Letters by EJB
I refer to the newspaper report “Doctors to be disallowed from dispensing Medicine” NST 29th March where the DG of Health has apparently agreed to a pilot proposal where doctors seeing patients at their clinics only prescribe and patients will then have to locate a pharmacy where they will have to purchase their medications separately. Don’t ask when these negotiations started and who were at the discussions who finally agreed to this proposal. In all likelihood doctors’ representatives were either kept away or presumably threatened with the OSA (Official Secrets Act)
It seems the ruling party has learnt nothing from the last elections. More pertinently one must ask. Is this a dying priority for the Ministry of Health now especially when it reported only these last 48 hours about the lethal outcomes of the dengue scourge which it has repeatedly shown it is unable to control and the rising incidence of resurgent tuberculosis? We will not even discuss about waiting time for patients who queue up to see doctors at 4 am in the morning or of parents begging in the media for financial help to save their sick children.
The DG of Health, one would have thought, would have his hands full trying to pool his resources without digging further holes he cannot cover. But there you are. He appears to have caved in to the pharmacy lobby. This debate is not new. It is ancient in terms of healthcare provisions in Malaysia. The basic contention. Why should General Practitioners or other doctors prescribe when there are pharmacists around? Answer, for the convenience of the patient especially in the rural areas or in locations where pharmaceutical chains open ten stores to show a 30 million ringgit turnover so that they can get into the second board while employing only 5 pharmacists to cut costs. These pharmacists will only be in during shift hours and usually not available after 9pm where the rigors of a 24 hour practice will call upon the dedication and commitment of a medical doctor where treatment and prescription come hand in hand.
Was this proposal also the result of a pow wow discussed quietly and clandestinely in a remote backroom of the Ministry? Or could the flashing of this sudden pilot proposal headlined in the NST’s frontpages an attempt to improve Merican’s rather sagging image recently. However, if Merican and co have proposed this truly in the belief that it is for the benefit of patients, then they cannot even possibly fathom the inconvenience they will now inflict on patients who will have to hop off two different locations for medical treatment especially if they are a distance apart.
It appears that Prime Minister Abdullah Badawi is essentially saying it’s business as usual and may have indeed missed a point what the electorate was trying to point out to him in the last elections. Cost of living has boomeranged out of control for much of the middle and lower income groups in this country. The idea is to reduce costs and keep them down if you can, not increase it. This maneuver by pharmacists with the tacit approval of the DG of Health doesn’t point in that direction. This pilot project appears to be directed to enhance or further secure the business interests of pharmacists rather then a genuine calling to help patients. The Malaysian Pharmaceutical Society president John Chang Chiew Pheng’s statement that this move will not necessarily cost patients more is decidedly less then assuring. Hopefully the new Health Minister, Liow Tiong Lai, doesn’t have a hand in this considering the fact that he denied the statement later the same evening. If he has, then clearly lessons of the past have not been learnt.
The Ministry and Malaysian healthcare in general face some serious problems, especially the lack of doctors, accessibility to specialists, waiting time and rising incidences of some serious illnesses both infective and degenerative. The Minister and his DG with their limited resources must focus on this rather then pander to businesses such as the pharmaceutical and medical equipment industries. It was bad enough during Chua Soi Lek’s time when for some mysterious reasons best known to him; he appeared focused on traditional medicine when the nation was having problems even running its conventional medical services properly. Shouldn’t the MOH be trying to make services more convenient for patients instead of fragmenting them and making patients run all over the place for consultations, tests and now prescriptions? Who runs this Ministry anyway?
EJB