Since the beginning of 2022, Thailand has faced a tide of change that challenges many facets of Thai society: phone scams, elder neglect, economic recession, pandemic, an increasing number of factories closing and moving out to other international production bases, a highly competitive economic market in global contexts, global politics issues, and local issues such as flood and pollution in many provinces.
When uncertainty comes knocking at our doors, “future thinking” is crucial for both citizens and government to handle unexpected changes, especially preparing for rapid adaptation to elevate every aspect of health security for people of all classes and genders.
How should the Thai healthcare sector adapt to the upcoming challenges?
Thailand Policy Lab (TP Lab), National Health Security Office (NHSO), and Thailand Future Foundation (TFF) conducted a workshop to predict a better future for the enhancement of healthcare accessibility in Thailand. By using “Foresight” as the main tool, this workshop is designed to foresee and find the new direction of the Thai healthcare sector. Instruments include interviewing specialists by using a set of questions concentrating on its national health security for creating further analysis and policy recommendation.
As a result, the executive members of National Health Security Board and Quality and Standard Control board have reflected many points which can be included in a draft of the execution plan of NHSO in the fifth wave (2023-2027). They have also concluded five megatrends or the next 3-to-10-year implications which can serve as the new lenses to develop a plan to enhance overall national health security as follows:
Five megatrends to enhance national health security for all
- Internet of Health
It is widely known that the internet helps reduce distance and time in distant communication and a life without the internet is similar to a body with some organs missing. In the recent outbreak of COVID-19, it is also one of the main factors that help curb the unprecedented pandemic. This means that the internet can become a new opportunity to enhance the Thai healthcare sector.
The Internet can help connect healthcare services with rural regions which will increase accessibility to healthcare and reduce bureaucratic paperwork for hospitals. For instance, its cloud system can link patients’ information, make them available to every hospital, and thus reduce redundant registrations for new patients. This new trend has already emerged as up to 69% of patients turn to consult with virtual reality doctors before seeing doctors at hospitals and up to 100,000-baht operation costs have been saved with remote robotic surgery.
However, there are still some concerns on technology literacy, information security, as well as how to best compromise with the status quo. But if the government can rapidly adapt to this trend, the internet will become the key to solving healthcare service’s bottlenecks.
2. Human Dynamics for Well-being
In the present, “good well-being” means maintaining good physical and mental health. It has also become the key factor to elevate society. Because of various contexts and limitations, many citizens face different health issues. Therefore, apart from physical and mental health, healthcare policy must respond to various needs from economic and societal backgrounds such as race and age. Moreover, this information should be systematically collected for further use.
The current system has an opportunity to enhance this aspect by incorporating technology to calculate precise budgets, help attract highly skilled laborers, effectively respond to needs of people of all ages, as well as become an international medical hub. More importantly, when citizens are physically and mentally well, everyone will be able to effectively contribute to economic development.
However, challenges remain as these questions are unanswered: how do we link patient information between public and private hospitals for both Thai residents and overseas? How does the sector move to the paperless system without slowing down its efficiency while still protecting people’s rights to healthcare?
3. An Era of New Risk Frontiers
The most important key takeaways from the outbreak of COVID-19 is that challenges may arise unexpectedly and fatally and that there won’t be a second chance to respond to the crisis. Thus, it is important that the government prepare for any uncertainty and that the citizens also see this as the first priority.
Amidst the era of new risks from war, pandemic, and climate change, the sector could allocate budgets and human resources to prepare for new risks, for instance, opening a healthcare centre for high-risk patients in short and medium term, as well as enhancing skill sets for workers in related organisations. These executions will eventually help handle unexpected risks in the future.
As interdisciplinary collaboration might need an involvement from other organisations, how can the healthcare sector deal with red tapes in bureaucracy and complex organisation structure? If these challenges are addressed, the sector will be able to use interdisciplinary collaboration to prepare for new risks in the future.
4. People-Centric Prosumer
People-centric policy will be able to earn people’s trust because they will believe that the government can solve their problems by using the administrative power that was earned by the people’s consensus through election.
Healthcare sector can increase people’s involvement as both a service customer and a service provider to its community, increase the role of alternative healthcare services to respond to various needs, integrate private sectors to develop public healthcare, as well as incorporate latest technology in providing healthcare services. For instance, using an innovative clock can help track people’s healthcare data, systematically collect them for further analysis without more operating costs while encouraging more people to take care of their health. This means that the government also needs to involve other stakeholders such as technology providers, clock manufacturers, or even fitness centres in order to develop the latest technology in the sector. Another stakeholder that should be included is religious organisations as their health are important as well.
Challenges in this area are how the government shall utilise these big data to their fullest potential and how the government shall devise its policy by placing its utmost importance on the people. If these challenges are addressed, it will bring about behavioural change and make people realise that they have their own rights to be protected by the state.
5. Decentralise Financial Models
Blockchain has been utilised to decentralise financial sectors and sustainably allocate financial flows amidst the current uncertainty in the world. This decentralised model will help the healthcare sector achieve financial sustainability, increase more healthcare benefits, and increase the value of users including empowering them rather than emphasising only on the end result of the healthcare service. Moreover, it gives an opportunity to survey for other income sources. For instance, locals in Denmark collect a sum of money to local hospitals to manage disease control in their region and a leader of the local community in New Zealand leads a fundraising for elderly care and makes a decision on the budget allocation.
To achieve the new financial models, we need to decentralise the power on decision making to the local communities as they have different kinds of needs. This information will not only help create more inclusive national healthcare policy, but also emphasise that people can advocate for policy change as well.
Effective planning for budget allocation on local levels will become a new challenge. However, if resolved, it will be able to expand the coverage of rights to national health security for people of all backgrounds. Another challenge is that there will be more cost on the expanding coverage, but it would be resolved if local communities are aware of its importance and agree to allocate the local budget on this matter. This action will eventually contribute to sustainable expansion of national healthcare security.
These megatrends involve not only public health policymakers, but also other stakeholders as they are intertwined with economic, societal, cultural and political aspects. Presenting these megatrends to stakeholders and decision makers will help them comprehend the big picture surrounding the current state of the Thai healthcare system.
3Re Strategy to Enhance Competency of Healthcare Security in Thailand
The first is to “refine” the governmental organisations’ role in developing the healthcare system. Currently its complex organisational structure has hindered healthcare accessibility. If related organisations can redefine its role to increase more accessibility points, it will reduce complex steps and waiting time for patients. Hence, more people can access more healthcare services while reducing the organisation’s overlapped operating costs.
The second is to “reframe” and increase its responsibility in providing healthcare services that respond to the needs of people of all backgrounds. In this case, other stakeholders can be involved to increase accessibility to healthcare services, alleviate people’s financial burden, and shoulder medical officers’ responsibility. For instance, the postal service can increase its role from sending packages to sending medicine. Pharmacy can provide vaccines or preliminary health screening instead of only selling medicine. Other organisations can also help provide knowledge on healthcare.
The third is to “reimagine” the future. Future thinking is to help provide knowledge to related organisations and equip them with the tools to prepare for new risks and devise plans to deal with uncertainty. It will also help open up to new opportunities and challenges which will increase the organisations’ competency. Ultimately, it might help elevate its potential to align with global contexts while being able to effectively prepare for the uncertain future.
This workshop has been successfully held by the determination of Thailand Policy Lab (TP Lab), National Health Security Office (NHSO), and Thailand Future Foundation (TFF) to create inclusive public policy which will leave no one behind. Five megatrends are also the lenses to seek new opportunities and to design the new strategy to national healthcare security. Meanwhile, the 3Re strategy is a pathway to overcome current challenges while putting people’s interest in the healthcare system at the first priority. More importantly, rapid adaptation to uncertainty is also crucial in creating a model of national health security in global contexts because starting only one step behind others might bring about detrimental effects to people’s rights and access to healthcare.