Primary Care and Family Medicine:
Practical Implementation Challenges
8 – 9 June 2009
Holiday Inn, Silom, Bangkok
The Health Care Reform programme in Thailand is recognised as one of the most ambitious reform programmes anywhere. It spanned all the major aspects of the health system, with the goal of achieving universal coverage for the whole population for high quality health services. Much of the reform programme was aimed at closing the gap on inequities in access to health care. The most notable success of the health reform programme is the establishment and thriving of the Universal Coverage Scheme, a scheme which ensures health care for 47 million people, all of those not covered by other schemes.
As well as Universal Coverage, the main threads of the reform programme addressed the establishment of Family Medicine and Primary Care services in communities, close to patients homes, and the first point of contact with health services; decentralisation of authority and management; Civil Society involvement in planning and monitoring of health services; accreditation of providers; innovative financing systems; and management reform of hospitals. The reform programme has been internationally acknowledged as being based on sound research and public and professional debate.
The increased involvement and funding for local authorities provides the opportunity to address other social determinants of health, in collaboration with the health sector. Action is now being taken in some places in a much more concerted way, to link the inputs of community opinion, local authority activities and the health sector, specifically in relation to health planning. Primary care teams are being recognised in some places as the key to good primary care and family medicine delivery, and primary care networks are helping to ensure that communities have regular teams to consult on an ongoing basis.
The recent World Health Report 2008, Now More Than Ever, reiterates the need for health systems to contribute to the achievement of social justice, equity and value for money. Excessive, hospital based, specialisation discourages a holistic approach to the individual and to continuity of care. While resource allocation focuses on expensive curative care, national health systems are losing out on the health gains which could be achieved by providing qualified, professional primary care and family medicine services at much lower cost to the patient and to the health system and while addressing more than 70% of illness and diseases.
This conference will address the progress in shifting priorities towards qualified professional family medicine and the challenges Thailand faces in doing so. Experiences from other countries will be presented, so that mistakes can be avoided and progress accelerated. During the conference parallel sessions will be held to establish the basis and operating mechanism for an ASEAN network on primary care. Ambassadors from WONCA (the World Organisation of Family Doctors) will be available to meet with those interested in professionalizing family medicine.
The sessions will deal with issues such as the political will and momentum necessary to focus health service delivery on primary care and family medicine, converting strategy into real implementation, regulation of services, quality standards for family medicine, financing, human resources, primary care teams, referral between primary and secondary care, and professional standards and qualifications.
The conference is being hosted by the Health Care Reform Project, an EC-funded project which has provided technical support to the reform process for more than 10 years and which will finish in August 2009; the Ministry of Public Health, World Health Organisation, the National Health Security Office, and the ASEAN Institute of Health Development.
Primary Care and Family Medicine: Practical Implementation Challenges
8th and 9th June 2009
Monday 8th June 2009
09.00 – 09.05 Welcome and introduction to the conference
Dr Winai Sawasdivorn, Secretary General, National Health Security Office
09.05 – 09.15 Opening remarks and welcome
Minister of Public Health
09.15 – 09.30 Opening remarks and welcome
Dr Samlee Plianbangchang, Regional Director, WHO South East Asia
09.30 – 09.45 Remarks from the European Commission Delegation
Mr Jean-François Cautain, Deputy Head of Delegation, The Delegation of the European Commission to Thailand
09.45 – 10.00 Context of the conference
Dr Thaworn Sakunphanit and Monica Burns, National Project Director and European Team leader, Health Care Reform Project
10.00 – 11.00 General practice as an essential part of a socially responsible healthcare system
Dr Iona Heath, Family Doctor, Chairman of International Committee Royal College of General Practitioners, UK, and WONCA Ambassador
Questions and discussion, chaired by Dr Somsak Chunharas, Director, National Health Foundation
11.00 – 11.30 Coffee
DVD presentations and poster displays available all day in the foyer, with personnel available for discussion and information
11.30 – 12.15 Specialty training and career structure for family medicine in Brunei
Dr Maslina Mohsin, Acting Director of Health Services, Ministry of Health, Brunei
12.15 – 13.00 Lunch
DVD presentations and poster displays available all day in the foyer, with personnel available for discussion and information
13.00 – 13.05 Introduction to the afternoon sessions
Dr Weerawat Phancrut, Deputy Secretary General, NHSO
Chair of afternoon sessions Dr Somsak Chunharas
13.05 – 13.45 Experiences from Sri Lanka – planning and financing of primary care development
Susie Perera, Director Policy Analysis and Development, Ministry of Healthcare and Nutrition, Sri Lanka
13.45 – 14.30 Developing family medicine and primary care around the region – challenges for Thailand
Dr Garth Manning, Primary Care Adviser, Health Care Reform Project
14.30 – 15.00 Coffee
15.00 – 16.00 Where primary care fits in Thailand’s health reform programme
Dr Somsak Chunharas, Director of National Health Foundation
16.00 – 16.45 Questions and discussion - Dr Somsak Chunharas to chair
17.00 – 19.00 Meeting of all Health Care Reform project national consultants, secondees and study visit participants (Silom 1 Room)
Primary Care and Family Medicine: Practical Implementation Challenges
8th and 9th June 2009
Tuesday 9th June Building on successes - and practical challenges in Thailand
09.00 - 09.15 Opening remarks
Dr Siripon Kanshana, Deputy Permanent Secretary MOPH
09.15 – 09.30 DVD of the Thai – EU Health Care Reform Project and introduction to the breakout sessions
Dr Weerawat Phancrut, Deputy Secretary General, NHSO
09.30 – 10.45
Crystal Ballroom / Emerald Room I / Emerald Room IIDistrict planning tools
Health need assessment using service data and socioeconomics data from the service providers
Dr Samrit Srithamrongsawat
Dr NilawanUpakdee
Five steps to community health need assessment
Saisiri Danwattana
Siriwan Deowsurin
Pramual Sukshim
Pauline Ginnety
Experiences from the districts
Facilitator:
Saisiri Danwatanna / Advocacy for primary care
Experience sharing on advocacy tool implementation for primary care
Danai Wangboonchai
Araya Chupaka
Sumalee Prathoomnun
Experience from Thai Health Promotion Foundation
Ur-aree Meuninkul
Experiences from the districts
Facilitator:
Sumalee Pratoomnun / Opening remarks
by Dr Amorn Nonthasut
Regional network on primary care – experiences in the region
Dr Amorn Nonthasut
Dr Jumroon Meekanon
Dr Preethi Wigegoonewardene (Sri Lanka and WONCA)
Dr Susie Parera (Sri Lanka)
Dr Maslina Mohsin
(Brunei Darussalam)
Dr Siti Nasibah Pengiran (Brunei Darussalam)
Dr U Than Sein (Myanmar)
Dr Khamla Phouthonesy
(Lao PDR)
Dr Adang Bachtiar (Indonesia)
Ms Yuka Iino (Japan)
Ms Shrinkhala Shrestha (Nepal)
Dr Tu Thanh Cao (Vietnam)
Dr Marie Lucy Aska
(Papua New Guinea)
Mr Tshewang Nidup (Bhutan)
Facilitator:
Dr Supattra Srivanichakorn
10.45 – 11.00 Coffee
11.00 – 12.15
Crystal Ballroom / Emerald Room I / Emerald Room IIApplying experiences of primary care from other countries to Thailand
Dr Krishna Suvarnabhumi
Worawan Toonyasook
Dr Surasit Chitpitaklert
Dr Arunee Tipwong
Wandee Saengjarern
Dr Orawan Tawaytibhongs
Facilitator:
Dr Thaworn Sakunphanit / Professionalising primary care
Perspectives from the Ministry of Public Health
Dr Nonglak Pagaiya
Perspectives from Thailand Nursing Council and Midwifery
Dr Somchit Hanucharurnkul
Dr Nongluck Suwisith
Perspectives from Royal College of Family Physicians of Thailand
Dr Somjit Prueksaratinond
Dr Kidaphol Wadhanakul
District Team Capacity Building
Dr Somchai Panumaswiwat
Nattakan Muengdha
Facilitator:
Sumalee Pratoomnum / Regional Network on primary care – brainstorming on best practice
Dr Amorn Nonthasut
Dr Jumroon Meekanon
Dr Preethi Wigegoonewardene (Sri Lanka and WONCA)
Dr Susie Parera (Sri Lanka)
Dr Maslina Mohsin
(Brunei Darussalam)
Dr Siti Nasibah Pengiran (Brunei Darussalam)
Dr U Than Sein (Myanmar)
Dr Khamla Phouthonesy
(Lao PDR)
Dr Adang Bachtiar (Indonesia)
Ms Yuka Iino (Japan)
Ms Shrinkhala Shrestha (Nepal)
Dr Tu Thanh Cao (Vietnam)
Dr Marie Lucy Aska
(Papua New Guinea)
Mr Tshewang Nidup (Bhutan)
Facilitator:
Dr Supattra Srivanichakorn
12.00 – 13.00 Lunch
13.00 – 14.30
Crystal Ballroom / Emerald Room I / Emerald Room IINetworks for primary care
Dr Panapat Tocharoenvanich
Dr Surasit Chitpitaklert
Dr Chalor Santiwarangkana
Dr Suradej Waleeittikul
Dr Amorn Rodklai
Dr Pongthep Wongwachirapaiboon
Facilitator:
Sumalee Pratoomnun / Financing for primary care
Resource allocation
Dr Thaworn Sakunphanit
Health care financing for sub-district health promotion hospital
Dr Tawekiat Boonyapaisarncharoen
Health care financing for service provider network
Dr Nivat Jeegungwal
Dr Charoen Serirattanakorn
Facilitator:
Dr Thaworn Sakunphanit / Regional network on primary care – arrangements for the network
Dr Amorn Nonthasut
Dr Jumroon Meekanon
Dr Preethi Wigegoonewardene (Sri Lanka and WONCA)
Dr Susie Parera (Sri Lanka)
Dr Maslina Mohsin
(Brunei Darussalam)
Dr Siti Nasibah Pengiran (Brunei Darussalam)
Dr U Than Sein (Myanmar)
Dr Khamla Phouthonesy
(Lao PDR)
Dr Adang Bachtiar (Indonesia)
Ms Yuka Iino (Japan)
Ms Shrinkhala Shrestha (Nepal)
Dr Tu Thanh Cao (Vietnam)
Dr Marie Lucy Aska
(Papua New Guinea)
Mr Tshewang Nidup (Bhutan)
Facilitator:
Dr Supattra Srivanichakorn
14.30 – 15.00 Coffee
!5.00 – 15.30 Launch of the Regional Primary Care Network
Dr Supattra Srivanichakorn, Director,
ASEAN Institute for Health Development
15.30 – 16.30 Lessons learned and what next
Dr Pongpisut Jongudomsuk, Director,
Health System Research Institute
Contributors and selected topics for presentations in the breakout sessions
The following people are preparing very short presentations to facilitate discussion with the participants of the break out session
District planning tools and district health needs assessments
Dr Nilawan Upakdee, Faculty of Pharmaceutical Sciences, Naresuan University
Saisiri Danwattana, Consultant to Health Care Reform project, District Health Needs Assessment
Siriwan Deowsurin, Nurse, Social Medicine Department, Had Yai Hospital, District Health Needs Assessment team
Pramual Sukshim, Health Volunteer, Baan Laempho Health Centre, Muang District, Phitsanulok
Dr Samrit Srithamrongsawat, National consultant, Director Health Systems Insurance Research Office
Advocacy for primary care
Ajarn Danai Wangboonchai, National consultant
Sumalee Pratoomnun, Advocacy component manager, Health Care Reform Project
Ur-aree Meuninkul, PR Advisor, Thai Health Promotion Foundation
Araya Chupaka, National consultant on community survey on patients’ perceptions of primary care
Applying experience of primary care from other countries to Thailand
Dr Krishna Suvarnabhumi, Ms Worawan Toonyasook, Dr Arunee Tipwong, Wandee Saengjarern, Nitchara Hatsaman, Sukanya Hangsapruek, secondees to UK family medicine practice
Dr Orawan Tawaythibongs, study visit participant, Ratchaburi Hopsital
Dr Surasit Chitpitaklert, Queen Mary’s study visit, National consultant, Social Medicine Department, Maharaj Nakhonratchasima Hospital
Professionalising primary care
Dr Somchit Hanucharurnkul, Thailand Council of Nursing and Midwifery
Dr Somjit Prueksaritanond, Royal College of Family Physicians of Thailand
Dr Nonglak Pagaiya, Human Resources for Health Research and Development Office
Nattakan Muengdha, Sompoy Health Centre, Rasi Salai District, Sisaket
Dr Somchai Panumaswiwat, National consultant, Rasi Salai Hospital Director
Networks for primary care
Dr Panapat Tocharoenvanich, Head of Social Medicine Department, Hat Yai Hospital
Dr Nipat Kittimanon, Buddhachinaraj Hospital
Dr Surasit Chitpitaklert, Queen Mary’s study visit, National consultant, Social Medicine Department, Maharaj Nakhonratchasima Hospital
Dr Pongthep Wongwachirapaiboon, National consultant
Dr Pakorn Tongwilai, Queen Mary’s study visit, National consultant
National developments in financing for primary care
Dr Thaworn Sakunphanit, National Project Director, Health Care Reform Project
Dr Tawekiat Boonyapaisarncharoen, National consultant
Dr Sukit Peungketsoontorn, National consultant
Dr Nivat Jeegungwal, study visit participant, National consultant, Primary care fund manager NHSO
Dr Charoen Serirattanakorn, Warin Chamrab Hospital Director
Version of 3.06.09