Dr. Narong Saiwongse, deputy permanent secretary for Public Health, has praised the National Health Security Office’s (NHSO) Long-Term Care Fund as a good solution to Thailand’s aging society. In his view, the LTC Fund practically increases the quality of life among both the elderly and dependent patients.
“Because no ageing society can avoid dependent people, it is necessary to develop service system for the dependent. We need to do this to ensure people losing their independence can still have quality of life,” Dr. Narong told the LTC Forum 2020. Held by the Human Resources for Health Research and Development Office (HRDO) as a part of its project to learn from the LTC Fund management, the event ran from November 17 to 18, 2020 under the Moving together to Sustainable LTC theme. The Thai Health Promotion Foundation (ThaiHealth) has funded this project.
The NHSO established the LTC Fund in 2016 to take care of dependent elderly. Thanks to the fund, long-term care has been provided to people who cannot perform activities of daily living on their own and need help from others. The LTC fund has used local administrative bodies namely subdistrict administrative organizations and subdistrict municipalities as key mechanisms for budget management.
“Focusing on bedridden people’s quality of life, long-term care addresses both healthcare and social needs. It is thus good to engage local administrative bodies as key mechanisms. They are the main agencies responsible for the quality of life and social context of people in their areas, after all. The Public Health Ministry, meanwhile, specializes in healthcare,” the deputy permanent secretary for Public Health said.
Dr. Thinakorn Noree, manager of HRDO, said the project to learn from the LTC Fund management revealed many local administrative bodies were quite good at managing budget and human resources. These local authorities, according to him, have integrated LTC Fund’s works with other subdistrict-level funds for efficiency. So far, several other local administrative organizations are not effective implementing LTC Fund’s works.
“The efficiency of long-term care provision still differs from area to area due to many factors such as local administrative bodies’ knowledge and understanding of LTC, the number and competencies of caregivers, the strengths and cost of primary care in facilities involved, as well as their database,” he said.
“So many local administrative bodies are afraid of seeking budget reimbursement out of fear of being investigated by the State Audit Office. This is because there has not been any clear regulation on this part especially in the very first years of the LTC Fund. Aside, some local administrative bodies do not understand LTC works. They still think that the Public Health Ministry must be in charge of long-term care while in fact the dependents have both social and healthcare needs. Local authorities’ contributions thus will make a big difference here,” he added.
“We have found that LTC system is strong in areas with capitals in the forms of strong primary-care system, an interprofessional team that covers family physicians and physical therapists, close collaboration with communities, and understanding local administrative bodies that recognize the importance of quality-of-life development, etc. From our project, we have also found a common cause of LTC-system weakness. Among them is the fact that most caregivers are already old. Managing LTC human resources is still very challenging,” Dr. Thinakorn concluded.
Dr. Kajeerat Prug-ago, director of ThaiHealth’s Health Systems Development Section, said ThaiHealth had played a role in supporting LTC services through three aspects. Firstly, ThaiHealth has joined hands with relevant ministries and agencies in pushing supportive policies, including laws and regulations. For example, ThaiHealth has been pressing the government into providing homes or shelters to dependent elderly. Secondly, ThaiHealth has offered academic support by creating knowledge that will provide answers to LTC system. Thirdly, ThaiHealth has strengthened the civil sector and engage it in developing and driving sustainable LTC system.Held under the Moving together to sustainable LTC theme, LTC Forum 2020 has attracted representatives of local administrative bodies, health agencies, and their partners such as the Health Department and monks, as well as key policy-making agencies like the NHSO and the Local Administration Department. The event will conclude on November 18, 2020.