ASEAN Economic Community. Brunei Darussalam Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Viet Nam

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2 ASEAN Economic Community Brunei Darussalam Cambodia Indonesia Lao PDR Malaysia Myanmar Philippines Singapore Thailand Viet Nam

3 ASEAN + 3 China Japan South Korea

4 ASEAN + 6 China Japan South Korea Australia New Zealand India

5 ASEAN 10 members 600 m population GDP 1.6 mm US$ อ างอ ง ผ อ านวยการกองอาเซ ยน2 กระทรวงการต างประเทศ

6 Financial Results of 2011 Market

7 Financial Results of 2011 Market

8 ASEAN Economic Community Free flow of of Goods AEC Single market and Production base Free flow of of Services Free flow of of Investment Free flow of of Skilled Labor Free flow of of Capital

9 AEC Economic Hubs Hopeful Medical Hub: Thai, Singapore, Malaysia Education Hub: Singapore, Philippines, Malaysia Logistic Hub: Financial Hub: Singapore Agro Hub: Automotive Hub: Thai, Singapore, Malaysia Thai, Vietnam, Philippines, Indonesia, Malaysia Thai, Indonesia, Malaysia

10 TOP 10 FLY-IN REVENUE Ytd YTD Aug 12 OPD IPD. %GR. Ytd Aug 12 Top 10 Contribution : 82% Growth : +43.1% +43.9% +28.7% +31.1% % +19.9% +14.6% +72.3% +82.4% +43.2% +8.0% -2.7% Millions UAE QAT MMR KUW ETH BGD OMN CAM FRA UK OTHER IPD RATIO % 51% 64% 59% 77% 66% 57% 62% 59% 88% 80% 65% %+/- OPD +11.2% +30.0% +41.9% % +14.0% +28.0% +27.4% +79.9% +64.8% +13.2% +28.1% %+/- IPD % +27.9% +24.5% % +23.2% +6.4% % +84.1% +40.7% +6.8% -14.1% %PER OPD +2.0% +5.6% +8.7% +5.4% +9.4% +11.6% -2.0% +2.1% +53.2% +9.2% +10.2% %PER IPD +69.4% +19.2% +6.5% % +17.8% -5.0% +84.5% +46.7% +34.3% +30.4% -10.5%

11 Proposals of ASEAN Association of Medical Regulatory Authorities (AAMRA) Development of ASEAN Board of Exams in various disciplines Recognition of the medical professionals via membership/ fellowships of the ASEAN Societies Mutual Recognition and Registration between Member States Dec 5, 2011 AMC Meeting Bali 11

12 Roadmap for Implementation of ASEAN MRA on Medical Practitioners Exchange information and expertise in order to promote adoption of best practices on standards and qualifications Compilation of required information: Recognised Basic Qualifications and/or List of Recognised Institutions (country of origin and host country) Recognised Post-Graduate Qualifications and/or List of Recognised Institutions (country of origin and host country)

13 Roadmap for Implementation of ASEAN MRA on Medical Practitioners Domestic Laws and Regulations pertaining to Education, Registration, and Licensing for Medical Practice Basic and Specialist Core Competencies and Scope of Practice Code of Ethics and Professional Conduct and Practice Guidelines CPD (Continuing Professional Development) requirements in Host Country

14 Roadmap for Implementation of ASEAN MRA on Medical Practitioners Registration Policies and Procedures in Host Country Licensing Policies and Procedures in Host Country Number of Foreign Professionals Practicing in Host Country (by country of origin and by type of practice) Contact details of Professional Regulatory Authority of Host Country (address, , website, phone, fax) Access to all AMS for certificate of good standing (by request only),, and verification of registration status by host Professional Regulatory Authority

15 Future Plan Temporary License Postgraduate training for foreign doctors Specialists in some specialties approved by Royal College of Specialty for educational purpose only Education Hub/ Training Center Undergraduate program English program for medical school Foreign students Private medical schools Collaboration with foreign medical school (US, UK, Australia, German)

16 Future Plan Education Hub/ Training Center Postgraduate program English program Postgraduate training for foreign medical graduates Public-private partnerships in training program Medical license examination Part I Basic medical sciences (English) Part II Clinical sciences (English) Part III Language, culture, domestic law and regulations, OSCE, Patient interview and physical exam (Local language) Medical Hub

17 Malpractice Insurance Countries to work towards possible portability of malpractice insurance for medical practitioners practicing in other AMS

18 AEC Effects to Thailand Healthcare 1. NOT IMMEDIATELY (2015) 2. Free flows of capital and investments 3. Free flows of patients (services) 4. Free flows of specialized healthcare personnel Physicians Dentists Nurses

19 Healthcare Consumer Movements after AEC MED SCH TOP TIER REGIONAL HOSPITALS MID TIER GENERAL HOSPITALS STANDARD HOSPITALS COMMUNITY HOSPITALS PRIVATE CLINICS VILLAGE CLINICS PRIVATE PUBLIC

20 Healthcare Consumer Movements after AEC (UC Level) MED SCH TOP TIER REGIONAL HOSPITALS MID TIER GENERAL HOSPITALS STANDARD HOSPITALS COMMUNITY HOSPITALS PRIVATE CLINICS VILLAGE CLINICS PRIVATE PUBLIC

21 Healthcare Comsumer Movements after AEC (Inter Level) MED SCH TOP TIER REGIONAL HOSPITALS MID TIER GENERAL HOSPITALS STANDARD HOSPITALS COMMUNITY HOSPITALS PRIVATE CLINICS VILLAGE CLINICS PRIVATE PUBLIC

22 Healthcare Personnel Movements after AEC MED SCH TOP TIER REGIONAL HOSPITALS MID TIER GENERAL HOSPITALS STANDARD HOSPITALS COMMUNITY HOSPITALS PRIVATE CLINICS VILLAGE CLINICS PRIVATE PUBLIC

23 BDMS Preparation 1. Personnel preparations* 2. Standardization 3. Networking 4. Synergy

24 BDMS Preparation 1. Personnel preparations* Recruitment strength Development strength Engagement strength (physicians & personnel) Succession strength (bench)

25 1. Personnel preparations* 2. Standardization Clinical Standard Thai Hospitality Standard Efficiency Standard Environmental Standard BDMS Preparation

26 1. Personnel preparations* 2. Standardization 3. Networking Networking (coverage & depth) Affiliation Representation BDMS Preparation

27 1. Personnel preparations* 2. Standardization 3. Networking 4. Synergy Standard of care sharing (knowledge) Personnel sharing Equipment sharing Referral system BDMS Preparation

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29 Personal Words 1. Human capital is the most important component of service businesses (esp. skilled HC) Skilled human capital must be seriously protected

30 Personal Words 1.The POSITIVES for Thailand; Engaging (personnel) Networking (hospital) Synergizing (group) Thai people (personal) Thai livability (environment)

31 Personal Words 1.The NEGATIVES for Thailand; Salary (personnel) English (paradox) More litigations? (personnel) Financial (hospitals) PPPP (national)

32 Personal Words 2. PPPP: The critical surviving factor in healthcare is the real Public, Private & Professional Partnership. Synergizing and sharing of the limited resources in the Kingdom

33 Personal Words 2. Critical Balancing, Standard vs Economy?

34 Personal Words 3. Serious Preparations to Help Thai Citizens, UC Level Social Security Level Government Officials Level

35 Dec 5, 2011 AMC Meeting Bali 35