Resistance was so strong that MOPH leaders tried on more than one occasion
between 2001 and 2010 to bring back the previous system, usually when there
was a change of government. In the end, they lost these battles.
In 2002 all major MOPH programme budgets (provincial, district and subdistrict
health services, and subsidies for the Medical Welfare and Voluntary Health Card
Schemes) were pooled, making available a total budget of 26.5 billion baht.
The estimated shortfall of about 30 billion baht needed to start nationwide
implementation of the new scheme was allocated by the Government. Although
this entire sum was initially managed by the MOPH, the capitation-based UCS
budget passed via the CUPs to the provider facilities, which meant that the
MOPH’s annual supply-side budget allocation dried up completely. All that
remained was some funding for major capital investments and small budgets
for the Food and Drug Administration and the Medical Science Department.
Moreover, the MOPH failed to secure from the Budget Bureau adequate
funding for its normative and stewardship functions, such as disease surveillance
(Department of Disease Control) and public health services (Department of
Health). As a result, provincial and district health offices had to “request” funds
from the CUPs to maintain these legitimate functions in their jurisdiction, which
further strained relationships.