by Milton Combe
As leader of the opposition and a lawyer I would like to bring to your attention and query some incredible policy changes implemented overnight by the current Health Minister who appears to have a penchant for running roughshod of this country’s laws.
The Health Minister recently made a decision in allowing its specialists at the Putrajaya and Selayang hospitals to charge patients private sector fees. The primary reason of this policy appears to be to enable such specialists to remain in government service instead of opting for private practice for financial reasons. No doubt efforts must be made to ensure the continual presence of senior specialists in government service to enable tax payers the benefit of proper treatment in especially these trying times of declining medical standards. But is this modus operandi legal? These changes appear to have the support of the MCA’s Star columnist V.K. Chin who is notorious for his writings of skewed wisdom on many topics just so it pleases his political masters although they may defy logic. But we cannot blame V.K. Chin as his very existence depends on advocating such articles which unfortunate readers of the Star have to sometimes endure.
1. Unlike private hospitals which are built and managed through private financial initiatives, public hospitals are built with public funds sourced via income tax, etc. Is it lawful for government doctors who are civil servants to charge or profit using such facilities without undergoing a corporatisation exercise like TNB, Telekom, Klang Port Authority etc that is usually endorsed by our courts and advertised accordingly in the newspapers after of course the whole exercise is agreed upon in parliament and an Act passed? This is a dangerous legal precedent. If by all means policy makers feel that this is the way our specialists or skilled staff need to be rewarded then indeed this is what needs to be done. Which will then bring into question how is it the other GLCs took the right legal steps to privatization but the Health Minister, who is known for his lack of tolerance for “illegal” clinics but instead promotes traditional medicine in our hospitals, has suddenly decided it is OK if his ministry does not follow the rules?
2. Secondly, the report states that government policy is – general hospitals and clinics are meant for the lower income group and it was difficult to verify the financial status of everyone seeking treatment. The implication is that, those with financial means should seek private treatment. Now this is indeed news. Government hospitals are put up using tax payer’s money. It does not matter if the tax payer drives into GHKL with a Rolls Royce but he may indeed be paying far higher taxes then the average person. He should, like every other tax payer, be entitled to proper treatment and not be told that he needs to pay additional private specialist fees or shooed away to seek treatment at a private facility. Has the Treasury, Auditor General and Attorney General Chambers been advised of these arrangements?
3. More alarmingly is, who is going to screen if a patient has the ability to pay or not? Is there going to be subtle lobbying to solicit patients and information regarding their illnesses modified to compel apprehensive patients to seek earlier paid specialist treatment? Worse still if touts, as in GHKL’s infamous mortuary appear, who will be there to monitor and protect ignorant distressed relatives who may mortgage their houses in a rush to save a loved one? Will the Minister then set up yet another Health Special Branch Police Unit to prevent this from happening?
4. Is this a pilot project? Will specialists in Temerloh, Muar, Batu Pahat and Gua Musang also benefit ultimately from this exercise or will it be confined to presumably urban hospitals whose populace may perhaps afford this new endeavour? And if it is restricted to only these urban hospitals, would it mean that our specialists located in these rural towns will be making a bee line to Putrajaya and Serdang Hospitals using whatever cables necessary and in the process abandon their posts in these not so profitable rural district hospitals?
5. The Health Minister has further stated that some of these Hospitals will be internationally accredited so that the medical tourist dollars could be raked in. Again, will dollar and euro rich patients have priority in being treated in a hospital built on government and tax payer’s funds at the very expense of our own citizens who helped put up the institution in the first place. And indeed, if these “arrangements” go awry, will the average Malaysian patient, after fifty years of Merdeka, be actually left on the wayside, as depicted by LAT.
6. And while the Minister dwells on which specialist gets to do what, perhaps he should consider the fact if this scheme indeed becomes successful there is a real possibility that specialists earmarked to earn from this program may then be tempted to keep the cake to themselves and prevent other specialists from coming in as is now rampant in UKM and UM. What will he do then when he is faced with such a situation? Will he overrule sometimes self-seeking heads of departments who currently have the final say to conjure an excuse to keep a specialist out? Or will the Minister decide to cross the bridge when he gets there, by which time he may not be in office.
These patchy policies to fix chronic problems the Ministry has been facing is in danger of not only failing but more importantly may bring this government to greater disrepute then it already is in. The Minister clearly appears to be in short supply of proper informed or experienced advisors. There are of course better ways and methods in solving these issues contrary to V.K. Chin who thinks that this is the “best arrangement for the time being”. Perhaps the Minister should read the book “An Old Man Remembers” written by a previous DG of Health as to why Resident Generals and this country’s earlier Prime Ministers took Healthcare seriously and personally looked into it themselves.
It is also important to note why Prime Ministers of that genre paid special attention to the post of Director of Planning and Research at the Ministry which was almost always reserved for only the most able and experienced officer and how Malaysia, a third world nation, was able to achieve first world standards in health care statistics with the minimum of budgets in its early years. The adage that the ultimate healthcare objective is to provide the population with the highest obtainable standard of health and medical care must still be this government’s objective. And this can only be attained by long-term planning. There are no shortcuts.
Heyyyy, thats not the only area where there is misuse of government facilities.
BN/MCA are currently running the Apa Khabar Orang Kampung (AKOK) programme with health clinics/camps being organised on Saturdays at rural areas. Of course, the thrust is that it is BN’s arrangement, so dont forget to vote for BN.
But whose money is this? And whose employees are the Doctors, and their facilities? By the way, the Health Ministry will be spending millions for this “campaign” just before the elections. One wonders why it is not done all year round and for the full 5 years?
The health staff who come on those days are not volunteers. They are paid to attend, and given a day off in lieu. And we pay the taxes.
Misuse? Abuse?
Haven’t you seen strange people using government vehicles on weekends and public holidays for their private use at all kinds of places? They use government petrol too. What’s new or shocking? Semua boleh.
Why not in the Bilehland?
The SIL not even employed by the government can have office in 4th floor?
It is an open secret that C S Lek is going for MCA presidency next. He will do anything to get his name/ pictures in the news, think Namewee/ PHSFA/ Bogus TCM in Govt hospitals etc.
If he has guts, he should stand up and correct all the wrongs in Malaysia Chicken Association. Stand up, show that you r no chicken, that you r not like Ong Ka Ting/ Kong Choy, then you will earn our respect.
What he is doing now, are nothing but to gain publicity.
Come to think of it, he is no different from the bunch of UMNOputras. A big disgrace to Malaysia.
I think Dr Chua CS is genuinely trying very hard to make the health care system here work. I note Mr Milton Combe grievences from his long letter are mainy towards specialists in some Government hospitals charging private rates, the rich encouraged to pay more for their treatment and fear of depriving citizen of medical services with the penchant for the heath tourist dollar.
While it is the ideal to provide free health service for everybody in the country with the best medical care, it is not achievable. Somebody has to pay. What Dr Chua did was nothing new. This has been experimented and even adopted in several countries. In Singapore, specialists in ‘Government Hospitals’ have been allowed to charged private rates for certain class of patients for many decades. In fact they have even taken the step further by allowing their consultants to ply their trade in the private hospitals part time. Even with such arrangements, specialist still leave in great numbers because the pull is so strong. One simple reason why specialist leave is because going private is a career advancement – less work for more pay with about the same level of responsibility. Not many people want to stagnate in their career. In any case, I do not see the standard of care in Singapore dropping to any significant degree with this policy. Even though I agree this is not the best solution to keep specialist in government hospital, it is a least a very sincere attempt. Perhaps Mr Milton Combe has some good suggestion as to how this problem may be tackled.
Is it so wrong for those who can afford it help the government out a little by paying a bit more for their health care consumption, even though they pay more tax? It would be unfair if the government has unlimited resources but does it? In any case, higher cost usually comes with fringe benefit for instance, better attention from doctors, better facilities, shorter waiting time etc. I think it is a bit presumptious and unfair to accused the government of trying to short change the rich by making them less welcome in Government hospital. I do not think anybody has been barred from treatment in Government hospital simply because they are thought to be rich enough to afford private care. Again, the Singapore Health Service does indeed have what they call mean testing, where the individual and his immediate family are assessed economically to see what quantum of subsidy is required to provide the level of care that is needed for some condition.
The entire world is gearing up to earn health tourist dollar. Is it such a sin to provide health services to others outside our country for economic gains. We do that in our casinos and seem to be OK with it. We should actually be proud of our health service if it is able to attract foreigner to come for treatment. It is the best testimony of our standards. Do we really have to neglect out own countrymen when there are foreign patients to treat. I think we should give our Doctors more credit for their sense of responsibility. In any case more money earned from the health dollar, more money can be poured back to subsidies health service. I see no cause to argue against that.
By the way, there is a big difference between illegal clinics and traditional chinese medicine. I hope Mr Milton can see the difference.
Let’s us be realistic here, now I don’t want to insult anybody’s brain but do you think with our hospital’s reputation we can attract tourist dollar? Come on, patient died on the way to the hospital because ambulance runs out of gas, and if you are sceptical that there may be more killing instead of saving going on in what we call our hospital, who can blame you? And that’s why advance country they put a label on us, thirld world country! This is a dream, is a bad dream.
“These patchy policies to fix chronic problems the Ministry has been facing is in danger of not only failing but more importantly may bring this government to greater disrepute then it already is in.”
I agree about bringing disrepute.
Those responsible must be made to clean the toilets of houses of ill-repute.
Hail to the Dollah Dynasty
http://www.atimes.com/atimes/Southeast_Asia/IH28Ae01.html
There are still huge question marks surrounding the 2004 proliferation case involving Scomi, a company owned by Abdullah’s son Kamaluddin, which was allegedly involved in supplying dual-use technology to Libya’s clandestine nuclear-weapons program. …The Iraq Survey Group, which the US set up to investigate weapons in Iraq, listed “Abdullah Badawi” on its names of recipients of the oil-for-food scam… Abdullah’s son-in-law Khairy Jamaluddin this month attempted to silence an opposition leader by labeling him “a puppet of the United States and the Jews”. Meanwhile, Abdullah’s information chief and other ruling United Malays National Organization elites have recently moved to intimidate bloggers and Web portals for exposing high-level government corruption. Malaysia’s courts, meanwhile, have recently handed down hardline Islamic legal interpretations by denying several Muslims the right to change their religion.
OF COURSE ! Especially those ketua who have the power to say yes or no to the money used and the access to Jabatan Akaun Negara ( JAN ). They spend it on themselves and their friends. For their enemies it is little or none. The people like us see it everyday.
See, the government is stupid because it is encouraging cronyism, neopotism, suppression, oppression, unfairness, unethical work practise and all while preaching transparency, justice, integrity, cleanliness, Islam Hadhari and all the hypocrisy.
For the doctors or specialists and for the matter even, the other medical workers, Kementerian Kesihatan Malaysia has really screwed them. The doctors’ rank is taken away just because some Tom, Dick and Harry who is jobless after graduating from university is joining the ministry. They are given the same rank. All the other medical workers come under the same rank too. It is demoralizing, insulting and disrespectful. It is just a rank, a title but it does not function at all.
You talk about excellence in higher education. How excellent is that when you give a similar rank to some people who have no experience just because of a university qualification ! There is no cemerlang, gemilang and terbilang in human morals and ethics when you stop respecting the speciality of a particular profession.
Personally, cemerlang, gemilang and terbilang does not mean what I can see. You can pretend to be just that. But in your heart you have another selfish motive. If you politicians don’t realize this, you will have to forget your Islam Hadhari and all that you preach.