Letters
by Suka Jaga Tepi Kain
Thus far the new health minister, Liow Tiong Lai has made two statements regarding the notorious PHFSA (Private Healthcare, Facilities and Services Act). One is that doctors should not own too many clinics as they will not be able to focus on seeing patients (that is if they are still seeing patients) and the other is that of private hospitals overcharging. In today’s Star, the DG, Ismail Merican wrote a letter about how the Ministry used its enforcement resources to track down a “bogus Burmese doctor” who worked with a private hospital following a complaint. Hopefully this complaint was genuine and not borne out of professional jealousy.
This doctor was apparently employed previously by the DG’s own alma mater, University Malaya but became “bogus” when he left their employment. Presumably he or she had MMC registration previously. Could this not have been solved by a simple phone call to the hospital asking them to make certain the doctor renews his registration? Or was this created by the MMC themselves by dilly dallying his registration or worse still being obstructive in not renewing his registration? Or perhaps, what is deemed proper by the University Malaya, is not being deemed proper by the MMC or the MOH?
It is no secret that a great many of the Ministry’s own doctors are treating patients without registration. But the DG has seen it fit to apply Section 31(1) (c) of Act 586 of the PHFSA fastidiously in going after a single doctor who apparently is a bona fide one but is now technically not because his registration was not renewed or perhaps pending renewal. Mercifully no one was prosecuted. Apparently three cases have been prosecuted. Two are awaiting trial and one pleaded guilty. And we all know what happened to that one doctor who pleaded guilty don’t we? Liow should ask this DG, who obviously is still obsessed with this Act, as to what happened to all the promised amendments that he and Chua Soi Lek agreed to? Another broken promise? Tak Tau? Not within his powers? Ask the AG? You see. This is why you lose elections. The MCA just cannot keep its promises simply because it has no control over the pathetic civil service that attempts to run this Ministry. You want to know more. Just ask Chua Jui Meng.
It is all very proper for the Minister to complain that certain doctors own too many clinics. Perhaps they do. And perhaps too, they are good managers who know how to handle their resources. As for the 250 private hospitals overcharging, what exactly does the Minister plan to do? Is he going to send enforcement officers to pore over itemized bills and lock up hospital managers, their doctors or specialists? Understand first, that private hospitals function in a different climate. It is called market forces. Supply and demand. You limit the number of specialists and hospitals in the private sector and at the same time run a poor public service hospital, then this is what you get. Overcharging and various dubious attempts to make a profit. It happens in almost every industry right from rice to diesel. How do you curb this? You either improve your own services or decentralize your hospitals into Trusts as in the UK or corporatise or privatize them as in Singapore or the US. Competition always seems to have a sobering effect on enterprise. The Health Department, then, basically takes on a monitoring role and focuses on public health.
Which brings the issue of the Ministry’s recent proposal to deploy millions of genetically modified “warrior” mosquitoes to fight dengue fever. The mosquitoes are apparently to be released first in Pulau Ketam. Has Liow been to Pulau Ketam? Does he actually know why this island has a high incidence of dengue? Pulau Ketam is 10 nautical miles from Port Klang and has a population of about 10,000 Teochew, Hokkien and Hainanese villagers. It’s specialty – seafood. But it holds one sordid detail. Pulau Ketam has to be the dirtiest island on earth or at least Malaysia. A walk along its passageways will reveal appalling filth and garbage in the form of containers, bottles, metal sheets, engines and even dead animals strewn all over the island especially under the stilts.
Not all of it is the islanders’ fault as some of the rubbish could be as a result of the highly polluted Klang River. The MOH has one health facility on the island itself. There is another facility hardly 300 meters from the Port Klang jetty where the previous South Port stands. Two kilometers away the Ministry has another health facility at Telok Gadong. In addition the MPK (Majlis Perbandaran Klang) has its own health facility in town itself. Could the MOH not make concerted efforts with a clearly overwhelmed Alam Flora to clear the rubbish and improve the virtually non-existent sewage facilities at Pulau Ketam instead of dabbling in dodgy genetic engineering experiments? Does it not have the public health and enforcement resources to clean up the island or has it spent it all in implementing the PHFSA and going after “bogus” doctors or health facilities.
It is status quo at the Ministry of Health isn’t it? Prioritization appears to be a problem. Nothing really has changed. Despite the MCA being virtually whitewashed in the recent elections with it losing support from not only its own community but Malaysians in general, it still runs this Ministry. The reason why this Ministry will never improve is obvious. It just doesn’t have proper management. Despite Ong Ka Ting’s belated attempts to redeem himself and make the MCA more relevant, it will not be able to do so in a BN hopelessly handicapped with ineffectual civil servants who have only seen one side of the coin – government service. Not a single health professional in this Ministry has any experience working in the private sector where accountability is all but mandatory. Any experienced healthcare professional in the private sector can reform healthcare services in this country to be on par with the rest of the world. As evidenced especially with the new governments in Penang and Selangor, the only way this Ministry is going to improve is for the PR to come to power. And for the sake of all Malaysians, the sooner the better.
When we met with YB Dato Liow, MOH, we have actually asked for the Act to be re-named ” Healthcare facilities and services Act ” to reflect that this Act is for all healthcare services in Malaysia. There should be no distinction between healthcare standards in Public and Private hospitals. What is good for Public shoyld also be good for Private. I think that is what the Rakyat expects.
When we met with YB Dato Liow, MOH, we have actually asked for the Act to be re-named ” Healthcare facilities and services Act ” to reflect that this Act is for all healthcare services in Malaysia. There should be no distinction between healthcare standards in Public and Private hospitals. What is good for Public should also be good for Private. I think that is what the Rakyat expects.
That’s why the problem ministries are given to MCA. It will be interesting if one conducts a study on deaths that occur in government hospitals due to slow response from medical personnel, inadequate service, medication or expertise.
Let’s be realistic, no Malay civil servant give a hoot to a Chinese Minister. In fact, the Minister fears them.
YB Lim,
You forgot to mention that when Liow was first appointed Minister, his DG within a few days announced that doctors will not be able to dispense medications any longer in a first page report in the NST. The same evening, YB Liow denied the report and said doctors will continue to be allowed to dispense.
2 weeks later he said the Ministry is conducting a study and probably initiate a pilot project to see if doctors can indeed stop dispensing and pharmacists prescribe.
No doubt the rakyat are more happy that they can see their doctor, get examined and collect their medicines at the counter before they leave the ever people unfriendly BN thinks they know better.
Doctors now include their consultation charges together with medications. Just imagine a doctors charging only for consultation in future…………. now we charge btwn RM 5 and 8 per visit, it may be btwn RM 20 and 30 in future. Why burden the rakyat further ? Would be prefer a one stop centre where u cld get what u want or two stops ?
The DG and Minister are set to finsih off the rakyat and the doctors !!!
Why hasn’t the health department done a clean up of Pulau Ketam. I agree that it is one of the filthiest place in Malaysia.
The MOH should also look into the facilities and staff of theirb hospitals. I have been hearing horror stories of the Unineversity hospital in Kubang Kerian, where the nursing staff are arrogant and refuse to help patients or immediate family members who wanted to assist the patients.
I know for a fact that to seek specialist attention would set me back a few months in government hospitals; simply because we lack the specialists who have run to private entity for better remuneration. Pay the Doctors well and they will be with the government. But no, MOH simply refuses to keep its promise.
We have good and bad goverment hospital as well as good and bad private hospital.It all boils down to the management of the said hospital.As far as the health ministry is concern ,The DG mades the rules,The health minister is just for dressing only.
If the health minister is serious of changes in goverment hospital, he must first get his own people to oversee all goverment hospital.I surprise that private hospital can buy medicines in bulk cheaper then goverment hospital.
when public hospitals are in a deplorable state with medicolegal cases rising in number, the Ministry is more interested in going after private doctors and hospitals.
Those who had contributed in putting Bee n clowns on the stage should not complain,.
It is audit time and it is 50 years too late, already 20 generations are lamed, now the moh, next, you all know lah. How to stop , revamp the whole moe first and get the hR back into contemporary values and into globalisation.
Never lie to yourself, our ways are doomed, lets change it before another 20 generations submerge go down the drain, it would be very very difficult then for the parent and the child, if i think if the parent is low standard then the child cannot be that brilliant either.
Funny how cannot meet bee end child in normal schools.
Lopez, this is because Bee End children are “ABNORMAL”. They don’t go to normal schools, they attend elite schools which means they do not have confidence in schools managed by the government they represent. This is analogous to slapping their own bloody face!!!!!!
“children are “ABNORMAL”. They don’t go to normal schools”
Local school time wasting and not many fresh ideas of today world.
Go to those International school, they can learn more abt. others civilization & today world rather than memorize from the textbook.
Promotion of competition to reduce healthcare costs in the private sector? Unfortunately, this does not seem to work because of
widespread “market failure” in the private healthcare sector. These are some of the reasons:
1) “Information asymmetry” between the provider (doctor or hospital) and the consumer (patient or family members)
2) Patient is unlikely to shop around for lower
cost providers when the need to seek urgent care arises
3) Consumers are unable to judge the quality of care provided
by providers (and whether the care provided is actually
medically necessary)
4) Psychology – people want the “best care” for their sick
relatives. Especially so, when a third party payer (such as an
insurance company is paying the bills)
Singapore Specialist is very successful in pulling Malaysian to spend there. Whereas, Indonesian will be coming to Malaysia to seek treatment, at Loh Guan Lye Specialist, Gleneagles Specialist, Island Hospital, etc.
I find comments made by “Suka Jaga Tepi Kain” are interesting and I’m sure they were based on his personal views. When the Minister of Health made the 2 statements they were made with public interests in mind.
With regards to doctors running too many clinics, the statement made was practical as it will be impossible for a doctor to manage and operate too many clinics at once. If this is allowed, it will be detrimental to the public because it will affect quality care and patient safety.
On the issue of overcharging by private hospitals, the Minister’s statement is reasonable considering the fact that costs of living is escalating. The PHFSA attempts to cap cost of treatment, thus protecting the public from exorbitant health care charges.
With regard to the bogus doctor, it seemed that the writer enjoys belittling the Ministry’s efforts to stem out bogus doctors. The Burmese Doctor’s case was properly investigated and appropriate action was taken.
The writer’s allegation that Ministry is employing unregistered doctors is mischievous. I would like to advise the writer to have his facts right before making such sweeping statements.
The writer went on to say that the Ministry had not looked into the amendments of the PHFSA. BAP would like to inform him that there is a special committee comprising of representatives from MMA, APHM, PCDOM, FPMPAM, MDA, FOMCA, CAPS, PPIM and MMC to look into the amendments to make the law more stakeholders friendly.