Letters
By EJB
13.2.08
It appears that there is no end to the spin of Annie Freeda Cruez for the yarn she creates for DG Merican. Today the NST highlighted an article, “Malaysia’s rural health service second to none”. They forgot to add that it was for the year 1965 when you had to worry essentially about cholera, typhoid, malaria and hookworms.
DG Merican, just fresh from conning doctors that the PHFSA (Private Health Care and Facilities Act) is not meant to penalize registered doctors but is there actually to weed out bogus ones, has seen to it that, Basmullah Yusom, a registered practitioner, still languishes in Kajang Prison. He shows no remorse for blatantly lying to doctors and to parliament. He appears not to have a conscience either as he goes on another PR jaunt with Annie Freeda Cruez. Today it appears that he is trying to win brownie points by highlighting to the largely gullible Malaysian public that our rural health service is well run and effective. He is, of course, now in danger of believing his own bull.
Merican’s ebullient statistics include a health clinic every five kilometers and that more than 95 per cent of the rural population have access to a doctor. There are also 2,965 clinics and 151 mobile clinics in rural areas and there is one health clinic or centre for every 20,000 people while there is one community or rural clinic for every 4,000 people.
Impressive statistics until one actually walks into one of these clinics and realizes that there is only a nurse or HA who is going to attend to today’s epidemic of hypertension, diabetes mellitus, heart disease and cancer. Their duties – check your BP, sugar, etc and dish out 30 year old medication for the next 6 months packed in two polystyrene bags with a “Kalau mau jumpa doctor…tunggu tiga bulan ya…”. If the patient returns alive on follow-up, repeat above. Any complications, refer to “Hospital Besar” and join the queue where the rest of Malaysia will also be waiting to see not a specialist..but a medical officer in the specialist clinic, who could have been just transferred from the same district the patient was seen. This is the modus operandi of the Malaysian Healthcare System for the last 50 years.
Forget about obesity or even dengue, HIV, hepatitis or the reemergence of tuberculosis all of which have already claimed thousands of lives. Access to a doctor? Yes, try waiting three months if you are lucky. And incidentally how many of these clinics, especially the mobile ones comply with PHFSA rules. And how is it nurses are doing neonatal care, deliveries including curative, family health, dental, nutrition and dietetics, health education and promotion, home nursing, care of the elderly, rehabilitative services, environmental sanitation, adolescent health and community mental services. Not to mention Medical assistants merrily providing general anesthesia still in Sarawak in the year 2008. Aren’t these against the PHFSA? Oh hang on? Yep, that’ right. One rule for Merican and one rule for Basmullah. Silly me. Nurse kill government patient OK. Basmullah no pay RM1500 for private clinic, go to jail.
Merican even appears to take credit for the healthcare provided for the Orang Asli. The Orang Asli Affairs Hospital in Gombak is run by the Orang Asli Affairs Department. And parliament was informed further in May last year that it is so well-run by the Orang Asli Affairs Department (JHEOA) that the Health Ministry has no intention of taking over the management. Much of the base work and credit for Orang Asli healthcare must surely go J. Malcolm Bolton and subsequent British Officers who improved Orang Asli Healthcare even throughout the Emergency.
There are enough publications in the literature to confirm that healthcare among the Orang Asli has been in terminal decline after independence with the Health Ministry itself having the distinct notoriety for scapegoating the Orang Asli’s themselves whenever disasters such as hepatitis break out among them. As recently as last year, Nicholas and Baer reported that the crude death rate and maternal mortality rate is still twice higher among the Orang Asli then the rest of all West Malaysians. (Healthcare for the Orang Asli: Consequences of Paternalism and Colonialism).
But Merican and Annie, go further. They utter that horrible phrase “telemedicine and teleconsultation”. We have to take it that Amrin Buang, the Auditor General must have clearly failed to delve into this rip-off. Merican must be quite oblivious to the death of Medical Online linked to KUB in July 2003. Tasked to develop telemedicine, Medical Online died a horrible death when it couldn’t pay suppliers because of the insidious learning curve associated with this project by the project managers and the ministry. Its troubles in Ipoh said a lot about jumping the gun. How do you install a multi-million ringgit IT system comprising of expensive hardware and software when there is no electricity supply? Just like hospital having ISO status but roof is leaking?
Worse still no one in the Ministry of Health realized that technology waits for no one. While billions were spent on both hardware and software, all courtesy of the tax-payers money and probably Petronas, none in the ministry actually grasped that if they don’t learn it fast enough, the equipment and software is trash. Being practical appears not to be the Ministry’s stronger points. In its euphoria to achieve first world infrastructure, the MOH just failed to grasp how really appalling our third world mentality is.
Just a little research would have showed that even the National Health Service(NHS) in Britain was sliding into a £20 billion (RM120 billion) IT disaster. British tax-payers till this day have been unforgiving and have threatened to punish Labour for their miscalculation in trying to implement electronic patient clinical records without studying in depth its feasibility. Basic problem – clinicians, whose support was essential in the introduction of IT to clinical care, were unconvinced and the costs / benefits for the NHS were unclear from Day One. Suppliers and ignorant ministry officials in Malaysia must have done such a sales pitch about paperless hospitals that our cabinet must have been left completely transfixed.
Today Malaysia will have to deal with the financial calamity arising from a civil servant at the Ministry which the government chose to believe. Woefully the main officer responsible for this mess is still apparently at the Ministry of Health and she is even expecting a promotion. And apparently the dumb lady even let the suppliers keep the source codes after paying millions for the software. Such are the brains that run the Ministry of Health and squander what must be, meager resources by now.
But this government never learns. Since it is must be mesmerized beyond belief at its ability to fool all of the people all of the time, it has now ended-up believing its own bull. But since, parliament has been dissolved, I fear, Malaysians must brace themselves for greater thought provoking articles by both Merican and Annie Freeda Cruez.
If people think the bad services and incidents is the worst thing about our healthcare system, let me tell assure you that it will not be. The financial aspect of our healthcare system is untenable. 70%-80% of us have 90% of the cost borned by the government that delivers a poor quality product, while 20%-30% get fleeced by the private sector for delivering a mediocre quality one.
If the quality were to be raised, the cost would be untenable for the government and YET there is no real planning and thought in reforming the system. The medical insurance industry is a mess that does not deliver promised services at promised cost. A compulsory savings and medical insurance system would be fleeced by the corrupt if implemented. I would not participate and go to jail if I have to if the government forced it.
Its still early yet for our healthcare system to fall apart.
“Its still early yet for our healthcare system to fall apart.
What system??
Yes, it’s all bull! Its the usual Malaysian way of ‘just for show only’. Everything is so beautiful, ‘first world facility, 3rd world maintenance’ (comments by ABB). Many facilities are there but cannot work! The result of ‘divide and rule’ which discourages competent ‘rakyat’ not interested to work in their own country but go elsewhere to work for people who appreciate their ‘work’.
Hold your heart and ask yourself sincerely how do you rate the ‘productivity’, ‘competency’ and ‘degree of commitment to their work’ of our health care (or any civil service staff) workers? You would vomit blood and got your blood pressure shot up higher each time you go to hospital for any treatment.
Without corruption and ‘construct where there is a genuine need’ practice, we could easily afford specialist centres in at least the capital city plus 1 major town in every state! No need for ‘sakit jantung’ from far away state to travel all the way to IJN in KL!
I’m sick of all these situation. If the main culprit of ‘lousy management of the existing cabinet’ is not dealt with, we are only wasting our time; and yet they think they are the one who know how to manage this country! What a BULL!
I think that Dr. Chua Soi Lek should have a good comment on this matter. Somehow, we cannot hear his voice anymore.
Hi chiakchua,
The symptoms you mentioned in your posting exist way before AAB’s administration thanks to Dr M.
Unfortunately, AAB lacks a proper spine and courage to bite the bitter pill and do the right thing to reform the “system”.
Guess everyone heard of the phrase “Prevention is better than cure” but no one bothers to practice it especially in governance of state and administration of bureaucracy.
Nobody listens to the educated when there are huge amount of $$$ and opportunities floating around during Dr M’s time even when these golden years are just temporary and we are in fact spending away the future ?
When the problem has manifests itself into its current state, it would be more than just bitter pills that we have to bite but more like a serious operation with a high fatality rate. By then, even the best “surgeon” or in our case, the best leader would most likely fail.
We deserve this for closing our eyes and ears and failing to think with our brains and looking further into the future.
However, it is rather sad that not only the previous and current generations of Malaysians are affected but our future generations as well.
Some points to ponder when casting your vote:
Anybody who wants the premiership so much that he’ll spend 4 years organizing and campaigning for it is not to be trusted with the office….
The reason politicians are so busy is that they spend half their time passing laws and the other half helping their friends get around them.
Political campaign speeches are like steer horns: a point here, a point there… and a whole lot of bull in between!
These days, the only time politicians are telling the truth is when they call each other a liar.
Inside every politician lurks the playground bully who ran for class monitor.
Political campaigns are conducted so that people can find out what politicians stand for and politicians can find out what people will fall for.
Political promises are guarantees that are guaranteed to be forgotten within 48 hours after an election.
Some politicians can fool too many of the voters too much of the time…it tells a lot about the type of voters we have nowadays
For once, I have to disagree with LKS. I am a specialist in MOH and I am not supporting any side politically. I think Malaysia has one of the best system in the World. Where else in the world that you will get RM1 treatment (you can even refuse to pay) including the specialist care. Not even in Singapore. We even offer free chemotherapy to cancer patients FREE, the SIngaporean don’t even do this to thier own citizen. Our MOH hospitals is even willing to go extra mile to treat all the foreigners when they are seriously ill (also FREE). We doctors in public hospitals are willing to do our best despite the poor pay. I worked in Sarawak rura hospital before, I was even given the power to ‘order’ a helicopter from Kuching just to transport patient to General Hospital (also FREE).
“Their duties – check your BP, sugar, etc and dish out 30 year old medication for the next 6 months packed in two polystyrene bags with a “Kalau mau jumpa doctor…tunggu tiga bulan ya…â€. If the patient returns alive on follow-up, repeat above.”
This is a BIG LIE coming from the mouth of LKS just because you are antigov and is not based on fact. I don’t blame your stupidity because LKS is not medically trained. 30 year old medication do not mean they are less benefit. Latest and most expensive drug also do not mean they are the best drug.
Patients are given appointments in specialist clinic according to the seriousness of their illness. Those will serious illness will be seen immediately or even admitted for emergency treatment. 3 months appointment will be usually given to stable patient.
“Any complications, refer to “Hospital Besar†and join the queue where the rest of Malaysia will also be waiting to see not a specialist..but a medical officer in the specialist clinic”
All the medical officers will be under direct supervision of specialists and consultants. They are not allowed to work alone.
LKS, I am very disappointed to your article This just show that LKS is willing to write anything just to make the government look bad even though it’s a lie.
nckeat88, the article is not a piece of writing by LKS but a letter by someone else. I think you should apologise for your abrasive and disrespectful language on a man who has done and sacrificed so much for people like you and me.
The main thrust of the article is that with the wealth that we have, the healthcare system should be better. The amount of money and resources spent unnecessarily or unwisely or channelled elsewhere could have been better managed and utilised for a much better healthcare system. No use asking the people to pay peanuts and get monkeys to treat them.
Maybe we should all hold our horses and be calm and start analysing if things could have been better so far our healthcare system is concerned rather than latch on to a position and start calling names and shooting with uncouthed language.
Start with yourself, nckeat88. How many patients do you have to personally attend to a day as a specialist? How many patients do you have to delegate to medical officers? What is your pay now? How long do you intend to stay with the government hospitals? What do you think is the standard of medical services and personnel provided? Maybe you have been too long in that system to be able to make a professional independent judgement?
Just because we charge RM1 per person whether citizens or foreigners does not mean that it is a good system. There is no need to pick on a few small things and get emotional and abrasively defensive.
Are the services and helicopters really free? You mean the money comes from the government and not from the people?
NCKeat, if what u said is true that means u’re must be one of few remaining dinosaurs waiting to be extinct, only one out of many who really work their butts-out but get paid peanuts. But how many others of your calibre are out there, I dare say near zero
One of the reason it is RM$1 is to help the poorer Malays, that is the plain truth, but the doctors, I just wonder how many of the newer generations ones(benefiting from the Quota system) is truly capable & of course graduating form such questionable Quota-filled medical degrees, can u really be accepted overseas????
HB Lim: It doesn’t matter who wrote the article. The writer and LKS are only interested in humilating the government. Malaysian health system may not be perfect but this is the only country which can offer reasonable healthcare to everyone. It is sad to see people only criticising without appreciating what we have. We, the medical staff who are working on the ground do not treat patient according to their race. Even though the pay may not be as good as in the private sector but I am still paid 4X the Malaysian GDP which I considered is above average compared to most Malaysian but most importantly I got the job statisfaction but treating the people in need.
damianyeow: “One of the reason it is RM$1 is to help the poorer Malays” Please don’t try to be racist. We are just a bunch of medical staff trying to do our best. WE don’t ask our patient to vote BN first before we treat them. Why should I care whether I am accepted overseas? Of course I am, I can work in UK or Singapore and I graduated locally but most important is that I want to serve the Malaysian!
nckeat88, your dedication to serve is admirable and very much appreciated by me. No doubt about it.
It is not a case of humiliating the government for the sake of humiliating. My contention, spoken or unspoken, is that with better use and allocation of our wealth and if meritocracy had been the basis of appointments and promotions etc in our healthcare system, we would have a much, much better health system.
The past BN government would like all of us to be like you to be perpetually thankful to them for whatever little public facility that they have made available and would like to see all of us us to be like you to be contented with what we have, to be unquestioning, to be politically ‘dead’ or a political ‘slave’ or ‘zombie’. But as citizens, shouldn’t we be entitled to ask, could it have been better?
To be sure there is nothing wrong to be contented about life like you and think great about and be thankful to the government like you. But your kind of attitude is precisely the type that fuels the rot which is spreading through our dear country threatening to destroy it to its core. When educated people like you becomes politically ‘dead’ or a political ‘slave’ or ‘zombie’, what future do we have for this country?
As a specialist doctor, I am sure you are more than able to see better than ordinary folks the situation now prevailing in the healthcare system and contrast that with our wealth or the wealth that have ‘gone away’ from the national coffer and assess whether we could have a better system if our resources have been better managed and used. If so, should we be contented to say that this is the only country in the world that provides reasonable healthcare for everyone or that this the best healthcare system?
What all right-thinking people, especially the educated ones like you, should be grasping is that the main Malaysian policy malaise is that much, much resources have been wasted on the Bumiputra subsidy policies and the the results we get from these subsidy policies are deteriorations in standards, more corruption, more discrimination, wider cleavages between the races, more inefficiency and hence more wasting of national resources.
This rot has pervaded all public systems, not just the heathcare system. We have to arrest the rot but one of the main reasons we are very hampered in our efforts is because of educated people like you who are politically ‘dead’ and who adopt the defensive or the ‘tidak apa’ attitude.
nckeat88, I am not being personal but speaking generally from my heart on this aspect of abled professionals who are contented with and defending the system despite the apparent and undeniable rot. I hope you understand. Of course if the premise or basis of your argument is still that we should be indebted with what we have or that this is the best that we can have, then I have nothing more to say to you nor should I waste anymore time on you.
On your part, if you still hold on to that premise or basis, so as not to do an injustice to your high academic and professional qualifications, I think you should just be quiet and think again about the future direction of this country if the widening gaps between the various races and religions are not attended to and mended but allowed to be on this roller coaster to bigger and growing widening and tensions, fueled, kept in motion and accelerated by the Bumiputra policies and the policy of the State promoting one religion at the expense of the other or governing this country as an Islamic country rather than a secular one.
It is time to look ahead twenty, thirty, fifty years ahead and start formulating and implementing the change that we need now to avert a national disaster. The changes to the healthcare system are but a small portion of the big overall change that we need. The ultimate situation that we need – true meritocracy and affirmative policies based on needs, not on race.
What kind of service can you expect from these govt. clinics when their ex chief the infamous MOH Chua Soi Lek who is too busy Fxxking his so called girlfriend fit to be his daughter rather than discharging his duties as the MOH (Minister of Health).
You may still remember the infamous 80’s D P Vijandran case exposed by Sdr Karpal Singh of DAP. Both of these BN members share the same identity, both are SEX MANIACS.
Chua Soi lek has the guts to ask Malaysians for forgiveness and to continue in public service. He thinks Malaysians is GOD. If an apology is all that is needed after a sin or crime has been committed, we don;t need courts and prisons in Malaysia to try and imprison convicts. Only GOD can forgive sins, not Malaysians.
Can you trust BN to lead Malaysia in the future? To the residents of Labis, be extra careful this coming GE, never vote for BN and the werewolf. Your daughter might be thier next victim! MALAYSIA BOLEH TANPA BN !!
i am a medical officer currently working in private. i am not here to talk about the doctors rather the gov healthcare services. i hav to disagree with nckeat88 as i had a recent encounter with our gov services recently. i would say tat being a dr i am willing to sacrifice anything to provide better care for my pts but there r limitations of wat we can do in the gov.
my relative was diagnosed with ca recently and him having no money for chemo i referred him to the gov. first of all no parking, then our encounter with rude front desk staff, and referral to other specialties tat can take up to 1 month. to add salt to our wound, the medication the oncologist prescribed is out of stock n we were told to wait for 2 weeks! talk about service. of course the oncologist and the mo r very pro on every appt.
when i was with the gov as a dr, i do not see the things pt had to endure to see a gov dr, but right now i can understand the pain and sufferring one have to go through just to get this so called good service. so nckeat88, u have to be a pt b4 u can give opinion on our gov healthcare service as u have not had a taste of it yet.
i am sure u can also see the many flaws, problems, limitations, red tapes, politics, quota systems and many many more rubbish within our gov healthcare service.
damianyeow,
Youre just biased and ignorant in making your racist statement,I suggest you go to any govt clinic to see for yourself are there only poor malays attending the clinic,this would probably enlighten you.As for overseas acceptance,every country has their own governing bodies eg GMC for the UK.Even though top malaysian medical schools are listed in the WHO medical school directories they are not accepted in the UK as the new ruling of the GMC states that non EU qualified doctors( singapore,hong kong,japan included)are not eligible for working permit,for your information previously our degrees were accepted for training purposes(partial registration) in the UK.As for US the key is in obtaining USMLE.UKM and UM basic medical degree are accepted in singapore although not a full registration status.Local masters program is fully based on merit and not quota! One has to get his facts right before churning out such unscrupulous and malicious racist statement