Notes from Thailand

Britain is twice as wealthy as Thailand. So why does it have better private hospitals and 5G?

Krabi’s coast. Just add about 1,000 Swedish tourists and you get the picture

When I married my wife, I married into a different lifestyle: that of Swedes who like to stay at home in summer and use their main annual holiday to break up the cold, dark winter. Christmas is about family - and Swedish families can migrate to warmer climes in winter like flocks of birds. About 2pc of Swedes go to Thailand at least once a year. We went with two other families, including my Thai-Swedish sister-in-law who was able to explain culture and context. It was wonderful, and fascinating. Here are some of the points that struck me.

1. Thai private hospitals are a phenomenon. I had a foot complaint that had me hobbling around London for months, wearing trainers into the office. My local GP was of no use; I wasted money on private MRI scans and consultants trying to diagnose the problem. Nothing worked. But when I went into Wattanapat hospital in Aonang the problem was diagnosed, surgery carried out, electrocautery administered and all completed all within 90 minutes. I felt like Lazarus for the rest of the holiday. In Bangkok, one of my friends had a trapped nerve in her leg - which was diagnosed and treated in two hours. She walked in without an appointment and was never unattended for more than a few minutes. Blood tests, x-rays, intravenous painkillers, specialist diagnosis, treatment pathway for when she returned home: all for 7,500 bhat (~£175). I was operated on by the same doctor who diagnosed me: they don’t seem to fragment it into specialities. She was an expert and her Gucci belt suggested a place at the top of the earnings tree. But the whole thing still cost me about £400. She told me, mid-operation, that she was thinking of moving to the UK but heard about NHS conditions which she considered dangerous for patients. The UK has a good private health sector, but money cannot buy the integration or speed that Thai hospitals offer.

   I found out later that people now travel to Thailand to bypass European hospital logjams. Most Thai private hospitals hold Joint Commission International (JCI) accreditation, a gold standard for global healthcare quality with ~350 standards for things like surgical hygiene, anaesthesia protocols, medical personnel qualifications and patient safety. I suspect most NHS trusts would fail to meet this standard, even though they cost far more money. The drawback is that they sometimes offer things not necessarily needed (in my case, crutches and biopsy: in my son’s case scraping after a jellyfish sting) but better to have a bias towards belt and braces. UK private healthcare is more a premium-priced overlay on NHS infrastructure rather than a reimagined delivery model. Thailand shows what proper integration achieves: clinical outcomes Western healthcare once promised but increasingly fails to deliver.

2. China’s influence is huge. News about the Thai-Cambodia conflict over here talks about America as peace broker. The local press there talks about China. America once fought a war to keep on side with the Asian democracies, to prevent China’s influence. Now Trump alienates them with punitive tariffs and they start to ask if Beijing - for all of its flaws and ambition - is the more reliable partner.

   I wrote about this in The Times and my trip to Thailand bore this out. China now accounts for 26pc of Thai trade vs America’s 18pc. Take Thai durians, a stinking fruit that you get fined for eating in hotels - yet is still seen as a delicacy. Thanks to the China-Laos Railway (a flagship Belt and Road Initiative project opened in Dec21) these durians can now reach China in four days, half the previous land-sea route duration. To visit Thailand is to see China’s growing influence. It’s funny to see America squander the influence, goodwill - and the liberal order - that it once fought for in Korea and Vietnam.

3. The Western model is doing better in Thailand than in the West. They adopt our capitalism, individual freedom but without the regulation and special interests. Its lack of health and safety is a bit extreme for my liking: I was taken aback to see parents riding with toddlers in motorbike taxis, no one wearing a helmet. Some 14,000 die on motorbikes this year, whereas the UK has the safest roads outside of Scandinavia. Thai motorbike taxis (you can order them on Bolt for about £1 per 25-min journey) are so cheap that young people heading out for the night take them. They have ‘minicabs’ of little vans fitting six without seatbelts in the back. Are we too safety-first here? Certainly, but I’m not so sure I prefer the Thai system

4. Thailand’s 5G infrastructure is better than the UKs. An eSim got me unlimited digital access for $10 a week; I was downloading songs in the middle of the sea when I struggle to make WhatsApp calls on the street I live at home. Thailand’s mobile networks deliver median download speeds of 104 Mbps, vs the UK’s paltry 59Mbps. Its fixed broadband ranks 6th globally; the UK fails to crack the top ten. About 95pc of Thais are covered by 5G, vs ~85pc in UK and 22pc in my native Scottish Highlands. Thailand has built modern mobile infrastructure designed for visitors and digital-economy users. Britain allowed infrastructure decay through underinvestment, regulatory barriers and operator complacency - resulting in G7’s worst mobile performance.

Thailand is no utopia. Its GDP per capita is less than half of ours; their minimum wage is £1 an hour. Most of its people live in what would be called absolute poverty in the UK. I saw townships where people live in squalour. It’s easier to jump straight to 5G if you have less legacy copper network to maintain; a greater incentive to build medical facilities and comms for visitors if tourism makes up 18-20pc of your economy (vs 9-10pc of UK). But travel gives a chance to see how other countries do things - and, in many cases, do things better. I was struck to see so much done better in Thailand.