Wrong prescription for private docs

ON May 6, hundreds of doctors, mostly dressed in black, gathered at the Prime Minister’s Office in Putrajaya in a peaceful protest against the use of a non-medical Act to ensure compliance to the medicine price display law.

The last time doctors had protested was during the height of the Covid-19 pandemic when the Hartal Doktor Kontrak strike took place on July 26, 2021.

The Hartal Doktor Kontrak strike was launched by junior doctors who were tired of the contract system, which had left a question mark on their future.

This time around, it was the private practitioners who were unhappy with the use of the Price Control and Anti-Profiteering Act 2011 (Act 723) to regulate the display of medicine prices at private general practitioners’ (GP) clinics, community pharmacies or hospitals.

While the cause of the two protests, which took place four years apart, may be different, they are a telling sign of the cracks in our healthcare system.

Doctors are not merchants, retailers or grocers, and as such, they believe a non-medical Act should not be invoked.

Instead, they want the medicine price display rule to be regulated under the Private Healthcare Facilities and Services Act (Act 586), but so far, there are no such provisions under Act 586.

Although Act 723 comes under the Domestic Trade and Cost of Living Ministry, it deals with pri­ces of goods and services provided to consumers. And in this case, consumers are buying medicine.

The Health Ministry has also clarified that Act 586, which is under its purview, only deals with the regulation of private healthcare facilities and services through licensing and fee schedules, which only covers professional, consulta­tion and procedure fees.

Both ministries have assured GPs that during the three-month grace period of the enforcement of the price display law, compounds will not be issued and instead, practitioners will be gui­ded to adapt to the new law.

Undoubtedly, the new regulation has resulted in added costs to some practitioners, but the issue of whether it is governed by a medical Act or not, should not be the bone of contention.

The price display law has empo­wered consumers to make infor­med decisions. In fact, my collea­gue Martin who visited a pharmacy recently, said he was now able to decide whether he wanted to buy patented or generic drugs, the latter of which costs a fraction of the price.

“The pharmacist explained to me that the compounds are the same for the generic medicine and it was even easier to consume.

“I now know what I am paying for, and I can compare prices between pharmacies,” he said.

The price display rule has empo­wered consumers as they now have the opportunity to know what they are paying for, but there has to be a trade off.

It is high time the GPs demand for a revision of the consultation fees, which have stagnated since 1992. And 33 years is a long wait, and in fact, it is my entire lifetime.

Former Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maha­ra­jah said GPs would incur a price increase of between 10% and 20% with the new price display requirement – but this can only be mitigated by increasing consul­tation fees.

“Can you imagine in 1992, I was not yet in medical college; now I have been a doctor for 25 years and I’m finally getting an increment,” he told this writer.

The fraternity is calling for the consultation fees to be revised to RM50-RM150 from the current RM10-RM35. It is not an unreaso­nable dem­and given how much time has passed.

Communications Minister Datuk Fahmi Fadzil, who is government spokesman, said last week that the issue would be studied. He said Health Minister Datuk Seri Dr Dzulkefly Ahmad had infor­med that a Cabinet paper on the matter had already been prepared.

The government should revise the fee schedule as soon as possible.

The healthcare system has been tested by various challenges, such as manpower issues with facilities bursting at its seams, and recently, medical inflation.

The Covid-19 pandemic has already exposed the cracks within the public healthcare system that was on the brink of collapse at one point.

We need a healthy private healthcare ecosystem to reduce the burden on the already batter­ed public healthcare system. And the GPs play an important role in helping treat minor illnesses and reducing patient load at government facilities.

Dzulkefly has a lot of matters to resolve in his second stint as health minister and the revision of the GPs’ consultation fees should be one of the low-hanging fruits that he should tackle first.