The National Health Security Office said yesterday the idea would ease the workload on hospitals under the universal health scheme.

Office secretary-general Dr Sa-nguan Nitayarumphong said it would spend Bt1 billion converting healthcare centres into primary-care units. They will become the first stop for patients.

About 90 per cent of outpatient cases are easily treated at primary-care units, Sa-nguan said.

The units will refer patients to hospitals only in cases of emergency and serious illness, he said.

He cited success with this in Malaysia, which built a public hospital on Langkawi without an outpatient clinic. Cases were dealt with at four primary-care units around the island.

The Medical Council has said it welcomes the idea. But it is sceptical of it going ahead under the country's current state-health system.

Council president Dr Somsak Lolekha said there were insufficient doctors to staff primary-care units. He suggested "specifically trained nurses" could replace doctors in less-populated areas.

"Many provinces are short of surgeons and doctors. Many have resigned as a result of government policy and gone to work in private practice". State policies left some provincial hospitals with just one surgeon. Many were forced to work so hard they eventually quit, he said.

Efforts to introduce primary-care units here had failed because the state was unable to ensure patients visit such physicians first, Somsak said. Effective emergency care involved prompt directions to well-equipped facilities.