstanding because of its proactive services, clearly specifying operation plans and monitoring procedures. There are development activities and continuous service improvement as well as service quality assurance and evaluation systems. Level 5 is the highest level. The operation and monitoring procedures are so most outstanding that they can set an example or be a model for other internal units and external organizations. The emphasis is on innovation with an outstanding aspect : representing a learning-based organization and a place suitable for a study tour for others. Quality Evaluation Criteria Each factor is evaluated by scores 1 to 5. The level of quality derives from the total mean calculated from the mean of each factor. The mean of the 4 factors is 1.00-1.50 : achieving Level 1 The mean of the 4 factors is 1.51-2.50 : achieving Level 2 The mean of the 4 factors is 2.51-3.50 : achieving Level 3 The mean of the 4 factors is 3.51-4.50 : achieving Level 4 The mean of the 4 factors is 4.51-5.00 : achieving Level 5 Steps of Obtaining Medical Engineering Certification Any hospital or sanatorium can follow these steps to obtain medical engineering certification from the Medical Engineering Division, the Department of Health Service Support. 1. Notify to obtain evaluation and medical engineering certification to Director, the Medical Engineering Division at 88/33 Satharanasuk 8 Road, Tambol Talad-kwan, Amphur Muang, Nonthaburi 11000. Tel. : +662-149-5680 Fax : +662-149-5657. 2. Conduct self-evaluation in accordance with the evaluation and certification forms issued by the Medical Engineering Division. 3. Receive the evaluation results. After passing, wait for the evaluation. If failed, correct the failed parts or participate in the annual training course offered by the Division according to the medical engineering development project. The course includes training, preparation, and implementation etc. 4. Be evaluated by the committee appointed by the Medical Engineering Division. 5. Announce the results of the evaluation. The hospitals or sanatoriums receive award plaques for quality development certification. Standards for Medical Engineering 1. Systemization Factors 1.1 Specify policies or goals indicating clear commitments to the operation. 1.2 Establish clear structures and responsibilities for the operation. 1.3 Create plans/ projects to facilitate the operation. 31
Department of Health Service Support 1.4 Set up systems to foster and support the operation with needed resource allocation and facilities. 1.5 Identify mechanism for monitoring, following-up, and evaluating. 1.6 Formulate development systems to develop bodies of knowledge in medical engineering, which continuously take great part in service activities of the hospital. 1.7 Set up database systems and documentation on medical engineering. 2. Maintenance Factors 2.1 Identify clear structures of maintenance units. 2.2 Provide spacious, clean, and proper areas. 2.3 Appoint an adequate number of personnel. 2.4 Appoint a chief responsible for maintenance. 2.5 Appoint personnel with expertise to consistently take care of maintenance. 2.6 Maintenance personnel are continuously trained. 2.7 Maintenance equipment is adequate and always available. 2.8 Maintenance equipment storage is of convenience and ready for calibration. 2.9 Maintenance procedure can always be audited. 2.10 Maintenance and service plans are clearly specified. 2.11 There is a plan for reserving spare parts and necessary materials. 2.12 Leaflets and handbooks on medical equipment maintenance are documented. 2.13 Up-to-date database covering all aspects on maintenance systems are available for quick and efficient search and usage. 2.14 Communication systems to support maintenance service are efficiently established. 2.15 Quality assurance for maintenance service is set up. 3. Medical Equipment Calibration Factors 3.1 The unit responsible for managing medical equipment calibration is clearly identified. 3.2 Staff members are appointed to take responsibilities and monitor medical equipment calibration of the hospital. 3.3 Requirements on medical equipment calibration are documented and followed. 3.4 A plan to conduct regular medical equipment calibration exists. 3.5 Medical equipment calibration is conducted at least once a year. 3.6 Qualifications of those who are responsible for medical equipment calibration are audited by internal units and external institutions. 3.7 There is a system to evaluate the calibration results after medical equipment calibration has been done. 3.8 Medical equipment with high risks is suitably verified. 3.9 Data, records, and documents on medical equipment calibration are collected and restored. 32
Department of Health Service Support 3.10 Training courses or development in calibration are continuously provided. 4. Safety Engineering Factors 4.1 Policies for safety engineering and environment in the hospital, which leads to implementation, are clearly specified. 4.2 The operation framework that covers all the policies is identified. 4.3 Units that take responsibilities are clearly specified. 4.4 Resources needed for the operation are supported. 4.5 Safety personnel are appointed at a hospital level and a unit level. 4.6 The hospital’s safety engineering and environment plans exist. 4.7 Risk assessment of safety engineering is searched and conducted by internal units. 4.8 Record search of risk assessment of safety engineering is conducted by an external organization. 4.9 Performance reports and suggestions are systematically submitted to administrators. 4.10 Reviews and improvement are continuously done after the results of items 4.7 - 4.8 are found. 4.11 Training and building safety awareness are provided for the personnel who might affect safety in the hospital. 4.12 There are systems to restore and control documents related to safety engineering of the hospital, by which the search can be conveniently and quickly done. 4.13 There are plans/processes, and preparedness to handle and respond to the emergencies related to environmental problems of the hospitals in the area. 4.14 Reviews and improvement for plans/processes to handle the emergencies (according to item 4.13) are done at times, especially after the emergency occurs. 4.15 Laws, regulations, and orders on safety engineering and hospital environment are collected and restored. 4.16 There are activities involved in safety such as 5-step cleaning activities (5-Saw), safety campaign, safety exhibitions, safety engineering, and hospital environment contests etc. 4.17 Documentation of handbooks/guidelines on safety risk managements is available. 4.18 There is cooperation with nearby hospitals or communities to develop safety engineering and hospital environment systems. 33
Department of Health Service Support 2.3 Medical Professional Licensing Standards for Sanatoriums and Health Service Enterprises The Bureau of Sanatoriums and Healing Arts is an organization that promotes and protects the public to get systematic and equitable health service. This is executed by promoting, developing, and monitoring private sanatoriums and institutions with healthcare and medical professions to maintain standard services in accordance with the medical profession law and the sanatorium law. The Bureau takes action in adapting the laws on sanatoriums, medical professional licensing, and other related laws. Moreover, the Bureau develops operational systems to protect the rights of health care receivers. The Bureau of Sanatorium and Healing Arts is committed to the following missions. 1. Medical Licensure ; regulation enforcement, monitoring procedure, and quality assurance of healing arts to conform to the Medical Profession Act B.E.2542, the Medical Profession Act (Edition 2) B.E.2547, the Medical Profession Act (Edition 3) B.E.2550, liable for 7 branches and 2 clinical disciplines. (1) Activity Therapy (2) Radiological Technology (3) Communication Therapy (4) Clinical Psychology (5) Prosthetics and Orthotics (6) Cardio-Thoracic Technology (7) Traditional Chinese Medicine (8) Optometry (9) Chiropractic In addition, the Bureau has established certification criteria for educational institutions which produce graduates in Activity Therapy, Radiological Technology, Clinical Psychology, Traditional Chinese Medicine, and Optometry. 2. Develop, promote, and monitor health care providers to legally achieve quality standards. According to the Sanatorium Act B.E.2541 and the Sanatorium Act (Edition 2) B.E.2547, there are 2 types of sanatoriums as follows. (1) Inpatient care institutions (hospitals/sanatoriums) : Currently, there are 326 private hospitals and sanatoriums all over Thailand, comprising 100 in Bangkok and 226 in other provinces (as of 30 September,2013). Standard guidelines to audit inpatient sanatoriums are as follows. Medical treatment in inpatient sanatoriums (annual audit) Audit Guidelines : Dentistry Audit Guidelines : Pharmacy Audit Guidelines : Nursing and midwifery Audit Guidelines : Medical techniques Audit Guidelines : Physical therapy 34
Department of Health Service Support Audit Guidelines : Radiology Audit Guidelines : Buildings Audit Guidelines : Equipment and management Audit Guidelines : Environmental hygiene Announcements of the Ministry of Public Health - The Sixth Ministerial Announcement (B.E.2544) on Criteria for Mortuary Management in Sanatoriums. - The Eighth Ministerial Announcement on Patient Referral Standards. - The Ministerial Announcement on Artificial Kidney Dialysis Machine Service in Sanatoriums. (2) Outpatient care institutions (clinics) : Currently, there are 4,265 outpatient care institutions in Bangkok (as of 30 September, 2013). Standard guidelines to audit outpatient care institutions are as follows. Audit Guidelines : Medical Treatment and Specialized Medical Treatment Clinic Audit Guidelines : Dentistry and Specialized Dentistry Clinic Audit Guidelines : Nursing and Midwifery Clinic Audit Guidelines : Medical Technique Clinic Audit Guidelines : Physical Therapy Clinic Audit Guidelines : Thai Traditional Medicine Clinic Audit Guidelines : Applied Thai Traditional Medicine Clinic 3. Health Care Business Promotion is conducted, conforming to the Ministerial Announcement on Specifications of Health Care or Beauty Enterprises. Location standards, services, service providers, criteria, and audit measurements are in compliance with The Health Enterprises Act B.E.2509, B.E.2551, announced in The Royal Gazette on 14 November,2551. Currently, there are 1,544 health enterprises (as of 30 September, 2556), comprising (1) 476 health spa enterprises (2) 1,031 health massage enterprises (3) 38 beauty massage enterprises Standard criteria for health spas standards are established with the following indicators. (1) Service quality (2) Skilled staff (3) Tools and equipment (4) Organization and management quality (5) Locations and ambience There are 3 levels of quality accreditation for health spa quality audits : passing with at least 50 percent of the 5 indicators. They include Platinum Level : passing with 90 percent ; Gold Level : passing with 80 percent ; and Silver Level : passing with 70 percent. Currently, there are 33 spas achieving the quality accreditation as follows. 35
Department of Health Service Support (1) Platinum Level : 4 spas (2) Gold Level : 16 spas (3) Silver Level : 13 spas In addition, the Bureau of Sanatorium and Healing Arts has disseminated useful information to the public in terms of protection for public health, consumers and patient rights. 2.4 Standards for Sanatorium Buildings and Environment The objectives of the standards for sanatorium buildings and environment are to set up clear development guidelines for sanatoriums, to elevate quality of sanatorium buildings and environment, and to avail equal opportunities for the public to access services. These standards are as follows. 1.1 Standards for physical structure, enclosure building systems, and environment 1.2 Standards for safety management 1.3 Standards for maintenance of buildings and environment conservation 1. Standards for physical structure, enclosure building systems, and environment (1) Hospital development plans (2) Entrance and exit (3) Direction signs, traffic signs, hospital’s name plate, buildings’ name plates (4) Hospital’s internal routes (5) Pathways (6) Walkways between buildings (7) Ramps (8) Parking lots (9) Patient drop-off and pickup area in front of the building (10) Bathrooms and toilets (11) Fire stairs and fire exits (12) Elevators (13) Built-in furniture (14) Power system (15) Lighting system (16) Emergency light system (17) Telephone system (18) Public relations audio-technology (19) Nurse call system (20) Fire alarm system (21) Fire extinguisher system 36
Department of Health Service Support (22) Water supply system (23) Drainage system (24) Waste water treatment system (25) Solid waste management system (26) Medical gas system (27) Ventilation/air-conditioning system (28) Surrounding, area between buildings, and landscapes 2. Standards for safety management (1) General management (2) Buildings and environment (3) Enclosure Engineering 3. Standards for maintenance of buildings and environment conservation (1) General management (2) Buildings and environment (3) Enclosure Engineering 3. Medical Hub 3.1 International Healthcare Centers Strategies on “Thailand as a Medical Hub” to accommodate the Government Strategy (B.E. 2557 - 2561) Historical background 1. The government policy and the policy of the Ministry of Public Health 1.1 According to the Government’s policy statement to the Parliament on Tuesday, August 23, 2013, “Thailand as a Medical Hub” is mentioned in Policy 4 : policies on society and quality of life, specifying strategies and public health development policies ; and in Item 4.3 : the public health policies. Item 4.3.7 defines strategies/policy operation : “activate Thailand with excellence in healthcare products and services in the Asian region in collaboration with all involved sectors. Create academic progress without any impact on the overall health service provided for Thai people. Support private sector to establish standard rehabilitation centers and review related regulations so that sharing personnel between the public sector and the private sector is possible and avails cooperation.” Furthermore, the Minister of Public Health (Mr. Pradit Sinthawanarong) 37
Department of Health Service Support made an announcement that “Thailand as a Medical Hub” is an important ministerial policy for the financial year 2013 - Operational Strategy 9 : “Support promotion policies on increasing the country’s revenues in medical drugs, Thai herbs, food, local goods, including being a Medical Hub without any negative impacts on the public sector service systems.” The Ministry of Public Health has been appointed to work as a key organization in mobilizing and managing the country policy on “Thailand as a Medical Hub” since 2004. This policy covers 4 key products : 1) medical treatment service 2) health promotion service 3) Thai traditional medicine and Alternative Medicine service 4) Thai herbs and health products. The operation has been very successful, creating enormous incomes to the country as specified in the Strategic Plan. Moreover, Thailand has become a Medical Hub as aimed in the policy, emphasizing on quality development and standard health service in Thailand, with surveillance on undesirable impacts on the main National Health Service systems. 1.2 The Office of the National Economic and Social Development Board has established the country strategies as a framework for allocating the 2014 budgets under the New Growth Model : creating a stable and sustainable economic base, with 4 key strategies as follows. 1.2.1 Strategy : Building Growth and Competitiveness ; A Medical Hub is mentioned in Strategic Issue 3 : Tourism and Service : Being a Medical Hub of the region. 1.2.2 Strategy : Inclusive Growth. The Ministry of Public Health is involved in Strategic Issue 10 : Improving health service quality and standards. 1.2.3 Strategy : Green Growth. 1.2.4 Strategy : Internal Process. 1.3 The Ministry of Public Health has established a service plan to upgrade quality and standards from primary, secondary, and tertiary levels up to the high expertise level, as well as developing competency of those who work on the 10 branches of health service which are the country’s issues. It is aimed to reduce differences in service systems and to enhance convenient and fast access to the service for people within the service network. 2. Thailand’s competitive potential The Health Tourism Market in Thailand generates more than 140,000 million baht in revenue, an increase of 18 percent compared to that of the previous year, comprising revenues in the following businesses. - Private hospitals : 70,000 million baht (50 %) - Tourism : 50,000 million baht (36%) - Health Promotion : 20,000 million baht (14 %) 38
Department of Health Service Support Diagram 1 : Revenues of the Health Tourism Market in Thailand Revenues of Thai Private Hospitals 70,000 Million Baht 140,000 Million Baht : Revenues of Thai Tourism Thai tourism market in 2012 50,000 Million Baht Revenues of Thai Traditional Massage Business and Health Spas situated outside private hospitals 20,000 Million Baht Source : Research Center, Kasikorn Bank, 2012 Of those services to foreigners, the first 5 health service recipients are from Japan, the USA, the UK, the Middle East, and Australia, respectively. In studying the nature of the hospital services, foreign patients choose the hospitals located in Bangkok and in the tourism provinces. They are classified into three groups : 1) foreigners residing in Thailand, 2) tourist groups coming for some medical services, and 3) foreigners traveling for a particular medical treatment. The popular medical services are Orthopedic Surgery, Cardiac Surgery, Cosmetic Surgery, Dentistry, and Gastrointestinal Tract disease, as shown in Diagram 2. Diagram 2 : Types of Health Tourists Foreigners Three Groups of Tourists traveling for a Foreigners particular residing in medical Thailand treatment 41% 27% Tourist groups coming for some medical services 32% Source : Conclusions for administrators, the Department of Health Service Support, 2012 39
Department of Health Service Support Diagram 3 : Foreigners’ Popular Medical Treatments Orthopedic Cardiac Surgerey, 10.48 Surgery, 6.84 others, 39.8 Cosmetic Surgerey, 14.1 Dentistry, 11.27 Physical Check up, 17.53 Source : Conclusions for administrators, the Department of Health Service Support, 2012 Table 1 : The number of foreigners travelling to Thailand for healthcare services, classified by the nationalities, 1998-2011 No. Nationalities The number of foreigners in each year 1 Japanese 2008 2009 2010 2011 2008-2011 200,642 1,639,413 2 American n/a 177,058 182,807 114,872 846,412 3 South Asian n/a 74,058 76,277 4 English 73,991 631,322 5 The Middle East 91,969 n/a 52,004 61,999 685,970 6 ASEAN 164,943 n/a 63,937 62,448 748,018 7 Taiwanese/Chinese 139,887 n/a 91,117 98,657 695,776 8 German 33,492 n/a 122,404 113,522 359,266 9 Australian 38,730 n/a 32,310 48,396 291,687 10 French 35,998 n/a 32,310 28,716 286,261 11 South Korean 31,000 n/a 24,915 42,831 263,532 12 Scandinavian 21,999 n/a 34,519 35,472 191,872 13 Canadian n/a 17,262 19,594 113,579 14 East European n/a n/a 117,780 15 Others 18,750 n/a n/a n/a 73,418 Total 12,782 n/a 12,784 14,109 2,188,257 Annual Increase 384,240 n/a 7,841 9,947 11,158,311 Percentage 1,363,295 695,779 192,516 147,379 92.04 -0.77 -48.96 934,587 954,107 34.32 2.09 Source : Department of International Trade, Ministry of Commerce, 2012 Note : N/A. The figure represents the total average, calculated by using information of all nationalities 40
Department of Health Service Support Table 2 : Thailand’s Competitive Advantage in Health Care Compared with Other Countries Competitive advantage Thailand Singapore India Malaysia South Korea + + Service/ hospitality +++++ ++ + + +++ ++ +++ Hi-tech hardware ++++ ++++ ++ 9 orgs. 34 orgs. ++ ++ HR quality ++++ ++++ ++ + + ++ ++ JCIA 21 orgs. 22 orgs. 20 orgs. Pre emptive move ++ +++ + Synergy/Strategy partner + ++ + Accessibility/ Market ++ +++ + channel Reasonable cost ++++ ++ ++++ +++ ++ Note : The number of + means the rates of good competitive advantage Source : Department of International Trade, Ministry of Commerce, 2012 3. Possible Impacts on Health Care Systems of the Country 3.1 According to the Third National General Conference in 2010, there were resolutions and suggestions to the Medical Hub policies as follows. (1) As a Medical Hub for the past 10 years, Thailand has experienced both positive and negative outcomes. The relevant positive ones include gaining national revenues, increasing incomes for medical personnel, and fostering jobs among related careers ; i.e., those in tourism, trade, and services both in Bangkok and the vicinity. In addition, the good reputation of the wisdom of the country, as well as the Thai unique health care, has been widely well-known to foreigners, increasing high opportunities of investment potential. Competence to keep pace with the progress of modern medical technology has been improved, along with technology transfer and development of health care institutions, to achieve international standards. (2) In terms of estimated negative impacts, it was mainly concluded that one impact is on access to health service of Thai people, which has been caused by brain drain from the public sector to the private sector, leading to problems in the lack of public service providers. Additionally, the demand for medical services highly increases due to the characteristics of illnesses and the health care coverage : “Good Health for All”. Another negative impact is that people may have to pay more for the medical care fees. (3) The policy on Thailand as a Medical Hub causes the needs for specialist doctors, especially the well-known ones who work for the private sector. These specialists also work as professors in the public universities. Moreover, it takes over 10 years to create such specialist professors, who play a key role in teaching medical students, medical residents, and at the same time give medical treatments to patients. The outflow of specialist professors yields a great impact on the rest of the professors who have to work harder. This, consequently, in the near future, may cause 41
Department of Health Service Support low quality in the production of doctors or medical residents, and affect the future of Thailand’s public health. (4) In regard to mechanism on follow-up and surveillance on the impacts, it was proposed that there should be participation in establishing policy development and strategic plans (the personnel, the formal relations between public and private hospitals, the main target groups in different dimensions, and public sector systems). Better operation will derive because of awareness of negative impacts, including the specifications of remedial measures jointly made by all impacted sectors, institutions, and organizations. Resolutions 1. The National Health Manpower Committee and the Ministry of Public Health in collaboration with the private sector should develop measures to appropriately solve the problem of health personnel distribution by geographic areas, leading to implementation in order to provide medical services to all the people throughout Thailand. 2. The Ministry of Public Health continues to develop a strategic plan to develop Thailand as a Medical Hub, Phase 2, without affecting the public health services for Thai people. 3. Cooperation mechanism between the public sector and the private sector should be improved to enhance policy development in making Thailand a Medical Hub. 4. The Medical Professional Council should stimulate and foster professional practice in accordance with the Medical Professional Act, and encourage awareness of providing good health care for Thai people among those with medical professions. 3.2 The National Economic and Social Advisory Council made comments and proposed suggestions on Thailand as a Medical Hub as follows. 3.2.1 Suggestions on the Medical Hub. 3.2.1.1 The goals of the Medical Hub ; i.e., excellence in medical care and public health, should mainly be based on medical and health care academic knowledge and technology. There should be an emphasis on potential development in education, training, academic excellence, and superb medical treatments. The access to all the excellences should be equally open to all the people. There should not be any barriers for people who use other health care programs such as the health insurance etc. Equality of access to quality healthcare services should also be established. 3.2.1.2 There are operation plans that do not negatively affect the national health systems. Such plans must be revealed to the people and those who are involved. There are also investment plans on healthcare manpower in terms of production and potential development, especially healthcare manpower in the provincial areas. 3.2.1.3 The operation of the Medical Hub must comply with the Statute of the National Health System B.E.2542 and the National Health Assembly Resolutions B.E.2553 on the Policies of the Medical Hub. 42
Department of Health Service Support 3.2.2 Suggestions to the Government. 3.2.2.1 Establish policies, supporting laws and regulations. (1) Operate the Medical Hub in compliance with the Constitution of the Kingdom of Thailand, B.E.2550, the Statute of the National Health System B.E.2542, and the National Health Assembly Resolutions B.E.2553. (2) Any organizations whose operation complies with the Medical Hub policies should invest not less than 10 percent of gross revenues in the production and development of medical manpower in order to achieve continuous healthcare system development in the provincial areas. (3) Exchange academic information and information on follow-up as well as evaluating both positive and negative impacts, including sharing resources. (4) Establish measures to enhance equality of access to the Medical Hub’s healthcare services for Thai patients. (5) Foster knowledge, understanding, and awareness among sanatoriums’ administrators, whose policies comply with those of the Medical Hub, to execute what is mentioned in Item 1 above. 3.2.2.2 Allocate more budgets on financial and non-financial incentives in order to maintain health manpower in the government sector, especially in the provincial areas. 3.2.2.3 Plan to increase sufficient manpower production and support the organization whose operation complies with the Medical Hub policies, and participates in manpower production and development. Meanwhile, the Government must support quality control in production to achieve standard requirements. 3.2.3 Suggestions from health providers whose operation complies with the policies of the Medical Hub. 3.2.3.1 Not less than 10 percent of gross revenues should be invested in the production and development of manpower in order to achieve continuous healthcare system development. 3.2.3.2 Plans and measures are set up to ensure equality of access to the Medical Hub’s healthcare services for Thai patients. 3.2.3.3 Operation should be conducted in consistent with the National Health Assembly Resolutions B.E.2553 on policies of the Medical Hub. 3.2.3.4 In case there is a shortage of medical personnel in some fields in Thailand, and they have to be employed or imported from foreign countries, the employment must be in accordance with WHO Global of Practice on the International Recruitment of Health Personnel ; for example, those who come from the country with a shortage of medical personnel must not be recruited. 43
Department of Health Service Support 3.2.4 Follow-up and surveillance. 3.2.4.1 The follow-up and the assessment of the national situations must be consistently done to set up surveillance on the situations, and to make a suggestion on preventive measures as well as reducing negative impacts. 3.2.4.2 Related data should be systematically collected such as data on the number of health tourists and their expenditures in Thailand, including data on personnel movement etc. 4. Using SWOT analysis in the Medical Hub Policy Operation and Health Tourism in Thailand As a Medical Hub, Thailand owns specific characteristics consisting of strengths, opportunities, weaknesses, and threats as follows. Strengths Weaknesses 1. Thailand is famous worldwide for its 1. Thailand faces a problem of a shortage tourist destinations. of medical personnel, and the problem 2. Private sanatoriums in Thailand becomes worse with treatments for foreign including Thai specialist doctors are well- patients. known and recognized by foreigners. 2. Thai medical personnel have limited 3. Medical curriculums of Thailand are language skills. connected to modern medical curriculums 3. Healthcare service business has been of the West. rapidly expanded and the public sector 4. Medical schools that produce doctors in doctors have moved to work for private Thailand are internationally recognized, hospitals. Consequently, a shortage of with high potential to meet foreigners’ medical personnel seriously occurs in demands for medical treatments . medical schools as well as in public 5. Medical treatment fees and quality of hospitals and sanatoriums. care in Thailand are correlated. 4. The public sector and the private sector, 6. Health service providers are service- including Thailand Medical Council have minded with warm hospitality. issued rules and regulations that obstruct 7. Patients are provided with quality foreign doctors from working in Thailand. services and all needed facilities etc. Thus, this has become a barrier for a 8. As a group, a longer stay in Thailand is short-term solution to the problem of possible. medical personnel shortage. 5. The Public Private Partnership (PPP) is not effective and clear. 6. Access to healthcare service systems is not thoroughly available (in the provincial areas). 44
Department of Health Service Support Opportunities Threats 1. Medical tourism markets are large and 1. Rapid expansion of medical services continuously expand. given by private hospitals causes a 2. Governments and health insurance number of specialist professors to move organizations/corporations in the from public medical schools, and work for developed countries support medical private hospitals. treatments in other countries in order to 2. More expensive fees for medical save their healthcare budgets. service, due to foreigners with high 3. Growth opportunities are very obvious buying power, generate probable higher even in the time of economic crisis. service costs of the public sector and the 4. There are a lot of opportunities for the private sector under social security related markets (health spas, nursing programs. This will affect labor costs and homes for the elderly, herbal products, competitiveness of businesses and and herbs) in Thailand to expand, without Thailand in the long term. many impacts on a shortage of personnel. 3. The swing of international customers 5. According to the AEC Blueprint, due to the global economy condition healthcare is specified as one of the together with the development or services to remove substantially all adaptation of rival countries gives Medical restrictions. Hospital services, medical Tourism business more risks of services, and dentist services are not fluctuations in income. restricted for Thai people to have access 4. National conflicts cause many problems to. Such businesses allow foreign equity (with more vulnerability than those in the participation of not over 49 percent. past). 6. The AEC population increases. 5. There is competition from rival countries that also announce to be a Medical Hub. 6. Personnel movement after the establishment of the AEC worsens a shortage of medical personnel. After the discussions with all sectors, the Ministry of Public Health has proposed the following comments. 1. Confirming strongly to provide healthcare without any impacts for all Thai people, with long-term goals set by all sectors. 2. Establishing efficient risk management and enhancing protection of the policy operation from the estimated impacts. 3. Developing academic excellence as well as tertiary management of medical schools and public hospitals, to enhance good healthcare services and high quality of life for Thai people. 4. Specifying health personnel development and personnel maintenance in the systems. 5. Developing a Public Private Partnership (PPP). 45
Department of Health Service Support 6. Developing a national data warehouse. The Ministry of Public Health has set up the 5-year Medical Hub framework to facilitate the Country Strategy for all related sectors to use as operational guidelines and to move forward to implementations as follows. Vision Thailand as a world class health care provider in the next 5 years (2014-2018). Objectives It is aimed at developing Thailand to become a world class Medical Hub, using limited healthcare resources, natural resources, and the surroundings in such a valuable way that the country’s revenues can be increased and the people’s quality of life can be literally improved. Missions 1. Develop and increase Thailand’s competitive potential in healthcare service with other countries from the upstream process to the downstream process. 2. Develop and promote healthcare providers to achieve the level of an Excellent Center in all the regions of Thailand. 3. Develop and support educational institutions to attain international academic excellence. 4. Promote and develop public and private health institutions, enterprises, and educational institutions so that they are capable of providing healthcare and academic services with international standards. 5. Promote and develop innovative creations as well as enhancing value- added healthcare services and products. 6. Develop a consumer protection system in healthcare by establishing a quality assurance process and a safety process with appropriate consumer conflict resolution. 7. Disseminate the Thai identity and the Thai wisdom to be recognized and impressed by foreigners, including making a difference in providing healthcare for foreigners. Goals The goals of making Thailand to be a world class health care provider in the next 5 years (2014-2018) are as follows. 1. A Wellness Hub includes - Health spas - Medical spas - Thai traditional health massage - Long stay for health - Health resorts - Rehabilitation centers 46
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