Letters
by CSK

I am a local graduate and have been in practice for 31 years. I am basically a physician by training and received my qualifications from the Royal Colleges in 1985. I see mainly kidney ailments and their predisposing illnesses which usually are high blood pressure, diabetes and heart ailments.

I was in government service for twenty years and the remainder now in private practice. I run a clinic in Penang and have visitation rights to private hospitals.

When I was in government service, yes, there was much bureaucracy. But nothing of the sort we see today. There was a greater deal of camaraderie. And although there were differences with private hospitals or clinics, generally everyone learned to work together.

When I first opened my clinic, it was fairly a straightforward affair. Apart from my APC (Annual Practicing Certificate), it was just ensuring the clinic was adequately equipped to treat the type of patients which I knew I would be treating, and making certain I had the type of medication I wanted to prescribe to my patients generally.

My first brush with the law, if you can call it that, came when a group of government medical assistants and health inspectors walked into my clinic without notice and brusquely gave me a warning regarding a new rule regarding toxic waste and how we should dispose them in yellow containers recommended by the ministry. I complied.

About two years later, there were problems regarding my X-ray machine, when third parties who appeared not so knowledgeable but apparently approved by the Ministry of Health, started walking in and out of my clinic for purposes of calibration and licence renewals. I could not quite understand why the supplier or manufacturer himself was not allowed to service or calibrate these machines. The cost ran into thousands of ringgit which I had to pay.

To add insult to injury, I was forced to attend Continuing Medical Education (CME) programs run by what looked like staff who didn’t know much about the programs they were conducting despite myself having a qualified radiographer to do the X-Rays. The cost of the CME programs again had to be borne by me.

And then came the PHFSA (Private Health Care, Facilities and Services Act). No one understood the need for this Act. Read the rest of this entry »

Letters
by Balwant Singh

I read with great interest regarding plans to privatize the National Heart Institute announced recently. As a former heart patient, who had surgery performed in Penang Hospital Heart Centre, another government facility offering cardiac services, I would like to clarify a few points regarding this issue.

Firstly , the main reason IJN has been successful is the fact that it has managed to attract and keep a group of dedicated cardiologists and surgeons, who continued to develop the service and subsequently contribute to the success story it actually is today.

This is possible because IJN has managed to escape the long bureaucratic arms and clutches of the civil service which more often becomes a hindrance and certainly a push factor for doctors leaving for the more lucrative private sector.

By being a semi private entity, decisions for advancement of services, introduction of new treatment etc, training and even better remunerations for staff are more readily made, unlike the usual delays and difficulties encountered within the Ministry of Health framework.

Secondly , it has to be pointed out that services in IJN for civil servants and their families are borne by the government. Therefore, IJN is actually not providing any free healthcare, but instead charges the government normal market rates for decent cardiac care. Read the rest of this entry »

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. Read the rest of this entry »

Letters
by Unrecognised doctors

The Star, published an article, “Flunked doctors have a chance”, dated April 10, 2008. We were very saddened to know, that the Health Minister and the Director General of Health, have failed to understand the plight of our situation. This issue should not be treated as a platform for showing ones power or a battle of egos, or a money making scam.

Many of us have graduated from the year 1992. We all have families to support, and not having a steady income, to come up with the finances yet again for this purpose is not only near impossible but even unreasonable. Even if we are helped by the government giving us loans, for those of us who have passed and received our medical degrees over 15 years ago, to go for a compulsory course of 3 years, then sit for the final exam, only to become a houseman seems unfair and impractical. After this process, one has to slave for 2 years as a houseman, and 3 years as a medical officer, and then is eligible for permanent registration. Many of us will be near retirement age, and this proposal seems unrealistic. We seem to be getting the shorter end of the stick, and come to you for support. Read the rest of this entry »

Letters
by GS

When Chua Soi Lek first came to office, he apparently called for a meeting of all senior officers and when asked about the priority of problems at the Ministry of Health, he reportedly was inundated with numerous comments about the dastardly troubles private hospitals had created and how they and their devious doctors were leeching the poor Malaysian public and something had to be done urgently. The gullible Chua, ever willing to show-off the political strongman that he conjured himself to be, wasted no time in implementing the shelved PHFSA and together with his DG, utilizing the BN’s brute but now mercifully clipped majority in parliament, brushing off all objections against the Act just so he can show who’s boss. Needless to say despite all of Chua’s and Merican’s big talk and assurances, the first victim who got thrown into jail was a registered doctor, a stark reminder of the previous government’s callous and appalling methods of governance.

New Health Ministers are almost always a shoo in for our health ministry officials who have become rather slick in cornering incoming, inexperienced and invariably unknowledgeable Ministers into making silly decisions. All Ministers are political animals and make distorted decisions essentially because the minister is fed only half the story or the story he generally likes to hear. And so it is with the new health minister Liow Tiong Lai.

While Tanzanian president, Jakaya Kikwete, was going on an all out war against witchdoctors (read bomohs, sinsehs, etc) who were gorging out eyes of albinos and the Brazilians were calling in the army and possibly Cuban doctors to help battle the mortal incidence of dengue in that country, back in Malaysia, the hapless Liow had thrust upon him a meaningless business turf battle between pharmacists and doctors as his first task. The Brazilians must have wondered about the priority of the Malaysian health minister and cannot be faulted if they thought that Malaysians had indeed licked the dengue scourge and were actually moving on to bigger stuff.

Far from it. The dengue fever outbreak in Brazil had infected 55,000 people, and killed 67 Brazilians so far this year with half of those killed by the mosquito-borne illness being under 13-years-old. But Malaysia’s “Disease Control Director”, Hasan Abdul Rahman reported a proportionately higher mortality ratio of 9,889 people diagnosed, with 26 of them dead for the first three months from January to March alone of this year. Maybe we may have something to learn from the Brazilians or more likely our stats are out of sync.

But these problems will pale into comparison as the new and inexperienced health minister has made a second momentous decision. That of shipping unfortunate children with congenital heart disease to Devi Shetty’s “world famous” heart center 2000 miles away in Bangalore, the Narayana Hrudayalaya. Even Chua, known to be a brusque decision maker refused to take this decision. But the new health minister had no qualms sending these children off….or was he pushed into make this decision.

When the NST published their under-researched cum marketing piece for the IJN on the lack of heart surgeons and the need for critical care for paediatric cardiac surgical patients in a center spread on 2/4/08, they didn’t quite delve into the factors as to why this country has not caught up with the rest of the world or at least India, despite the government spending millions to curb the rising incidence of heart disease. Paradoxically, after 50 years of Merdeka, we are in fact sending off patients overseas for treatment just like the Mauritius, Ghana, Nigeria, Sierra Leone and Bangladesh to the Narayana Hrudayalaya Institute of Medical Sciences (NHIMS) Do we not have the expertise? Elementary. It is just poor management of our resources. Read the rest of this entry »