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.