Health Ministry should focus on its own problems

I WRITE as a doctor who has served 25 years in public service and another 25 as a private medical specialist. During that time, I was chairman of the Malaysian Medical Association’s (MMA) Schomos, which represents housemen, medical officers and specialists, for one year in 1994. Several years later, I was elected president of the Association of Specialists in Private Medical Practice Malaysia (ASPMPM).

During my time with the government, and even until recently, the World Health Organization regularly commended the Malaysian health service under the Health Ministry as one of the best in the world.

Having the most comprehensive network of healthcare centres, district hospitals and general hospitals, the Health Ministry was capable of handling all aspects of healthcare.

The sick, whether citizen or foreigner or immigrant, could walk into the corridors of our public healthcare system and receive amazingly good care for a token fee.

However, over the last decade, the situation has taken a turn for the worse. What is happening to the Health Ministry in this short span of time is worrying and so serious that something must be done before it is too late.

When I became a private medical practitioner in 2000, only about 10% to 20% of patients were covered by medical insurance, hence the vast majority of the population sought care from public hospitals. But all was well.

Over the last two decades, private hospitals have flourished and so has the private medical insurance industry. Currently, 80% of admissions in private hospitals are covered by insurance.

Could the rise of private medical centres have led to a decrease in demand for care in public hospitals, resulting in complacency by the government to further develop its healthcare infrastructure?

The Health Ministry is currently facing three main issues: brain drain at the top; brain drain at the bottom as trainees and medical officers are driven away to the private sector or other countries; and lack of funds, hence the lack of new infrastructure to support the growing population.

Rather than allowing the public to be distracted with hikes in medical insurance premiums and the so-called rising cost of private medical care, the ministry must look after its own affairs and continue to develop centres of excellence like the National Heart Institute.

For a start, a moratorium on private hospitals is needed, as every new hospital will draw away dozens of much needed experienced specialists from the government sector.

Next, serious improvements in service conditions, better promotion prospects for specialists and more training opportunities for medical officers must be instituted to stop the outflow of specialists and young doctors from government service to the private sector or other countries.

Finally, the Health Ministry needs funds to build new hospitals and keep the old ones well equipped with the latest equipment, too.

The Health Ministry, Treasury Department and our Parliament­arians should wake up to this reality of a sinking institution instead of choking private medical institutions with rules, regulations and laws.

Reducing insurance premiums or controlling the cost of private healthcare treatment through the Reset (Revamp, Enhance, Strengthen, Expand, Transform) strategy and diagnosis-related groups payment system are only temporary measures that allow the middle class to receive better care in private medical centres.

Let the existing private health centres flourish and the insurance companies with their capable actuarial consultants and economists work out the premiums and adjustments; the government must focus on providing good public healthcare.

DR SNG KIM HOCK

Kuala Lumpur