Public shy away from 1Malaysia clinics

Deserted: A clinic in Subang Jaya was found empty at 4pm on a Sunday.

KLINIK 1Malaysia (K1M) was launched in 2010 to provide basic medical care for the urban poor in the country.

While statistics from the Ministry of Health (MOH) have shown that the number of people seeking the services of K1M located throughout the country has increased from 1.32 million in 2010 to 4.42 million in 2013, an investigation by StarMetro on the scheme’s existence in Klang Valley has shed light on some major issues.

Patients at K1M are attended to by assistant medical officers (AMO) and the clinics are meant to operate for 12 hours, from 10am to 10pm. It is free for senior citizens but others pay RM1.

Despite this, not many people seem to be going to the K1M clinics, judging from checks by StarMetro in Kuala Lumpur and Selangor.

One clinic was found to have an average of only 15 patients a day while a Klinik Kesihatan would see at least 100 patients daily, depending on the location.

An informal survey showed that the public were staying away as they would rather see a doctor who could prescribe a wider range of medication than an AMO.

While they welcomed the presence of K1M, they want it to function like a Klinik Kesihatan (government health clinics) which has more facilities. Government health clinics are equipped with facilities like nebulisers and ECG (electrocardiogram) machines.

“It is considered busy when I see more than 15 patients a day,” said an AMO who wished to remain anonymous.

Most AMOs said they treated an average of between 25 and 30 patients a day — a low number for a clinic that operates 12 hours a day.

Patients said they stopped going as the treatment and medicine given did not meet their expectations.

“It is a waste of time going there.

“My daughter had a fever and sore throat, but the AMO only gave her paracetamol. He did not have any mouth gargle or lozenges,” one patient said.

Health activist Chan Li Jin recalled how her two children were sick with different ailments but were given the same medicine by the AMO.

“I was down with fever, one of my children had flu and the other was suffering a bad cough. The AMO gave us all the same medicine, which did not work. We had to go to a private clinic a week later and we were prescribed antibiotics,” she said.

For people like Rose Ismail, a clerk living in Cheras, K1M can do little without a qualified medical practitioner.

“My elderly mother suffers from hypertension, but we could not seek treatment at the K1M as there is no doctor,” she said.

Malaysian Medical Association president Datuk Dr N.K.S. Tharmaseelan said, the people’s lukewarm response to K1M in the city comes as no surprise.

“These clinics provide only basic care and are manned by AMOs but patients have access to thousands of other places as transport is not a problem,” he said.

Dr Milton Lum, an elected member of the Malaysian Medical Council (MMC), said K1M was not viable.

“Patients today know what they want and where to go for medical treatment,” Lum said.

Both medical practitioners said the K1M was more needed in rural areas and the deep interior, especially in Sabah and Sarawak.

There is cause for concern if the experiences of StarMetro’s journalists are anything to go by.

Having to wait for nearly an hour for the AMO to return from dinner or being told to come back after the AMO’s lunch hour can only be a turn-off.

The location of some K1M, near night markets and pubs, are also not conducive after dark.

And when one is told that the clinic was closed before 10pm due to the absence of patients, it makes you wonder about the future of that clinic and the fate of the scheme as a whole.

More disturbing is the rumour that additional K1M may be set up.

“The poor are getting poor healthcare. That is not what the government wanted. The intention may have been good,” said Dr Tharmaseelan.

Some general practitioners (GPs) we spoke to suggested that instead of having K1M, the government should extend the hours of government clinics permanently and get doctors to work shifts.

“Most government clinics open from 8am to 5pm. It would be more sustainable to expand government clinics to maximise resources and save money in the long run,” they said.

Dr Tharmaseelan argued that instead of spending millions to build and maintain K1M, the money could be better used for new hospitals.

“There are only 132 public hospitals in Malaysia serving a population of 30 million. Patients are suffering because of the lack of beds.

“Alternatively, the government could come up with a scheme where they pay GPs who treat poor patients who cannot afford treatment in a public-private partnership,” he said.

Related stories:

AMOs and MAs are not learning much compared to being in a govenment hospital

Health Ministry director-general Datuk Dr Noor Hisham Abdullah explains

Private primary healthcare providers want in

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Family & Community , 1msia clinic


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