The eight strategies being developed appear as follows :
Strategy No. 1
Reorganize the structure and relationships among health service organizations at all levels within the overall national health service system
In order to reorganize existing health service systems and the relationship among system components to improve services to the people by more effective use of personnel and budgets, to enhance the systems’ capability of providing services that are responsive to the people’s health problems, to prevent the cost of health care increasing too sharply, and to solve the problem of inaccessibility, key strategies have been developed as follows:
1. Develop the capacity of the government health service systems
The objective is make the government health services capable of rendering effective services to the majority of population, that is both to the underprivileged groups who are eligible for free services and to those who may be able to pay the fees. If the latter were charged more realistic fees, it might result in increasing the quality of government health services and stabilizing the cost of health care in private hospitals which currently is rising sharply. There should also be more effective mechanisms for screening persons who are eligible for free services in order to avoid unnecessary expenses and thus making fullest use of existing financial and human resources. These new approaches require “total quality management” , which means strengthening managerial capacity, revising the payment mechanism or remuneration system to be more consistent with those of the private sector in order to avoid a high rate of providers.
2. Increase efficiency of primary care and the referral system
This could be done through increasing the efficiency of primary care provide by health centres and community hospitals while initiating new models for primary care in urban areas to reduces an unnecessary influx of patients to large hospitals. The existing referral systems should also be improved so as to make it easier for primary level health service centres to send their patients for treatment to secondary or tertiary level health care institutions whenever necessary. These referral systems might well cover private clinics and poly clinics and polyclinics which constitute essential components of the primary care facilities. This would enable large hospitals to provide better care for complicated cases by using their full potential. When the patients’ health has improved, they could be referred to community hospitals or health centres or even receive care within their own communities or individual families.
3. Upgrade health service systems which are not well planned and well organized
In response to emerging needs, some of the health service systems which are not well planned and well organized should be upgraded by increasing their efficiency and effectiveness, for example :
- Emergency care when patients need prompt attention and easy access to emergency services. This need could be met by setting up well fitted out mobile units or fully equipped ambulances to transport victims safely and promptly to appropriate emergency units. At present emergency services are available only when the victims arrive at the hospital. Efforts must also be made to solve the problems of hospitals refusing to provide services as in cases where the victim or relative cannot provide evidence that they are able to pay the bills.
- Services systems for treating high priority diseases when effective technologies for disease prevention and treatment are already available should be rigorously reorganized to better serve the people. For instance developing effective screening systems for cancer and genetic diseases could help reduce the magnitude of the problem and social burden involved as serves sickness could be detected and treated promptly.