Materia Medica Malaysiana

Take time to analyse needs

Comment by Soo Ewe Jin

DOCTORS are methodical people. They make a diagnosis to identify the nature of an illness or problem by examining the symptoms. Then they may venture to offer a prognosis, which is a forecast, especially of the likely cause of an illness or problem.

A good doctor normally remains cool even when people get emotional.

And issues related to health often generate a lot of heat.

This is something for the new Health Minister Datuk Dr Chua Soi Lek to bear in mind.

His training as a medical practitioner will naturally give him a doctor’s perspective even if his political responsibilities may require him to see things from many other different aspects.

Despite not having held any federal positions before, Dr Chua has started on the right track.

His approach to some of the issues has been refreshing.

He recently announced a revamp of the ministry whereby the emphasis should be on quality treatment and better medicine with better equipment rather than just building more hospitals.

And while his dialogue with the Malaysian Medical Association yesterday was in an official capacity, it can also be seen as a meeting with his peers to closely examine the state of the nation’s health.

Malaysia’s public healthcare system, despite a few glitches, is in excellent health.

From the biggest city to the smallest kampung, no Malaysian is deprived of access to healthcare.

The private health industry, on the other hand, is concentrated mainly in certain urban parts of the country although its rapid growth has led to increasing pressures on government healthcare.

And certainly one of the biggest issues must be with regard to the brain drain of government doctors and specialists to the private sector, as pointed out by Dr Chua yesterday.

He has suggested the setting up of private wings in government hospitals as practised at the University Malaya Medical Centre and Hospital Universiti Kebangsaan Malaysia, two hospitals which actually come under the Education Ministry since they are teaching hospitals.

But the proposal must be studied first and it is important that the committee study the plus and minus points of these two examples as well as those from other countries.

And the process must involve feedback not only from the service providers but also more importantly from the patients.

There is no denying that private healthcare is here to stay and will in all likelihood expand further.

But the health ministry must not lose sight of its prime objective of ensuring that healthcare is available to all at affordable charges.

It is too simplistic to say that all doctors in government service are strictly there for a social conviction while doctors in private service are motivated solely by monetary incentives.

When you strip away the external differences between public and private, there is still this common thread of the health practitioners’ desire to heal and live up to the Hippocratic Oath, or “to have a passion to serve the ill,” as Dr Chua puts it.

The patient comes first and the ministry should look into how both the public and private healthcare systems can work symbiotically together.

Opening up private wings may be one way to ensure that government doctors get better incentives to stay on.

But taking away their workload and addressing the issue of a long waiting time may require a different approach.

Take cancer, for example, where statistics show that one in four Malaysians is at risk of getting the disease, which is the same risk as in most developed countries.

Does it mean that every hospital, government or private, should invest in an oncology ward and buy expensive equipment to deal with that many patients?

Should the oncology wards at government hospitals be all transformed into private wings so that the government specialists do not gravitate to the private centres?

There are many cancer patients in some parts of the country who have to travel quite a bit to be treated because not every hospital nearby can afford the facility.

Yet within the Klang Valley, one can have access to many different cancer treatment centres, public or private, within a very tight radius.

Should not the facilities at certain private centres be made available to those who would normally have to go to public wards because they cannot afford private charges?

Once upon a time, only government hospitals could handle radiotherapy and even private patients had to be sent there.

But now that the situation has turned around, why not have both parties work with each other so that while the doctors can remain where they are, the patients can be treated where it is most convenient?

Perhaps the Government can work out a system of charges that will allow private practitioners to help out with government patients at special rates so that a better equilibrium can be achieved.

The Singapore Government has just announced an unprecedented move to allow patients doing liver transplants to pay public hospital rates even if the operation is carried out in a private hospital.

In Britain, the National Health Service turns to the private sector to help deal with long waiting lists, particularly for operations such as hip replacements and cataracts.

The ministry should look at these issues scientifically and quietly and offer us a prognosis only when it is ready.

For instant cures often do not bring about long-term healing.