Financial incentives, although important, had less influence than social recognition
(from a number of interviews with retired MOPH policy-makers, retired
physicians at district and provincial hospitals, and a health officer at a provincial
level).
A medical doctor always gets high recognition from villagers. Even if he
is a new graduate he would be greeted by older villagers and he would be
invited to be a chairperson of many important events in the district,
e.g. funerals, sports day and the New Year festival. This high social
recognition is naturally given to medical doctors and other health
personnel. When one gets high recognition, he or she should preserve it
as much as possible by paying back to the society.
Academic in a teaching hospital
The most important reason, cited frequently by many interviewees to explain
the dedication of public doctors, is that the MOPH health personnel are civil
servants who work for the King. Therefore, it is the highest honour “to serve the
country for the King and Royal Family”.
A key role model was Prince Mahidol Na Songkhla, the father of the present
King Bhumibol, who trained in public health in the early years of the 20th
century. He untiringly promoted public health and medical care in Thailand
through his work with the Rockefeller Foundation in establishing medical
colleges in Thailand. He is revered as the father of modern medicine in Thailand.
■ What have other sectors contributed?
A number of other sectors and developments also contributed to improving the
health of the Thai population, including economic growth and poverty reduction,
education, social equity and inclusion policies, and public infrastructure.
Economic growth and poverty reduction
Rapid economic growth (Figure 7.2) was associated with significant poverty
reduction, as indicated by a fall in poverty incidence from 49.7% of the rural
Thai population in 1988 to 10.7% in 2007 (Figure 7.9). The rural–urban gap
has been reduced although it is still large, with the urban population much less
affected by the economic crisis of 1997 than the rural sector.
Despite the reduction in the incidence of poverty, income distribution has been
very slow to change. It took almost 25 years to reduce Thailand’s Gini index