The Public Health Ministry and the World Health Organisation yesterday underlined this glaring problem to mark World Health Day, which falls on Friday.

With the theme of "Working Together for Health" this year, health authorities are highlighting the shortage of qualified manpower.

Armed with WHO data, Deputy Public Health Minister Anutin Charnveerakul said more than four million healthcare workers were urgently needed worldwide.

In Thailand, he said, the actual proportion of medical doctors per head of population was about one per 10,000 in rural areas, although the country's average proportion was said to be one per 2,800 compared with the ratio considered internationally acceptable of one per 1,800.

Last year alone almost 800 doctors left the state healthcare system, most of them moving to work in the booming private sector, said acting Public Health Permanent Secretary Dr Pratch Boonya-vongviroj.

More than 600 doctors had already resigned this year, he said.

Apart from losing workers to the private sector, the density imbalance of qualified health workers was a major issue, Pratch said.

Doctors in rural areas have workloads 20 times greater than their city colleagues, he said.

Thailand is still better off than many other parts of Southeast Asia, said Dr William L Aldis, WHO's Thailand representative.

The average proportion of nurses or midwives per head of population was set at 2.4 per 1,000, but the actual average ratio in the region stood at only 2.1 per 1,000 with some areas of the country experiencing numbers as low as one per thousand, Aldis said.

In general, Anutin said, the problem of an inadequate medical workforce could be put down to people's longer life expectancy and the burdens of disease that mark the modern lifestyle, such as obesity, cancer and heart disease.

In a bid to mitigate the problem, the Public Health Ministry has announced this year as the beginning of a decade of improvement in manpower development, said Dr Papassorn Chemboonsri, the head of the ministry's Praboromaraj-chanok Institute for the Health Workforce.

But he said healthcare was a specialised field and because of that, producing professional workers was not as easy as in other fields.

"In practice, it's impossible to require medical schools to simply double their capacity of producing doctors. More important than quantity is quality," Papassorn said.

The ministry is trying every possible way to step up production of health personnel, with the top priority being doctors, Pratch said.

The situation should be better in 10 years, he said.

Arthit Khwankhom

The Nation