Sahaswat, an MP from the People’s Party, pointed out that the policy limiting nurses’ working hours to 12 per shift is a superficial solution. He suggests increasing nurse staffing levels and adjusting compensation to match workload in order to address the problem of nurses leaving the system.
On 20 March 2026, reporters reported that on 19 March, Sahaswat Khumkong, MP for Chonburi District 7 from the People’s Party, commented on the policy limiting nurses’ working hours to 12 hours, saying that the government is addressing the problem at its symptom rather than setting minimum standards for human life.
Sahaswat said the policy limiting nurses’ working hours to no more than 12 hours per day and 52 hours per week has been presented as progress for Thailand’s healthcare system, aiming to reduce fatigue, errors, and improve patient safety. In principle, this is correct and should have been implemented long ago in a system where nurses’ work directly affects human lives. However, the policy is being enforced immediately without aligning with the system’s reality. In fact, Thailand’s healthcare system has long exploited workers, with many nurses averaging 72 hours per week or 288 hours per month, covering about 36 shifts monthly. This is not an abnormal situation but the system’s normal state, sustained by labor beyond human limits. The issue is not whether a 12-hour shift is appropriate but how to reduce a system reliant on 72-hour workweeks to 52 hours without changing staff numbers or workloads.
He said this requires acknowledging that the problem is not simply "working hours" but that the healthcare system’s structure depends on staff working hard with low pay. Thailand has about 194,735 professional nurses, a ratio of approximately 334 people per nurse. Even though thousands of nurses graduate annually, the system loses more personnel each year, creating a vicious cycle: insufficient staff leads to overwork, fatigue, resignations, and thus staff shortages continue.
Within this system, limiting working hours without increasing staff, regulating workloads, or restructuring compensation fails to solve core problems and creates new issues, such as compensation problems and staff shortages.
Most importantly, this issue is not just labor-related but concerns patient safety. Numerous global studies show that nurse workload directly affects patient health outcomes. European research tracking over 113,000 patients found nurse-to-patient ratios as high as 1:8 to 1:13—below safety standards—significantly increasing the risk of complications and death.
Sahaswat noted that international data confirm that increasing one patient per nurse can raise readmission rates by 6–9%. In systems with legally mandated nurse-to-patient ratios, such as California, patient death rates have decreased by 10–13%.
This empirical evidence concludes that setting "workload ceilings" is crucial to protecting lives. Nursing policy analyses in the U.S. explain that without legally mandated nurse-to-patient ratios, hospitals set workloads themselves, making patient safety standards dependent on each facility’s resources rather than a minimum state-guaranteed standard.
In other words, in systems without legal limits, patient safety depends on budgets. Conversely, countries or states serious about this issue do not stop at limiting work hours but establish minimum safety standards by law, specifying the maximum number of patients per nurse per unit. This is not merely a staffing management issue but a state responsibility to protect public life.
Sahaswat said that considering all this data, it’s clear that Thailand’s 12-hour work limit policy tries to fix symptoms without addressing root causes. As long as staffing remains insufficient, workloads lack caps, and compensation pressures workers to rely on overtime, the system will adapt to continue operating through shift manipulation, hidden working hours, or shifting burdens back onto workers.
Therefore, the real problem is not just how much nurses work but that Thailand’s healthcare system depends on inhuman workloads to survive. Reducing working hours alone cannot solve all issues; comprehensive simultaneous solutions are required.
Sahaswat believes the work hour limit policy is not wrong but cannot be the sole answer. For genuine reform, at least four concurrent actions are necessary:
1. Increasing nurse staffing with targeted annual quotas and production to meet those goals.
2. Setting enforceable minimum nurse-to-patient ratios so nurse workloads align with patient numbers.
3. Adjusting compensation to reflect workload, to retain staff and reduce attrition.
4. Establishing mechanisms to protect nurses’ rights to refuse unsafe work.
The vicious cycle described earlier arises from too few staff, heavy workloads, long hours, and low pay, pushing nurses to private sectors offering better pay and hours. This policy only addresses long working hours. Without fixing staffing and compensation, problems will persist. Many nurses question why private hospital nurses have labor law protections and clear pay and hour standards while public hospital nurses do not.
Ultimately, this is not just a public health labor issue but a fundamental public policy question: will the state allow "life safety standards" to be dictated by budget constraints, or raise them to "minimum standards guaranteed by law"? Until this is resolved, even well-intentioned policies may be illusions of reform rather than true transformation.