Health workforce: more diffi cult to redistribute according to need
than anticipated
Strategic purchasing is another major component of the UCS design. The idea was
that money should follow patients (registered members in the catchment area),
refl ecting the distribution of population need for health services across the nation
rather than the (skewed) historic allocations to the administrative and service units.
The new capitation-based funding stream that went to the CUPs aimed in part
to allocate health resources more equitably between rich and poor provinces.
In the UCS’s fi rst 10 years this was only partially successful, primarily because during
this time the MOPH failed to provide leadership in addressing the problem of
inequitable distribution of staff. Although the non-salary component of the UCS
is allocated based on population size, age profi le, utilization and various other
factors (see full report on UCS implementation at www.hsri.or.th) the same cannot
be said for the salaries of health-care professionals.