HIV and kidney disease patients are considering protesting about a controversial decision to have Rajavithi Hospital buy drugs under the universal healthcare scheme, arguing the institution does not have the capacity for the job like the National Health Security Office (NHSO).
The decision would see the NHSO, responsible for overseeing the medical welfare service called the gold card, have its power to procure drugs overtaken by Rajavithi Hospital. This follows the Office of the Auditor General's findings that the NHSO has no legal power to buy drugs and medical supplies.
Patients and public health advocates have voiced concerns about whether Rajavithi Hospital can legally handle the procurement process.
Meanwhile, medicine stocks have been recorded as low in several hospitals nationwide as uncertainty lingers over who exactly is authorised to procure.
"We need to stage a rally, though we know it may violate the rules," said Aphiwat Kwangkaew, director of the Thai Network of People Living with HIV/Aids, referring to the government's ban on mass assembly.
"But we need to do something because we rely on a [continuous supply of] drugs."
Among the drugs being dealt with are life-saving ones that fight HIV/Aids. Stocks of these have run short in several upcountry hospitals since August. In these instances, the hospitals had to "borrow" drugs from state agencies and distribute them to patients, said Mr Aphiwat.
The real concern rests with if the purchase of antiviral drugs can be made in time to replenish low stocks, he said.
Without a regular dose of the drugs, the HIV/Aids patients' systems can develop resistance to the drugs, Mr Aphiwat added.
Stocks for kidney disease drugs are also running low. Thanaphon Dokkaeo, heading up the Association of Friends of Kidney Patients, said its members were not confident they would receive their daily dosages.
Kannika Kittiwetchakun, coordinator of Free Trade Agreement Watch, said the law authorising Rajavithi Hospital to procure drugs on behalf of other hospitals is unclear. For example, confusion can follow when attempting to understand what drugs are considered the hospitals' property and which must be distributed to other hospitals under the gold card scheme.
Ms Kannika added that Rajavithi Hospital is first and foremost a medical service provider, so its new role as a drug purchaser could pose a conflict of interest.
According to Ransan Sirichai, a pharmacist at Amnat Charoen Hospital, a better plan would be for the NHSO to continue to purchase drugs under the gold card scheme until the government can ensure that the hospital is prepared to assume its new role.
Ms Kannika says that the government must also clarify why the Office of the Auditor General made its comments on the NHSO last year after the office was allowed to buy the drugs for up to nine years.
