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.