The Design of Thailand International Public Sector Standard Management System and outcomes in Service for The Private Sector and People System (P.S.O. 1107): Case study of Siriraj Piyamaharajkarun Hospital

Abstract

The application of privatization in public sector is a one of strategic transformations that significantly helps promoting the organizational development in terms of efficiency and quality which subsequently resulted to the continuous financial development which refers to as revenue and profitability. Such development usually will be corresponded to the competitive market which indicates the organizational achievement. However, privatization can possibly create direct impacts on public sector and stakeholders as well if it was conducted in the public sector that emphasized on public health services such as public hospital where the core product is health care or medical treatment. The objectives of this research were to (1) study the privatized management system of Siriraj Piyamaharajkarun Hospital, which is another Government Super Tertiary Hospital affiliated with the Faculty of Medicine Siriraj Hospital, Mahidol University, by using five specific components of P.S.O. 1107 as a conceptual framework (efficiency, quality, equity, responsiveness, availability); (2) to initiate an innovative privatized super tertiary hospital standard management system. The research is conducted as a qualitative study, using (1) documentary researches which include the principle of P.S.O. 1107, work of literatures regarding the concept of privatization and public health service, to explain how adoption of privatization in public health sector can generate social values and social impacts (2) interview approaches; in-depth and semi-structured interviews, to engage people with the right form of information and knowledge needed to address the theme emerging from the study. The findings were that the application of privatization in SiPH led to certain degree of improvements, especially on the level of (1) efficiency which can be referred to as the maximization of human resources, financial development, and faster-timing in service provision; (2) quality in term of health services which showed that privatized medical scheme accredited by JCI Standards, enabled SiPH to provide better health services than Siriraj Hospital where HA Standard is held, however, both hospitals adhered to the same quality standard of medical treatments. Although privatized medical scheme is responsive to the needs of medical personnel and affordable patients, what emerged as potential drawback from the establishment of SiPH is an issue of inequity which can be referred to as (1) financial barrier that health service provision is dramatically depended on affordability than desirability (2) geographical barrier that hospital facilities in privatized scheme prevent accessibility from least affordable patients (3) cultural barrier that privatization influenced medical personnel to conduct unfair practices since only affordable patients could actually respond to their needs. Last but not least, it was also observable that the quantities of advanced and expensive medical specialties listed in SiPH were more than Siriraj Hospital because privatization granted SiPH to prioritize on financial development aspect rather than equity.