1. Role of ThaiHealth in the promotion of Thai people’s good health
ThaiHealth, after 10 years along the path, has welcomed several delegations of inspectors and auditors – experts from the World Health Organisation, experts from the World Bank, health promotion expert from private development organisation (Rockefellers Foundation). These visiting inspectors have found that ThaiHealth was a model organisation for health promotion with perceptible and widely recognised results.
At present, ThaiHealth’s work covers 1) effort to reduce health risk factors: cigarettes, alcoholic drinks, accidents, and premature sex; 2) effort to promote health factors: exercising, eating appropriate food, and mental livelihood; 3) effort to promote good health in all age ranges and to care for the underprivileged: the disabled and illegal migrant labour; 4) effort to promote health in workplace: implementation of Happy Workplace idea in government and private organisations, schools, temples, etc.; and 5) effort to promote health in local communities and rural areas, which is now covering 2,000 tambons, with each tambon having one health promotion learning centre.
Scope of Work of ThaiHealth
2. Project and budget approvals
With challenging missions and different frameworks from those of government agencies, ThaiHealth is designed to be small and flexible, with low burden of operational cost so that the budget given can get through to the working groups in local communities efficiently. (At present, ThaiHealth employs 120 permanent members of staff, using only 5% of the budget for operational cost, and 2% for staff cost)
Known that working with health problems takes time, continuity, and should not be interfered by the politics or businesses that are prone to losses, the source of income for ThaiHealth is designated to come from 2% of the additional duties collected from alcoholic beverage and cigarette products. (Collection of budget according to Health Promotion Foundation Act is not done by dividing the budget from the tax earned by the government, but is from an additional sum of money collected directly from alcoholic beverage and cigarette companies. Not only it does not create additional burden for taxpayers, it also helps to reduce the number of drinkers and smokers effectively because the companies choose to adjust prices of their products up, preventing people with less income from purchasing these dangerous products.)
As for the fund management, the foundation is administered and managed by the ThaiHealth committee headed by the Prime Minister and independent specialists, experts, accompanied by representatives from concerned agencies. The committee designates rules, regulations, protocols for money-spending activities with efficiency and flexibility just like in private organisations. It is also managed with good governance with efficiency, results, and value for money in mind.
Despite difference in money spending protocols from that of the government agencies, the finance of ThaiHealth is covered by strict scrutiny alike that of the government, some of the procedures are even more concentrated and stricter than the normal practice, for example:
It is regularly scrutinised by the Office of Auditor General, with 12 years of clean history.
An independent assessment committee has been set up, by nomination of the Ministry of Finance and by approval of the Cabinet. It serves as an external audit, scrutinising the performance and working procedures strictly. It is also stated in the law that ThaiHealth must submit each year an annual report before the Cabinet, the Parliament, and the Senate.
An internal audit committee has been set up independently from the administrative body, to conduct an internal inspection systematically and continuously all year round.
A committee for good governance has been set up to designate the working system to be in line with the good governance, according to the appropriate protocols, and transparency.
ThaiHealth is designated to report its year-end performance before the Cabinet, the Parliament, and the Senate. The annual report is strictly scrutinised by the two houses.
The strictest scrutiny comes from the media, the press, and the public sector. As ThaiHealth cannot exist without perceptible and acceptable results of operation and correct financial statements. The persistent scrutiny conducted by the media, the press, and the public sector covers every dimension of ThaiHealth’s existence. Not only is ThaiHealth has a strong intra-organisational system, it also expresses a clear goal for anti-corruption effort and to create transparent atmosphere. It co-founded the Anti-Corruption Organisation of Thailand (ACT). And to be a role model in terms of anti-corruption effort and good governance, the committee of ThaiHealth Foundation has also set up a committee for good governance to create policies and follow up on the performance continuously.
The procedure on project approval is according to the criteria written by the ThaiHealth committee, which says 1) the project must be revised by an independent expert with written comment on the suitability of the project in terms of content and value for money. The size of the project must correspond with the number of independent expert involved in the project, so as to perform a quality work. The actual number of independent experts involved in on-going projects is more than 1,500, all from different fields of expertise. 2) For a particular project that is worth more than 20 million baht, it does not only require independent experts, but it must also pass a careful consideration by widely-acclaimed respected executive committee directly appointed by the board. 3) For a particular project that is worth more than 50 million baht, it does not only require the same protocol as in section 2, it must also pass a careful consideration by the ThaiHealth Foundation board.
3. Results of operations and value for money of ThaiHealth projects
According to the result of operations between ThaiHealth and its accumulated network of government, private, public, and local community sectors, it has found that the health indicator ameliorated gradually as information shown below:
The proportion of Thai smokers gradually decreased from 32% in 1991 to 19.94% in 2013. Counting from the year of establishment of ThaiHealth until now, the proportion of Thai smokers decreased by 22% or 1.21 million people, representing the amount of money saved from smoking since 2001 by 13.955 billion baht.
From 2006 to 2012, the proportion of Thai drinkers of alcoholic drinks decreased by 13%. The volume of alcoholic drinks drunk by Thai people also decreased from 6.46 litres per person in 2005 to 6.08 litres in 2009. Thai population of 15 years of age or more who drink at a dangerous rate decreased from 9.1% in 2004 to 7.3% in 2009. Besides, the rate of purchasing of alcoholic drinks of Thai people decreased from 154.998 billion baht in 2007 to 137.059 billion baht in 2011. If Thai people can maintain the actual rate of alcohol consumption in the future, it can represent the amount of money spent on alcoholic drinks of 17.939 billion baht per year.
Proportion of population of 15 years of age who consume alcohol at a dangerous rate
Consumption of alcohol per capita (Unit: Litre:Person:Year)
Expenses of Thai people on purchasing of alcoholic drinks (Unit: million baht)
3. The rate of occurrence of road accident decreased by 43% during the past 10 years, representing a decrease of 107,565 times to 61,197 times in 2012. The recorded fatalities decreased by 37% during the past 10 years, representing a decrease of 14,012 deaths in 2003 to 8,746 deaths in 2012. The amount of casualties caused by road accident decreased by 100 billion baht in the last 9 years.
Occurrence of road accidents and fatalities
The gradual decrease of casualties caused by road accidents