1Care outpatient scheme – middlemen didahulukan?

Joint letter by Drs Ong, Haniffah & Palaniappan | Apr 19, 11
Malaysiakini

The government is introducing a new financing scheme for primary care (1Care for 1Malaysia) by forming a private company/corporation to act as an insurance company and managed-care organisation (MCO). We believe this company will:

i) collect funds from all working adults and employers

ii) pay for all primary care expenses ie. for outpatient visit, test and medication at both private and government clinics

In theory this scheme will save consumers from having to pay out-of-pocket for their primary care and thus protect them from excessive healthcare expenses. In reality the new company may become a middle man profiting from patients and their caregivers, with the result that healthcare costs go up, standard of treatment may drop and the public is burdened with a new healthcare tax.
Continue reading “1Care outpatient scheme – middlemen didahulukan?”

Sabah health services limping along

By Michael Kaung
May 15, 2011 | Free Malaysia Today

KOTA KINABALU: Sabah DAP said that it has received scores of complaints regarding the services rendered by the Federal Health Ministry to Sabahans in terms of quality of treatment, medical supplies and equipment.

Junz Wong, state DAP assistant secretary, said that both the patients and doctors are unhappy and frustrated with the state of affairs in the medical and health services.

The party believes that Sabahans are among the most ill-cared for citizens in Malaysia due to lack of drugs and healthcare equipment.

Wong justifies his claim by pointing out that Sabah only one radiotherapy machine for the whole state.

In the past, before the Sabah Medical Centre (SMC) was bought over by government, the hospital rented the radiotherapy machine.

Now after taking over the SMC hospital, the government is still renting it. Continue reading “Sabah health services limping along”

LKS, Get Well Soon

By Wong Ho Leng

Because of the Sarawak election, he delayed his cataract operation…

That fateful morning, we were put up at Kingwood Hotel, Kuching. I wasn’t surprised that LKS had called at 7 something in the morning. He does that quite often to me, to exchange political views. But this was an exceptional morning. He said something was wrong, and he wanted to meet me at the cafeteria of the hotel. 15 minutes later, he called again, and asked me to be in his room. I saw LGE, in his pyjamas, with his dad. LKS had a serious eye infection. We earnestly looked for a specialist. It was too early, and it was a Sunday. Anyway, we managed to get one. CSC would be coming to fetch, and I accompanied LKS to his breakfast. We shared about his fear. From outside, he was cool as a cucumber. He obliged when hotel guests requested photo shoots with him. None of them knew that one of LKS’s eyes had suffered a serious vision impairment from a rare infection. To me, it was a long breakfast. As Siew Chiang’s car drove him off, I offered a silent prayer for LKS.

LKS is a workaholic. Despite his eye operation, he still worked with his iPAD, and, we still communicated over the phone. Each time, before we delved into politics, I asked him about his condition, and he would give me the most elaborate detail. He must have gone through unthinkable pain, and, reading the text of LGE’s statement, I can understand LGE’s feelings towards his dad…
Continue reading “LKS, Get Well Soon”

A long haul

Tweets @limkitsiang:-

5th day:
[Admin] LKS 5th day w/o vision on left eye. However surgeon optimistic of sight recovery after Vitrectomy op. Q: how much? Wil b longhaul

4th day:
[Admin] LKS w/o vision on left eye for 4th day. Depending on outcome of Vitrectomy op to restore sight. Pray for the best.

Kudos to Prof Bong and Prof Hanafiah of HUKM

Tweets @limkitsiang :

@UKM Specialist Centre where SohAhKee(Mrs PangHokLiong) underwent miraculous +12hr rare pancreatic cancer operation othr specialists decline
04/19/2011 11:20 AM

Ops on 8/4 830am to 845pm carried out by young HepatobiliaryPancreatic Specialist Prof BongJanJien n team – believed 1st such ops in region
04/19/2011 11:29 AM

Prof Bong n specialists in HUKM show our talents compare w best in world Msia must retain/inspire them 2stay instead of joining braindrain
04/19/2011 11:35 AM

Specialists in Spore Malaysia declined Whipple ops on SohAhKee cos she has tumour virtually encasing her arteries n too dangerous 2operate.
04/19/2011 12:15 PM
Continue reading “Kudos to Prof Bong and Prof Hanafiah of HUKM”

Sibu Hospital : A sad story of Sarawak

Letter by Mimi

This is a sad story of Sarawak and the Sarawakians.

What went wrong in Sarawak?

From the photos taken at the Medical Ward at the Sibu in Hospital, no one would believe Sarawak is one of the largest contributors to the Federal fund.

End of Dec 2010, I spent some time caring for a relative who was admitted at the Sibu Hospital. From the outside, this hospital looks like a 3 star resort. However, inside the hospital, the story is totally different.

This is 2011. How come there is no air conditioning in the Medical ward (I didn’t have the time to check out the other wards)? During the day, the ceiling fans are merely swirling warm, muggy air in the ward. It’s so hot & balmy that the patients leave their tops unbuttoned (yes, even the female patients).
Continue reading “Sibu Hospital : A sad story of Sarawak”

NDM-1 – is it the death knell for medical tourism?

Letters
THE MEDICAL SENTINEL

Medical tourism, long ostracized as an evil third world nations with limited health-care resources should not be dabbling in, may have finally met its fatal match. Last week, the British based, Lancet Infectious Diseases Journal reported the emergence of highly resistant bacteria carrying a new gene termed New Delhi Metallo-beta-lactamase (NDM-1) and specifically associated it with medical tourism as the bacteria seems to have originated in patients frequenting India and Pakistan for procedures such as cosmetic and transplant surgery. NDM-1 is actually an enzyme that is produced by bacteria. The ability of bacteria to produce NDM-1 is apparently the result of mobile genes that can readily jump from various different bacterial populations allowing them to incorporate these special genes into their chromosomes.

The danger of NDM-1 is that it can fight against most known antibiotics known to man, thereby rendering the human species defenseless against these superbugs. It was first discovered in December 2009 by Yong and associates who described them in a Swedish national who fell ill with an antibiotic-resistant bacterial infection that he acquired in India. The infection was unsuccessfully treated in a New Delhi hospital and after the patient’s repatriation to Sweden, the gene was identified there.
Continue reading “NDM-1 – is it the death knell for medical tourism?”

Is new Medical Act responsible for dumped babies?

Letter
by Rudolf Tiller

IS NEW MEDICAL ACT RESPONSIBLE FOR DUMPED BABIES?

The frequency of babies/ fetuses found dumped at doorsteps, garbage dumps, drains, rivers, some killed blatantly and buried, or flushed down toilets have been on the rise over the last two to three years. Media reports suggest that the incidences reported are just the tip of the iceberg.

Shahrizat has claimed more support be given to single mothers. A lawyer apparently by profession, her latest outrageous outburst has now been to reprehensibly execute the parents. Ali Rustam has this novel idea that special schools be built only for teenaged mothers but soon after decided that an expedient scheme would be to actually reduce the matrimonial age to a minor 15 years. Rosmah on the other hand, appears totally lost and doesn’t seem to know actually what to do. But at least she has not come out with some of the ludicrous propositions suggested by Shahrizat or Ali Rustam.
Continue reading “Is new Medical Act responsible for dumped babies?”

Chinese-Malaysian a ‘living treasure’ in NZ

Introducing cells to suicide
by Jane Tolerton | NZ Listener

A breakthrough strawberry-birthmark treatment discovered by a New Zealand surgeon and his team points the way to treatments for other tumours.

Swee Tan is a master of the rhetorical question. Outlining how his research into strawberry birthmarks could lead to a new way of treating cancer, he asks: “Would that be a good thing?” Suggest he could be making big money in cosmetic surgery overseas, and he asks, ‘Would I be a happy man?”

Hutt Hospital’s director of surgery should be happy enough – because what began as his research into disfiguring strawberry birthmarks has just won his four-strong research team a major international science prize. The implications for cancer treatment and regenerative medicine are so valuable that news of the award has been under wraps for a couple of months while the intellectual property involved has been registered internationally.
Continue reading “Chinese-Malaysian a ‘living treasure’ in NZ”

National Health Financing Scheme…. more money for who?

Letters
By Liow Kevorkian

I refer to Health Minister Datuk Seri Liow Tiong Lai’s statement to the New Sunday Times stating that to ensure all Malaysians get adequate healthcare, wage earners will have to make scheduled monthly contributions to the proposed National Health Financing Scheme (NHFS). The self-employed, those who have an independent income as well as employers would also have to contribute.

I do hope the Pakatan Rakyat take their gloves off and beat this guy to a pulp on behalf of us tax payers before this entire scheme becomes another national shark swallowing contributors’ and tax payer’s money ripping another financial hole in our already empty treasury. The current Health Minister who has no significant support from even his own community and his hopelessly inefficient Health Ministry officials must first be made accountable for all the healthcare disasters that have made this country firmly entrenched as a third world nation in healthcare.
Continue reading “National Health Financing Scheme…. more money for who?”

The destruction of SMILES in the Land Below the Wind

Letters
by P.S. Nathan

I served as the Timbalan Pengarah Kesihatan (Pergigian) for Negeri Sabah from August 1987 to Nov 1990, In short I was posted from Johore to Sabah to take charge of the Dental Service there.

In 1985 a Survey of Dental Health of the School Children in Sabah was carried out, and I was part of that team that conducted that survey. My team covered mainly the East Coast area of Lahad Datu, Semporna and Padang Tunku area.I was also a member of the Committee that drafted the Survey report, and the Committee made Recommendations for the improvement of the Status of Dental Health of the School Children of Sabah.One of the main recomendations was that all Public Water Supplies should be Fluoridated.

In 1989 the then Sabah State Government took the most Unfortunate step of ‘discontinuing the Fluoridation of Public Water supplies in the State of Sabah’ Because “Water” was a state matter, the Ministry of Health could not do anything besides presenting the Report of the Special Committee of the World Health Organisation’ that did indeed recommend the “Fluridation (the optimisation of Fluoride levels) of the Public Water Supplies.That Special Committee of the World Health Organisation also noted that ‘Fluoridation of Public water supplies was the Most Cost-Effective Public Health Measure known to man’. Continue reading “The destruction of SMILES in the Land Below the Wind”

MCs by 1Malaysia clinics – illegal?

By Dr Anony

I refer to the reply given by Dr Nooraini Baba (NST, March 30th, 2010) in which she claimed that Assistant Medical Officers (AMO) can issue Medical Certificates.

She had then explained that the MCs issued by AMOs are not illegal, but just that they are invalid for the purpose of workers absenting themselves from work without pay under Section 60F of the Employment Act. In her reply, Dr Nooraini had quoted from the MEDICAL ACT 1971 (Act 50).

I would like to point out that there is NO provision under any Act of Parliament for the Medical Assistants who man the 1Malaysia clinics, to be referred to as “Assistant Medical Officers.” Instead, the
Medical Assistants are governed under the MEDICAL ASSISTANTS (REGISTRATION) ACT 1977 (Act 180), and they are thus properly referred to as Medical Assistants, and NOT as “Assistant Medical Officers.”

Continue reading “MCs by 1Malaysia clinics – illegal?”

Private or public wings are but a fallacy

Letter by JT

It appears that yet again, CAP’s SM Idris has decided to go on a frolic of his own. This time by stating that Private Wings in Government Hospitals are the wrong things to do. Sometimes one really have to suspect if this guy truly knows what he is talking about or goes about criticizing everything and anything sundry just to occupy his time. There are only three components to a hospital bill: 1) Doctor’s fees 2) Hospital charges (Bed, Nursing, Utilities, Investigations, etc) and 3) Consumables (Medicines, gloves, catheters, stents, etc).

This government has been benevolent enough in providing and perhaps in the case of Sabah trying to provide, items 2 and 3 but cannot match up to 1. Idris wants equitable healthcare for everyone. When he says equitable what does he mean? If he means placing a few GTN tablets under the tongue for a heart attack, or placing a plaster of Paris cast for a broken tibia, or delivering the 3rd child in a mother with no co-morbidities, or putting up a drip for a dehydrated patient or placing a few stitches on a wound caused by the neighbor’s dog, that’s fine. This government would have no problems accommodating them.

But if he is talking about plating/nailing every fracture of a victim of a high speed polytraumatized patient, reconstructing all the facial bones in an accident victim, or doing a bypass for a coronary patient with recurrent pain or ballooning and placing an emergency stent in a patient with a heart attack or doing a liver transplant in a patient with liver cirrhosis, then Idris must surely know that even all of Malaysia’s Continue reading “Private or public wings are but a fallacy”

1Malaysia clinic: is the Health Ministry above the law?

Letter
By RS

It is distressing to learn from Dr. T. Jayabalan, the health adviser to the Consumers Association of Penang that medical assistants are giving out prescriptions for the wrong medicines or prescribing medicines which they are not allowed to prescribe and they have also been found to have wrongfully diagnosed patients at a study conducted at Kampar, Perak. And feedback thus far, from the MOH regarding the validity of MCs (Medical Certificates) issued by 1Malaysia Clinics have been unsatisfactory. The explanation issued by the Health Ministry’s Medical Practice Division officer, Dr Noraini Baba, stating that according to an internal MOH circular, MAs are allowed to issue MCs seems to suggest that she either doesn’t know the law or thinks she can actually circumvent a law through a department circular.

But perhaps CAP too should share of the blame for this vague situation. The last time they made so much noise, it resulted in ignorant officers at the Health Ministry rushing to pass an reckless legislation called the Private Healthcare, Facilities and Services Act (PHFSA) which was conjured up in the dark corners of the Health Ministry and stamped with the Official Secrets Act (OSA) effectively excluding the stake holders from taking part in the discussions. The Act is surely unconstitutional.

A doctor today with an Annual Practicing Certificate (APC) is legal under the Medical Act 1971 but becomes illegal if his premise is unregistered under the PHFSA 2006. But a Hospital Assistant (HA) working in a presumably legal PHFSA premise, 1Malaysia Clinic, becomes immediately illegal Continue reading “1Malaysia clinic: is the Health Ministry above the law?”

Najib should give Liow Tiong Lai an ultimatum to resolve the Sabah health crisis or be sacked

I am shocked and outraged by a letter I have received from a serving medical officer of Queen Elizabeth Hospital in Kota Kinabalu about the deplorable conditions of the hospital complexes in Sabah particularly Kota Kinabalu which had been likened to Vietnam refugee camp.

Datuk Seri Liow Tiong Lai had been Health Minister for more than two years and despite repeated complaints, he had turned a complete deaf ear and blind eye to the prolonged healthcare crisis and the deplorable hospital conditions in Sabah particularly in Kota Kinabalu.

The serving doctor in QEH wrote of the horrors suffered by the sick in Kota Kinabalu where they are subjected to “a wicked game of musical chairs” shunted around various hospital centres according to their changing healthcare needs as “there is not a single centre that can address a patient as a whole”.

The medical maze, which has brought total chaos to healthcare services in Sabah, includes the state’s only referral centre, Queen Elizabeth Hosptal and nearby centres like Hospital Bukit Padang the mental institution, Hospital Likas, the makeshift hospital in Lingzhi Museum in Kepayan and Umno’s favourite Sabah Medical Centre (SMC). Continue reading “Najib should give Liow Tiong Lai an ultimatum to resolve the Sabah health crisis or be sacked”

Class divisions in access to healthcare — what about Malaysia?

By Azly Rahman

‘Why can’t all Americans have the same access to healthcare to those enjoyed by members of Congress?’ is a popular question on the ObamaCare debate.

At the time of writing I am following the debate over universal healthcare for all Americans. If the US$1 trillion Bill passes, it will help insure 32 million Americans that do not have access to healthcare.

This is another controversial issue in the tradition of Democrats and Republicans. This is a good case study of one of the enduring issues of an advanced capitalist state.

I know friends who do not have health insurance and who question the human rights dimension of it – right to life, liberty, and the pursuit of happiness, endowed by the Creator who insist that ‘all men are created equal’ and cautioned by the Enlightenment thinker Jean Jacques Rousseau that “… everything is good in the hands of the Author of Things and everything degenerates in the hands of Man”.
Continue reading “Class divisions in access to healthcare — what about Malaysia?”

Rumah Sakit Yang Sakit

An Open Letter to Health Minister

Dear Yang Berkhidmat Liow Tiong Lai,

Mr. Wong, an elderly man presented at Hospital Likas because of severe breathlessness and was found to have severe pneumonia on chest x-ray.

He was then admitted to the High Dependency Unit of Queen Elizabeth Hospital (QEH) 30 minutes away for treatment.

He improved after six days and was then transferred to the normal ward for further recuperation.

A bed was urgently needed one day later and the frail Mr. Wong was then shipped off to Hospital Bukit Padang for ‘rehabilitation’.
Continue reading “Rumah Sakit Yang Sakit”

Healthcare As A Bottomless Pit

By M. Bakri Musa, MD, MS, FRCSC, FACS

[Invited editorial, Malaysian Journal of Medical Science, 17(1):1-2, Jan-Mar 2010.]

As a young surgeon at the General Hospital Kuala Lumpur in the 1970s, I remember pleading with Tan Sri Majid Ismail, then Director-General of the Ministry of Health, for funding of my research project.

A distinguished clinician turned policy maker, Tan Sri Majid was professionally interested in my proposal. Nonetheless he politely declined it, but not before offering me a comforting explanation. Between funding me and building a Klinik Desa (rural clinic) in Ulu Kelantan, the choice was clear, he gently told me. Besides, he assured me, I would have minimal difficulty securing funding elsewhere while those poor Kelantanese had no choice.

Tan Sri Majid said something else that reverberates in me today. “Healthcare is a bottomless pit,” he advised me, “but the resources to meet those literally endless worthy needs are limited, so society must set its priorities and draw the line somewhere.” The job of government is to ensure a minimal acceptable level of care for all, he added, and beyond that it is for individuals to set their own limits with their own resources.
Continue reading “Healthcare As A Bottomless Pit”

Bumburing Calls On Health Ministry To Expedite Upgrading Work On Tuaran Hospital

TUARAN, March 5 (Bernama) — Former Sabah deputy chief minister Datuk Wilfred Bumburing has called on the Health Ministry to expedite the upgrading of the Tuaran hospital to cater for the health care needs of about 120,000 people living in the area.

He said the hospital was in dire need of upgrading and it was sad that a hospital for a large district like Tuaran, with a population of 120,000, had no bed at all.

“I was also told that the hospital had been downgraded to a clinic in the past. In my speech in Parliment last year to debate the 2010 budget I have outlined all the reasons and rationale as to why the construction of the hospital is most urgently needed,” he told reporters here on Friday.

However the member of Parliment for Tuaran denied DAP advisor Lim Kit Siang’s recent allegation that the BN government had not done anything to develop Tuaran.

Bumburing said the Health Ministry had assured him that the second phase construction of the hospital would start this year.

“While appreciating Kit Siang’s concern, I have to mention that we in the Barisan Nasional have carried our duty and responsibility in bringing up to the relevant authorities matters that are of urgent public interest,” he said.
Continue reading “Bumburing Calls On Health Ministry To Expedite Upgrading Work On Tuaran Hospital”

Cockcroach and Blood Stained Blankets in Hospital

Letter by Ganesh

My wife recently delivered our baby in Pantai Hospital Bangsar, Kuala Lumpur. Being a premium hospital situated ideally to cater to the Damansara Heights and Bangsar affluent residents, one would expect minimum standards of service and hygiene to be practiced.

I was appalled to find that the hospital had blood stained blankets and was infested with cockroaches.

Our nightmare began on the first day we checked in at about 1 pm. That evening, the hospital forgot to serve the tea time snack and also the dinner meal. When asked why, they could not give a proper explanation and had just said, “sudah lupa”.

My room was a brand new room that was just set up for a new patient. Initially, there were no blankets. My wife who was admitted, was freezing in the room for several hours. I had to ask several times for blankets to be given. However, when the blankets did come, the blankets were heavily stained with dried blood and urine. Refer to the enclosed picture. The staff nurse confirmed it was dried blood. I was shocked beyond believe. I immediately asked the nurses for an explanation but they were unable to give me a reasonable explanation. I demanded for the blankets to be changed.
Continue reading “Cockcroach and Blood Stained Blankets in Hospital”