PERHAPS it’s time for me to bell the cat. For many years now, there have been rumblings of discontent with the Malaysian Medical Council, which was formed to register medical practitioners and regulate medical practice.
Recently, amendments were made to the Medical Act 1971 to make it more effective as a corporate body and be independent of the Health Ministry. Unfortunately, nothing tangible has happened since then.
Delays in issuing annual practicing certificates (APCs), obsolete voting process in election of council members, delay in processing applications especially from foreign doctors, delay in arriving at decisions pertaining to discipline and professional misconduct, perceived bias and prejudices from council members, overworked staff with few resources and weak response to queries are some of the issues raised by frustrated registered medical practitioners (RMPs).
This inefficiency can lead to various medico-legal implications, especially to those working in the private sector with regards to problems in renewing licences and providing services at their clinics or hospitals.
MMC needs to change. The postal voting mechanism needs to be revisited. During the last election, many eligible voters (RMPs with good standing) did not or could not vote. Every election year, some 30,000 ballot papers are sent via Pos Malaysia about six weeks prior to the date of the election.
Over the years, only 20% to 30% of the ballot papers were returned. The reasons given were many, ranging from poor postal service to disinterested RMPs.
There should be a better way to get more doctors to vote. We cannot let the election of council members be decided by only a fraction of RMPs.
In this digital age, online voting could be an option. An independent election committee representing the various professional organisations should be set up with standard operating procedures to oversee the proper and transparent documentation of delivery and receipt of ballot papers, update the last known addresses of practitioners based on the current APCs issued, ensure fairness, avoid interference and handle queries promptly.
At present, certain members are elected repeatedly; either they are brilliant and have caught the attention of the eligible voters or something is amiss.
Council members are either elected or appointed. Elected members get voted in every three years. It is time we limit the tenure of each council member, whether elected or appointed, to two terms (six years). Currently, there are several members who have been serving since the 1970s. While we laud their commitment and dedication, we should also give way to new aspirants who wish to serve.
Some of the long-serving members are quite intimidating. They have a feeling of self-importance and often monopolise discussions. If you have an effective and capable president, he or she could ensure a more balanced discussion between the old and new. But this is not always the case.
The leadership style of the president is important to guide the MMC. Some believe in collective leadership while others prefer steering the MMC deftly to ensure justice and fair play.
Some presidents seem to be not interested in chairing MMC meetings even though the schedule is pre-fixed (every second Tuesday of the month). If that is the case, maybe it is time to appoint a president from any of the senior council members to ensure commitment, independence and neutrality.
Discussions at MMC meetings must be open and transparent. Members who have conflicts of interest, for example when accreditation of medical schools is being discussed, should declare their status and leave the room to allow for a more balanced discussion. The decisions made must be based on performance.
Disciplinary hearings need to be done more proficiently. Time is of the essence because undue delays could cause hardships to the RMPs being investigated.
Council members must be free of scandal and involvement in advertising products or devices for private companies. They must be seen to be “whiter than white”.
If they wish to publicly support products or devices, they must refrain from being a council member.
There may also be a need to have a lay person in the Council to ensure fairness and transparency.
The secretariat must be manned by permanent staff who have a sense of responsibility. They should be given prior training before performing their onerous functions and be reminded to respond promptly to queries from RMPs. Right now, about 50%-60% are contract officers who are not certain if they would be retained, resulting in a rapid turnover of staff and work apathy.
Many documents kept at MMC are confidential and should not be handled by contract staff who may not be altogether bothered about the sanctity of the documents.
Significant upgrading of hardware and software to make MMC more efficient and vibrant and updating the current website are also imperative to ensure a smooth flow of information.
Quality standards and acknowledgment must be sought to justify efforts towards improvement of processes.
Change is in the air. MMC too must change for the better, in line with the aspirations of the current government. Please facilitate and not frustrate.
TAN SRI DR MOHD ISMAIL MERICAN
Malaysian Medical Council