Worshop on Financial Crisis and Social Protection in Thailand
Closing Remarks by Annette Dixon
World Bank Thailand Country Director
September 11, 2009
Ayutthaya Province Thank you very much Khun Suwanee. It’s very challenging to try and summarize today’s discussions because they have been so wide-ranging. So what I want to do is just leave you with some thoughts, or some take-away as I would call them, to actually provoke further discussion. My first point is the end is just the beginning. Today’s discussions have been tremendously broad-ranging that I think the challenge that we face is to figure out what is the most important key issue for us to focus on. There are just so many issues on the table. In that sense today I think time has been our scarcest resource - not energy and passion and intellect and knowledge and experience. We have had all of those things, but we really haven’t had enough time I think to really get grappled with these issues.
The second thing that has really come through to me in today’s discussion is that we’re not just talking about social protection as the floor or the safety net that we talked about this morning. We’re talking about social protection in the context of strengthening Thailand’s social institutions. It’s a much bigger role and expectation for the social protection system. In that sense I think many people have talked today about the importance of social protection policy focusing on strengthening families to provide strong and healthy families, and particularly to help the most vulnerable families - not only to get out of poverty, but to achieve better outcome in terms of life chances in so many dimensions.
Social protection is being asked to help strengthen communities to support the sufficiency economy (philosophy). So it’s really about a whole community coming together to become empowered, to collaborate on solutions and to determine the direction that (communities) want to go in terms of their (own) development. At the broader national level, social protection policy is being looked at something that can help social cohesion in the context of a globalized, open economy on one hand, and an increasingly diverse country (on the other) – a country that is in the midst of an ongoing political termoil and conflict and deep sub-national conflict in the south.
All of these issues that Thailand has been grappling with, social protection policy has been asked to help build social cohesion in the way that actually helps bring people together, not to create more distance and more fragmentation on this society. So it’s a huge agenda, but nevertheless it puts at the center of the debate the development challenges that Thailand has in its next phase of development. My third point is a much smaller point. I think that there is an inclination to start with what we have already because we know it and we know it works well. It reminds me a little bit of the debate in the United States over healthcare reform. You know there was one camp says we’ve got some schemes that are working well, and if we just expand them, they’ll all fit together and they’ll cover everybody. It’s like a patchwork quilt that has got a huge hole in it and if we just sew the edges together, it’ll be okay.
On the other hand, there is another camp that says "No, we’ve got to throw all that out and build a new system because the system is so broken that we need to come up with something else." So in the United States, people say “Oh, we need a Canadian health system,” or “Oh, we need another kind of health system.” It’s a little bit like (either) you put together a patchwork or you try to actually build a new system which takes you forward. My point here is not just about harmonizing this scheme, although that might be important, but it’s really about bringing more instruments to reflect the diversity. I think you need to be thinking about new additional tools to add to what you have, and we talked about that this morning. My next point is about the paradox that Thailand and many countries at this stage of development face. As Thailand grows wealthier, the demand for basic social protection and basic social services increases even more. It’s not something you leave behind as you become richer, but it’s something that in fact public demand will build for (as your country grows). The more you have, the more people want (basic social services) to be better and to work better. So public demand and public pressure (for social services) will only increase.
This is a kind of a paradox. You know I’ve watched many countries which have focused particularly on developing other parts of their economy. And as they’ve got wealthier, they realized that they had to come back to focus on education reform, on health reform, on social protection reform – to really better reflect the new economic and social reality of their country, and to meet the needs and expectations of the population that became more discerning, more critical, and more demanding.
The next point I think is the importance of focusing on outcomes. I think we tend to discuss a lot about and think about the people who are missing out, and that’s important. But it’s also about the quality of the service and the quality of the systems. This is important because as Thailand has become more disparate, the debate has to focus more and more on those who are left behind and how their outcomes can be brought up to the standard that this society will expect. It’s not just a matter of improving social outcomes so people won't be left behind, but it’s also a matter of competitiveness.
If you look around, the countries that are doing well in competitiveness terms pay a lot of attention to equity of outcomes. They don’t like the fact that they are leaving a lot of people behind. Now, you do have different models to follow here. One of the things I looked at when I came to Thailand was the OECD PISA (Program for International Student Assessment) study results on education outcomes. It’s a study that looks at outcomes for 15-year olds and their learning competencies.
One of the great surprises here has been to look at Korea’s development. Korea went from being a country that had a very, very poor education to now the number one in the world in the PISA study in terms of learning outcomes for 15-year olds. They over took the Scandinavian and they did it by paying a lot of attention to the groups that were being left behind and to bringing (these groups) up. So you have to focus more and more on targeting and different approaches for that group. Because what has worked for the general population over time starts to work less well for the groups that are really had to reach out to because they’re really excluded and they’re really missing out.
The paradox is that countries that have very good elite education tend to come out of this study very badly because they do leave a lot of groups behind. So I think the agenda and social protection increasingly is about targeting and finding different approaches to reach these hard to reach groups that are really shut out of or socially excluded or economically excluded from the mainstream institutions. It’s becoming a much more challenging agenda.
The other point, of course, is that as Thailand develops, new problems emerge. And you see that in the health financing challenges. Thailand’s health profile is rapidly moving from a developing country profile with the health problems of the traditional developing country to the health problems that the middle income country has.
We see now an epidemic of diabetes and of obesity. These are bringing new non-communicable-disease challenges; they put different challenges on the health care system. So you have to focus on a rapidly-moving picture that’s just part of the demographic and economic challenge that we face. We talked a lot about the ageing population, which you should, but there’re also other dimensions to your problem. The point I’m making here is that there are moving targets.
My last point is really about building public support as we go. For social protection systems to be durable and lasting, they have to enjoy significant public support. I think we all know that it’s very important to focus on the governance of these systems because to the extent that social protection systems are not accountable and not transparent and not sustainable, then this scheme will not enjoy broad-based public support because this is about building social contract.
People will feel good about paying taxes if they know that their taxes are being well used, and they’re getting good results and that (their money) is being used in the transparent way. So perhaps focusing on this aspect of governance is very important for creating sustainability and durability in this social protection scheme.
As Khun Suwanee said, we will have follow-up discussions about how to continue this collaboration. I think it’s been a great opportunity to bring together a very rich conversation about Thailand’s unique development and its social protection systems, and what aspects of international experience might be useful to look at this phase of its development.
There’re many different levels at which our future collaboration between international partners and the Thai public policy community (may be fostered). Because this is not just about collaboration with government. I see it as a collaboration with the public policy community because all of us here represent a wide range of institutions. I think that this work can continue at a number of different levels. This is perhaps where we might want to talk about what would be the most useful things for us (international development organizations) to do in the future.
Firstly, I think, speaking for the World Bank and I hope the UN system, we can contribute and support ongoing policy debate and public discourse about the policy choices and options that Thailand has. I think this is useful in the context where you know there’s a lot of politicization of different approaches. International partners can help to bring international experience into this discussion and help the debate to continue in an ongoing and longer term sense.
Secondly, I think we can bring some technical assistance to help develop policies and to help work through the details of policies in terms of design choices. Thirdly, beyond a policy design, we can also provide the implementation support because there is a lot of experience about how to make these things work, how the administration system and so on needs to put in place to support the implementation of these policies.
Lastly I think we can help with monitoring and evaluation, which is really an important part of the feedback loop. There's a lot more thinking and talking to do and we already agreed on a date for our next meeting, so thank you very much.
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