Citizen Mobilization in the Fight against Corrupti

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Published on January 7, 2008

Author: Flemel

Source: authorstream.com

Citizen Mobilization in the Fight against Corruption: the case of health care funding in Thailand:  Citizen Mobilization in the Fight against Corruption: the case of health care funding in Thailand OECD Seminar on Open Government Seoul, February 20003 Think Centre Asia A Historical Case in Ministry of Public Health involving:  A Historical Case in Ministry of Public Health involving Politicians Government officials Non-Government Organization Businesses Press Public at large Overview of the scandal:  Overview of the scandal Procuring overpriced medicine and medical supplies Policy changes and channeling of funds by the Minister Co-operation between politicians and government officials Overview of the movement:  Overview of the movement Part of 30 years struggle for health care reform Doctors in the Ministry forced by officials and politicians to cooperate in past corruption Feel the corruptions has gone too far and widely affected their patients - public exposure was necessary Overview of the movement (cont…):  Overview of the movement (cont…) Exposing the scandal through the press by Rural Doctors Foundation Cooperation of nation-wide NGOs to expose and seek punishment Tested the new mechanism provided by the new constitution People in public health sector demanded reformed Environment at the time (1998):  Environment at the time (1998) New Constitution in late 1997 Asian economic crisis High level of unemployment and bankrupted businesses Press freedom – ethical reporter Multi-party coalition government – honest Prime Minister in a weak coalition New Constitution:  New Constitution First Constitution written by the people Public Participation Government scrutiny Creation of National Counter Corruption Commission (NCCC) Power to prosecute politicians in court High degree of independent No more paper tiger Freedom of Information Act Article 304 – 50,000 signature can remove political office holder Medicine & Medical Supplies Scandal:  Medicine & Medical Supplies Scandal September 1997, parliament approved 7 billion Baht (US$237.5 million) budget for “Health Care Welfare Program for the Poor and Disadvantaged” 1.4 billion Baht (US$35 million) was returned when IMF relax fiscal requirement, but MoPH Rakkiat proposed to the Cabinet to channel the funds to be centrally controlled Medicine & Medical Supplies Scandal (cont…):  Medicine & Medical Supplies Scandal (cont…) December 15, 1997 – the Minister canceled the Median Set Price for procurement - allowing no ceilings. 2 Advisors from the Minister and Deputy meet several provincial Health Chief to plan purchasing of overpriced medicine and medical supplies from 5 companies. Medicine & Medical Supplies Scandal (cont…):  Medicine & Medical Supplies Scandal (cont…) 111 items were over-priced by up to 1220% its market value. Methods of corruption: Regional health departments purchased for local hospitals GPO purchased from specified co. Send money to hospital to purchase and demand 5-50% funds back Hospital that already had funds were forced to use the channeled funds to purchase the medicine. Citizen Mobilization :  Citizen Mobilization 2 Parts The Rural Doctors Foundation and Rural Pharmaceutical Foundation NGO Coordinating Committee for Development Reasons for the 2 Foundation to exposed corruption:  Reasons for the 2 Foundation to exposed corruption The corruption was systematic – strong collusion between politicians and officials during the worst economic crisis. Ethical reasons as professional doctors Corruption leads to position buying in the ministry – unqualified personal managing their professions 3 choices faced by the doctors:  3 choices faced by the doctors Co-operate to advance their career Risk being transfer far from home and slow career advancement if refuse Expose the corruption – regain their credibility and ideology – risk their lives, assets investigation, uncertain public reaction and lost of ally in the Ministry The Rural Doctors Foundation and Rural Pharmaceutical Foundation:  The Rural Doctors Foundation and Rural Pharmaceutical Foundation July 1998 – “Poor Bureaucrat” send letter to newspaper indicating hospitals being forced by politicians and high ranking officials to purchase overpriced medicine from the channeled fund. Lack credibility. Chairman and many former chairman of Rural Doctors Foundation came out to confirm the accusation. The Rural Doctors Foundation and Rural Pharmaceutical Foundation (cont…):  The Rural Doctors Foundation and Rural Pharmaceutical Foundation (cont…) Rural Pharmaceutical Foundation joined in movement supplying information about the purchases. Gather information and facts, process of the scandals, technical information, laws & regulations. i.e. order forms, invoices, inventory lists, etc. The Rural Doctors Foundation and Rural Pharmaceutical Foundation (cont…):  The Rural Doctors Foundation and Rural Pharmaceutical Foundation (cont…) Create strong public support with persistent pressure – extent of seriousness of the problem must be shown – systematically expose the scandal Questionnaires send to hospitals around the country Must regain their credibility as they are part of the scandal The Rural Doctors Foundation and Rural Pharmaceutical Foundation (cont…):  The Rural Doctors Foundation and Rural Pharmaceutical Foundation (cont…) “Payan Pan-din” – Sovereign Witness Campaign To encourage witness to publicly testify Attorney General’s office refuse immunity to the witness The campaign was a failure The Rural Doctors Foundation and Rural Pharmaceutical Foundation (cont…):  The Rural Doctors Foundation and Rural Pharmaceutical Foundation (cont…) Rural Doctors Foundation send formal requests to the Prime Minister to set up an investigation. 2 politicians, 3 high ranking officials were named as mastermind. The channeling of funds and cancellation of Median Set Price by the Minister was to facilitate the scandal More and more people in the MoPH and in public health sector came out to the press putting more pressure on the government The Rural Doctors Foundation and Rural Pharmaceutical Foundation (cont…):  The Rural Doctors Foundation and Rural Pharmaceutical Foundation (cont…) This point – their movement received a lot of public attention Lack of personnel and time from the foundations could not sustain public pressure Coalition was needed for greater public mobilization NGO-COD:  NGO-COD Cooperation of 30 NGOs to create a coordinating committee for development Nation-wide network of NGOs in various sector Lead by Mrs. Rosada Tositrakul The Consumer Protection Foundation act as secretariat of the committee Clear responsibility was assigned – no overlapping in duties NGO-COD (cont…):  NGO-COD (cont…) 4 demands to the Government Ministry’s investigative committee should report directly to the Prime Minister, their investigative power should be increased, and findings made public Immunity to the whistle-blower The Minister and his Deputy must resign The Permanent Sec. and his Deputy must resign NGO-COD (cont…):  NGO-COD (cont…) Article 304 – 50,000 signatures collection to remove political office holder – Both the Minister and his Deputy resigned at mid point of collection The Committee further demanded Conviction of the Minister for facilitating the scandal Conviction of the Deputy Minister and Permanent Secretary for negligence Demand to take part in the investigation and trials of the accused. Drugs companies involved be charged Procurement process reform NGO - COD:  NGO - COD Obstacles Lack of clear regulations of the new constitution mechanism cause frustrations Lack of cooperation by the officials Consume full time work from every NGO from all sector Public too easily satisfy with superficial action by the government Factor for success:  Factor for success Internal factors External factors Factor for success:  Factor for success Internal Factors Doctors and Pharmacists are independent professions in the Ministry Strong grouping and associations – self regulated Highly ethical Long history of fighting for reform - ideology Strong national network and cohesiveness Factor for success:  Factor for success Internal Factors Foundations are independent and free from bureaucratic system No desire for political power Scholarships medical students are forced to work in the province and become members of the Foundation - continuous expansion Factor for success:  Factor for success External Factors Scandal shocked the society as it was done by a profession that they mostly trusts. It occurred during economic crisis, expensive medicine create more social distressed New Constitution Press reform Actions taken by the Government – 1st Committee:  Actions taken by the Government – 1st Committee Investigating committee was set up to investigate 5 provinces’ Health Department Found strong evidence and compelling witnesses indicating corrupt practices. Personal Advisor to the Minister and Advisor the the Deputy Minister was named as the mastermind to coordinate with local officials and drug companies. Actions taken by the Government – 1st Committee:  Actions taken by the Government – 1st Committee Officials then suggested, guided or order non-written means public health doctors to co-operate in the purchase. Findings forwarded to Counter Corruption Commission Counter Corruption Commission investigation:  Counter Corruption Commission investigation CCC investigation found the accused politicians and officials guilty of corruption. CCC has no power to prosecute or punish – forward findings to the Prime Minister for further action Counter Corruption Commission investigation:  Counter Corruption Commission investigation Unable to link the Minister and his Deputy to the scandal. Unable to prove that the Minister’s action to channeled the fund and cancel the Median Set Price for procurement facilitated the scandal. Did not investigate other provinces involve in the same scandal New Committee to prosecute:  New Committee to prosecute Both Personal Advisor to the Minister and Advisor to the Deputy Minister were criminally charged. Personal Advisor to the Minister is now serving 6 years prison term for corruption Advisor to the Deputy was dismiss for lack of evidence 23 other officials were found guilty of ‘minor’ breaches of discipline. Further investigation by the MoPH:  Further investigation by the MoPH 34 other provinces were found to be affected by the scandal Several officials were received minor disciplinary punishment NGO-COD protest at the differences in the punishment of the first 5 provinces investigated. Altogether 8 committees were set-up National Counter Corruption Committee:  National Counter Corruption Committee NGO-COD request the NCCC to investigate the scandal liking the Minister No evidence could prove his doing facilitate the scandal Indicted for being unusually rich – money found during the scandal Indicted for accepting bribe at the time of the scandal The End:  The End

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