Category: Health

Letters
by LTT

I refer to Dr. LMK’S letter “Eye specialist problem – another multiracial problem”, and sympathize with this ophthalmologist who wants to come home but is prevented as a result of bureaucracy pertaining to his postgraduate qualifications.

Some have commented that Dr. LMK should just go on to another country where his skills will be better appreciated, but this would be in essence giving in to racist policies that have now slithered into our professions. It would also mean that the change that all those Malaysians were yearning for when they took to the streets and turned up in massive numbers at all those ceramahs leading to the ruling party losing in five states and at the same time almost politically annihilating the previous government would have been for nothing. Further, all the efforts and sacrifices the DAP/PKR/PAS have made to seek a just Malaysia that practices equitable policies may come to naught. Malaysians must stand their ground and must unearth or hunt down the zealots and charlatans who prey on this country’s masses and in this case its medical institutions.

Dr. LMK should be commended that he wants to return home to make this country a better Malaysia. All right thinking Malaysians who have helped transform the political landscape should help him and other Malaysian doctors who plan to come home, by ensuring that the doctors who have hijacked this country’s healthcare system are flushed out once and for all. Dr. LMK should rest assured that there is nothing wrong with his Fellowship qualifications. The problems are all here with the so called “Master’s programs” and the muddled policies at the Academy of Medicine and the Ministry of Health which have been put in place by self-serving specialists who suffer a serious dose of inferiority complex. Continue reading “MCA to blame for marginalisation of foreign Malaysian specialists”

Letters
by Dr. LMK

I am an eye specialist (ophthalmologist) currently practising in UK, I
cannot come home because of my specialist degree.

“FRCS(Glasgow) in Ophthalmology” (hereinafter refer as FRCS) is a
specialist degree recognised by the whole world, the eye specialist
must go through a proper training and exam in order to get this
degree. Many eye specialists in many are holding this degree
including our famous eye specialists in Tun Hussain Onn Eye Hospital.

FRCS was confered by 4 boards, ie, Edinburgh, London, Ireland and
Glasgow. In 1999, UK has decided to change its training service due
to the European Union. FRCS exam was be replaced by MRCS exam. For
your information, MRCS is not a recognised degree in Malaysia.
However, Glasgow board is STILL offering this exam for this degree
until NOW. Continue reading “Eye specialist problem – another multiracial problem”

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. Continue reading “More bull by DG Merican”

Letters
by EJB

It is with regret that medical practitioners learn of a doctor being jailed under the Private Healthcare Facilities and Services Act 1998 (PHFSA) for not registering his clinic. This is clearly not what was promised to doctors when both the current Director General of Health, Ismail Merican and the previous Health Minister Chua Soi Lek were all gung ho about implementing an Act that was clearly poorly drafted. When the PHFSA came into effect on Nov 1, 2006, there was great resentment and distrust among private doctors. The PHFSA was regarded as an insult to their integrity and demeaning the profession. Many were distrustful about the implementation of a haphazardly written law by a ministry known primarily for its incompetence.

Despite the misgivings of senior GPs, specialists, ex-DGs, ex-MMA chairmen and even a senior judge such as Datuk Mahadev Shankar who was an authority on medico-legal proceedings, both the Minister and the DG ran roughshod over their objections in implementing this law. Doctors still recall how Chua and the DG quickly convened a meeting when medical practitioners threatened to march to parliament. At the meeting, they promised various amendments to the Act. The Malaysian Medical Association (MMA) and other medical associations trusted the word of both the Minister and the Director General and did not even push for all the changes to be in writing before the law was passed.

But today it is clear that the word and the credibility of the Director-General means nothing as the regulation has now claimed its first victim, Dr. Basmullah Yusom, a USM graduate, registered with the Malaysian Medical Council with a valid Annual Practicing Certificate. He was fined an unbelievable RM120,000 and jailed subsequently for three months when he could not afford to pay this fine. He couldn’t even afford counsel. Anyone, long enough in the profession will tell you that there are many medical practitioners who serve their communities quietly without expecting too much in financial returns. Continue reading “Botched PHFSA – why the Director-General of Health must resign”

Letters
by RS

With reference to media reports of a doctor being convicted for not registering his clinic, (Jan 19th 2008), it is incomprehensible that this registered doctor was fined a whopping RM120,000 for not registering his clinic. And since he couldn’t come up with the fine, he was sent off to serve a three month jail term at Kajang Prison.

In April of last year the DG of Health, asserted that the Private Healthcare Facilities and Services Act 1998 (PHFSA) was enacted to direct private hospitals to carry out their social responsibilities and was not meant to be punitive or detrimental in nature.

He and the previous Health Minister, Chua Soi Lek, further assured the medical community that since the Act was outdated, changes would be made and ratified by the Attorney-General’s chambers.

These changes have yet to be agreed upon or ratified but the Act has already been applied leading now to a doctor being convicted on a technicality.

Will the DG now tell the judge, that she should not have passed this type of sentence? Of course not, because that is not how the law works once an Act is passed. Continue reading “Will Ong Ka Ting review the PHFSA?”

Letters
by FK-506

In reply to Carpe Diem’s cherry picked quotes to the letter, ‘Organ transplant: Are we on the right track?’, the writer’s attempts to endorse this country’s nascent transplant program by trying to downplay key issues in any transplant program — financial implications and controversies surrounding brain death is reprehensible.

Quote : “… … … ..it isn’t quite right to place patients on VADs which have a limited life of their own into patients, not knowing if they are ever going to get a heart. This cannot be ethically correct.”

“Is it more ethical to deny me this option, based on not knowing whether I will get a heart in time, if the expertise is available and I am more than willing?”

For how long and at whose cost? Is Carpe going to pay this out from his or her own pocket? Clearly this person doesn’t realize the economic costs of such programs on government expenditure, unless of course, Carpe thinks that it is the state’s moral duty to transplant everyone with end-stage heart failure, liver failure, renal failure, etc. Chua Soi Lek moaned only last year that the MOH couldn’t afford to pay the RM900 million pharmaceutical bill for patients being treated by the Ministry. But miraculously he today is quoted to have said that the Cabinet, which has never shown respect for tax-payers money, is willing to provide even up to a billion ringgit for a transplant program. Incredible. Where is the set of priorities? Why don’t the cabinet approve the billion ringgit so that patients get better care, better follow-ups, better education programs, home nursing and of course better medicines, so that less patients end up in heart failure, renal or liver failures.

The age old idiom “prevention is better then cure” must hold true for this country based on the economy that we have unless Carpe is advocating American style healthcare, in which case, I would like to suggest that the technology be kept going but all transplants be borne by private funds. And I do hope Carpe fathoms the economic consequences of transplant programs. I hope he/she realized what happened to Barnard’s pioneering transplant work at Groote-Schur in South Africa. Transplant programs were immediately shut down by incoming President Nelson Mandela in 1994 when he realized that precious and limited health resources that could be used for Soweto’s populace suffering from cholera, typhoid, malaria and an AIDs incidence of almost 14% in some provinces, were being channeled to a glamorous transplant program. Are we in Malaysia any different if the startling statistics provided by our own MOH are anything to go by? In Sabah alone, even decades after independence, we have still not eradicated malaria and TB.

Quote: “Merican howled that what SJMC and Tan did were improper as ignorant patients may “not have been briefed about complications”. Tan, who pioneered liver transplant techniques at King’s College, London, of course left, preferring to base himself in “less ethical” Singapore, leaving Merican to focus on traditional medicine back here in Malaysia.”

That Merican howled is a fact. It is also a fact that K.C. Tan announced in the media that he was not willing to work in the ethical environment imposed on him. But the end result of this entire episode was clear. Malaysia’s liver transplant program in the private sector, supported quite earnestly by the media even then, was dead in the water. No RM30 million, 100 million or 1 billion ringgit boost to this program, although it was led by a Malaysian surgeon and the incidence of patients requiring liver transplants were equally a concern. Even private donations collected to help patients in this program were ultimately taken over by the Ministry. Why the double standards? Was it because K.C.Tan was a private surgeon working at a private hospital? Or was it due to something else? Yes the insinuation is direct. I am sure readers can make their own conclusions. Continue reading “Organ transplantation…brain death and financial implications (3)”

Letters
by Carpe Diem

I would like to comment on the letter by FK-506. However I will try to focus on rebutting factual inaccuracies in his letter, rather than comment on his insinuations and innuendos as my interpretations of his statements may be flawed.

Quote : “………..it isn’t quite right to place patients on VADs which have a limited life of their own into patients, not knowing if they are ever going to get a heart. This cannot be ethically correct.”

Whether this is ethically correct or not depends on the patient’s wishes, the facilities available and expert opinion. Unfortunately this is one area where opinions matter. An individual may consider it mental and physical torture to be hooked to a machine with no definite end in sight, but another may consider it a lifeline to a possibly better future. Is it more ethical to deny me this option, based on not knowing whether I will get a heart in time, if the expertise is available and I am more than willing?

Quote : “Merican howled that what SJMC and Tan did were improper as ignorant patients may “not have been briefed about complications”. Tan, who pioneered liver transplant techniques at King’s College, London, of course left, preferring to base himself in “less ethical” Singapore, leaving Merican to focus on traditional medicine back here in Malaysia.”

Well I have no love for traditional medicine, but I don’t see how this case affects the current scenario. Anyway, if I am not mistaken the issue against KC Tan then was on unrelated living donors. Please correct me if I am wrong. Continue reading “Reply to ‘Organ transplant: Are we on the right track?’ by FK-506”

Letters

by FK-506

As motorists on the NKVE scrambled to let pass the police outriders followed by a Perdana with an IJN logo with a host of other ambulances heading towards Subang Airport on Wednesday afternoon, many suspected the heart that 14 year old Tee Hui Yi so badly required after being placed on an ventricular assist device (VAD) for almost 12 months may have finally arrived. And indeed it had as she had her transplant done almost the same night courtesy of an unfortunate 15 year old accident victim who was declared brain dead at Ipoh General Hospital.

The miracle was all the more phenomenal as Tee Hui Yi’s predicament was highlighted only the day before on the front pages of the New Straits Times. Sadly she is said to have suffered a “hyperacute rejection” of her transplanted heart and had a second one put in which IJN happened to get from a patient from JB. Two hearts all in a day for one patient when none was available for almost a year. Miracles and coincidences do happen just like the statue of Virgin Mary crying blood sporadically in various churches around the world on Christmas. Hopefully Tee Hui Yi’s saga will finally end with her recovering fully.

Tee Hui Yi apparently developed viral myocarditis at the age of two and progressed to end stage heart failure. The indication for the expensive bridge to a natural heart in the form of the artificial ventricular assist device was presumably the failure of medical therapy in not being able to maintain her circulation optimally anymore on conservative therapy. In simple terms, for a future, she would need a heart. The VAD was just a stop gap. But in Malaysia this bridge to a heart or for that matter any other organ can be exceptionally long, arduous and occasionally a bridge just too far, leaving in its trail thousands dead on waiting lists. Continue reading “Transplantation in Malaysia – are we on the right track?”

by ZK

Criminalization of doctors under Chua Soi Lek and Ismail Merican even after the PHFSA (Private Healthcare Facilities and Services Act) appears unabated. The Malaysian Medical Council, without prior notice, recently instituted its own form of CTOS, the database company that displayed financial data publicly without updating them. The MMC is now making available to the public particulars of all doctors in Malaysia including complaints hurled at them – PROVEN OR NOT. Running down people and establishments is now a favorite Malaysian past-time but the MMC appear to have further refined this into a fine art form. This new CTOS (Complaints Tip Off Service) is yet another example of the convoluted thinking that exists in this Ministry.

The website itself appears rather slow and unstable but what is more alarming is it appears out of date. A recent prominent case is listed as still being processed and government doctors who have had complaints against them including the pediatrician responsible for the loss of the little baby’s arm at Klang are not listed. More disturbing is, complaints against MMC Council members given prominence in our local newspapers and complaints against MMC secretariat members are mysteriously excluded. If this sort of selective persecution and non–updating of this database is going to exist, why implement it in the first place? It will just create another CTOS furore. An ambition for first world infrastructure matched only by a third world mentality is always a recipe for disaster which has been proven time and again in Malaysia.

Now who could have been responsible for this and did the Minister know about this new implementation? The Malaysian Medical Council appears to be broadly divisioned into Council members and a general secretariat which instead of being neutral is mainly comprised of seconded MOH staff. The Council itself has only 9 members from the private sector out of 21, the rest being from the government sector. Continue reading “The Medical CTOs”