Hospitals to offer traditional cures

Star: THREE hospitals in the country have been picked by the Health Ministry to offer complementary medicines and treatment for patients.
They are Putrajaya Hospital, Kepala Batas Hospital in Penang and Sultan Ismail Hospital in Johor Baru.
Deputy Health Minister Datuk Dr Abdul Latiff Ahmad said the hospitals were chosen as pioneers to experiment the integration of traditional treatment and modern medicine.
Replying to Dr Rozaidah Talib (BN-Ampang), he said apart from providing herb-based treatment for cancer patients, the hospitals were also given permission to introduce Malay massage as rehabilitative treatment for post-stroke patients.
"If the treatments are scientifically proven to be effective, the ministry would consider endorsing the medicine as a catalytic substance to treat certain diseases," he said.
According to Dr Latiff, there was a high awareness level among the public of the effectiveness of certain traditional products, especially herb-based food or drinks with therapeutic ingredients.
"Refreshing herbs such as tongkat ali, kacip fatimah and mengkudu have flooded the local market and some herbs like misai kucing have been proven to help treat bladder stone problem."
He said the hospitals would employ experts from Chinese universities to research the effectiveness of various herbs in treating cancer and hire trained masseurs to provide the traditional massages.

Training our own paediatric surgeons

Star: KUALA LUMPUR: There is only one paediatric surgeon in the country trained in laparoscopic surgery and the Health Ministry wants to increase this number over the next few years.
“We want to train as many as possible. There is only one and we have a long way to go,” director-general Tan Sri Dr Ismail Merican said yesterday after opening the International Inaugural Paediatric Surgical Seminar organised by Universiti Kebangsaan Malaysia (UKM).
Another future plan was to have Malaysia eventually known for carrying out such training regionally and internationally, he said.
Overall, there were 20 paediatric surgeons in both the private and public sectors.
He said it was necessary to branch out into the speciality because there was a demand for it.
UKM was starting up an advanced surgical skills centre at Hospital Universiti Kebangsaan, where it would provide training, research and services in laparoscopy and minimally invasive surgery.
It has engaged Adelaide-based paediatric surgeon Prof Dr Tan Hock Lim to help establish the centre.

Pharmacies flouting law

Star: JOHOR BARU: Nearly a quarter of pharmacies in Johor were found to have violated pharmaceutical regulations.
The offences include selling of controlled drugs without doctor’s prescriptions, operating illegally and having unlicensed pharmacists.
Johor Local Government and Health Committee chairman Datuk Halimah Sadique (BN-Pasir Raja) said written warnings had been issued to the respective outlets.
“Action will be taken if they continue to violate the regulations,” she said in reply to a question posed by Dr Abdul Rashid Abd Mokti (BN-Sedili) at the Johor State Assembly here yesterday.
In the operations conducted, Halimah said 32 out of the 150 pharmacies checked were found to have violated pharmaceutical regulations.
Dr Abdul Rashid also proposed for the installation of CCTVs at these outlets but Halimah rejected this as it would be difficult to tell the drugs sold.
Low Teh Hian (BN-Pengkalan Rinting) proposed for the department to issue a list of drugs approved by the Health Ministry (KKM).
Halimah said all items approved would have the KKM number.
She also urged consumers to check the ingredients of a product and not be taken in by its packaging.

Halal vaccines soon

Star: PUTRAJAYA: A special paper on the use and certification of halal vaccines at public hospitals will be presented to the Cabinet soon.
Health director-general Tan Sri Dr Ismail Merican said both the Health Ministry and biotechnology firm National Institute for Natural Products, Vaccines and Biologicals (9BIO) would collaborate on the paper.
He was speaking to reporters after witnessing the signing of a memorandum of understanding between Islamic Development Department (Jakim) director-general Datuk Wan Mohamad Sheikh Abdul Aziz and 9BIO chairman Tan Sri Aseh Che Mat here yesterday.
The MoU will see 9BIO forming a team with Jakim to visit sites producing vaccines to certify its halal status.
At present, most of the vaccines in the country are imported and are not certified by Jakim.
Earlier, 9BIO chief executive officer Datuk Dr Nor Shahidah Khairullah said the company aimed to produce its own vaccines within two years once its factory in Enstek City was completed.
“Among the vaccines targeted for halal certification are those for children, such as polio and flu, and that for cervical cancer against the human papillomavirus,” she said.
Wan Mohamad said the MoU would help Malaysia and other Islamic countries in the production of halal vaccines.
“We hope that this will make Malaysia the reference and research centre for halal vaccine production in the future,” he added.

Pilot system to detect mistakes being tried out at KLH

Star: KUALA LUMPUR: A pilot incident reporting system where mistakes in treatment can be detected is being tried out at the Kuala Lumpur Hospital.
Health Minister Datuk Seri Dr Chua Soi Lek said a culture of safety would only develop when people were not afraid to report mistakes and when people were able to sit down and learn how to correct those mistakes and improve.
“One of the important prerequisites for this to occur is an incident reporting system. This is currently being piloted at the KLH under the guidance of a World Health Organisation (WHO) consultant.
“This makes Malaysia among the first in the world to comply with WHO standards. However, incidence reporting and problem solving is only part of the solution. The other part involves prevention,” Dr Chua said at the Malaysian Society for Quality in Health (MSQH) public forum.
The text of his speech was read out by the ministry’s medical practice director Dr Mohd Khairi Yakub.
It is understood that the incident reporting system comprises a standard two-page form which collects information on anything that may have gone wrong during a medical procedure.
Healthcare providers involved in the procedure could fill up this form anonymously with the ultimate goal of providing information to rectify procedures so that the same mistakes do not recur.
The form addresses seven areas, namely the patient, task and technology, healthcare provider, team, work environment, policy and procedures and external factors.
It is also understood that the reporting system would be extended nationwide and this would allow all public hospitals to learn from each other’s mistakes and improve.
MSQH president Datin Siti Sa’diah Sheikh Bakir said the society had accredited 61 public hospitals and 17 private hospitals which accounted for more than 50% of hospital beds in the country.
“The accreditation ensures international safety and quality standards are adhered to and hospitals are surveyed every three years to make sure they are always improving,” she said.

NS trainees must declare health

Star: PENANG: National Service trainees are strictly required to answer all 31 questions in the health declaration form.
National Service Council chairman Tan Sri Lee Lam Thye said that parents must also counter-sign the declaration enclosed with each national service (NS) notification.
“The trainees must answer honestly, accurately and truthfully because the NS Council and NS Department are very concerned about trainees’ health,” he said.
Trainees were required to submit the forms to their camp commandant at the pick-up point on the first day, Lee said.
Trainees must also inform the commandant if they become unfit after entering the camp for doctor’s verification.
“If the trainees have any illness, they should go to a government clinic or hospital for a medical check-up,” he said after checking the new Sri Mutiara national service camp at Balik Pulau here during a working visit with NS Department officers on Friday.
Lee said that the trainees with health problems needed to go to one government doctor to ascertain whether they were fit for camp.
He said that if the trainee was unfit he or she must submit a form for exemption with the doctor’s remark to the NS Council where a committee would decide on the exemption.
He said that there would be three paramedics stationed at each of the 81 camps nationwide.
He said that the first batch of 37,000 students selected for NS from Dec 29 to March 11 would receive their notices at the end of this month or latest by early December as notices had been sent via Pos Malaysia beginning Nov 17.
A total of 110,000 students were selected to undergo NS training next year, he said.

Mental illness afflicts more than 3 million Malaysians

Star: OVER three million Malaysians – or 16% of the population – have been diagnosed with mental illness, reported Tamil Nesan.
Quoting Health Minister Datuk Seri Dr Chua Soi Lek, the paper said this was shown in the findings of a national health and morbidity study that was carried out last year.
The study also showed that the number of Malaysians suffering from mental sickness had risen 6% over the past 10 years, Dr Chua said when launching the national-level World Mental Health Day event in Sungai Petani.
He said 20.3% of the sufferers are children below 16 and 19.5% are senior citizens aged 70 and above.
Mental stress among young people was mainly due to bad examination results, family pressure and lack of support from society.
Dr Chua said some students felt the pressure even when they do not get straight As and because they felt humiliated, stupid and useless.
Some take suicide as the way out, he said, adding that there were 20 to 30 suicides among 100,000 Malaysians each year.
Dr Chua said some mental patients remained uncured because they resort to bomohs.
He said the ministry has only 145 psychiatrists, while the country required another 300 experts.

New flying docs expected in six months

Star: KUCHING: A new permanent provider for the flying doctor service (FDS) in Sarawak is expected to be appointed in six months.
In the meantime, the state health department would hire an interim service provider with the help of the Health Ministry and the Department of Civil Aviation.
Assistant Minister of Public Health Dr Soon Choon Teck told the Sarawak State Assembly yesterday that the process was expected to take a month.
“The interim service provider must use twin-engine helicopters fitted with emergency medical service equipment to improve the safety and quality of the service,” he told Lihan Jok (BN-Telang Usan).
He added that the current 15 mobile health teams visiting FDS locations by land would also continue their work while the appointments were being finalised.
Dr Soon said a new contract for the FDS using the new specifications had been awarded to SAR Helicopters Sdn Bhd for 2007-2010.
However, the contract was terminated on Nov 12 because SAR Helicopters had been unable to fulfil it.
“They did not provide any service in January 2007. From February to June 2007, they were only able to provide partial service, which at best was only 26.9% of what was expected,” Dr Soon said.

Cord blood storage questionable

Star: KUALA LUMPUR: Doctors have expressed concern about the storage and effectiveness of cord blood.
Health Minister Datuk Seri Dr Chua Soi Lek said the complaints were on how long cord blood could be kept and unsubstantiated claims by private cord blood banks.
“The doctors want us to control matters like the advertising. So there will be guidelines from the ministry that will have to be adhered to,” he said, adding that the guidelines would be drawn up by a National Committee on Stem Cell Services.
Dr Chua said while cord blood was stored to potentially treat diseases such as lymphoma, leukaemia and thalassemia, there were claims and advertisements stating that it could treat illnesses including diabetes, cerebral palsy and regenerative disease.
“There are a lot of unsubstantiated claims.
“Besides, we do not know how long it takes for the samples to become defective during storage or if the quantity collected is enough,” he said.
He said private cord blood banks in the country charged between RM2,500 and RM5,000 for registration followed by a yearly subscription of between RM125 and RM250.
At present, there are three cord blood banks operating in the country.
The American Association of Paediatrics, in its latest policy statement, stated that private umbilical cord blood storage as a “biological insurance” should be discouraged because there was not enough evidence to support the routine harvesting and storage of umbilical cord.
Dr Chua said the ministry received an annual allocation of RM16.8mil and a one-off grant of RM15.6mil to boost its cord blood services.

Rules on nip-and-tucks

Star: PUTRAJAYA: To ensure that beauty treatments do not turn ugly, the Health Ministry has drawn up a set of do’s and don’ts on aesthetic medicine.
With immediate effect, private general practitioners are not allowed to carry out procedures such as breast implants, liposuction, eyelid surgery, laser and light-based therapies and hair transplant.
They also cannot deal with unapproved agents, inject non-evidence based products like Vitamin C, placental extract, stem cells and growth hormones.
The list, drawn up following a meeting last month with relevant stakeholders, will be included in the Private Healthcare Facilities and Services Act 1998 under the director-general’s directive.
A definition of aesthetic medicine has also been drawn up. It states it is a branch of medicine dedicated to creating a harmonious physical and psychological balance using non-invasive and minimally invasive treatment modalities.
The modalities have to be evidence-based and scientifically proven on matters such as the anatomy and skin physiology.
Director-general of health Tan Sri Dr Ismail Merican said yesterday that only trained and credentialed personnel could do Botox treatment.
He added that the general practitioners could, with proper credentials and training from a recognised institute, advise on matters such as medical cosmetology, chemical peels, cellulite control, hair removal and nutrition.
“It does not mean the general practitioner has no role but they should be concentrating on procedures which are not invasive,” he said.
He added that because aesthetic medicine was not a recognised medical speciality in Malaysia, the word “aesthetic” was not allowed to be displayed on signboards.
Dr Ismail added that a proposal would be submitted to register specialists in aesthetic practices in the registry being compiled by the Malaysian Medical Council and Academy of Medicine.
He said it was necessary to draw up such guidelines because the ministry was concerned about developments in the field and wanted to keep unscrupulous practices at bay.
“If you want to look pretty, do it the right way. Make sure the right people provide you with the services,” he said.

Girl's death: Panel probe claim hospital was lax

Star: PENANG: A five-man panel has started investigations into alleged negligence in the treatment of Year Six pupil, S. Subashini, who died at the Seberang Jaya Hospital, after apparently hanging herself.
State Health, Welfare and Caring Society Committee chairman P.K. Subbaiyah said the panel started talking to medical officers and staff of the Seberang Jaya and Sungai Bakap hospitals yesterday.
He said the panel would also invite Subashini's parents to give their statements.
“We view this matter very seriously and want to be transparent in our investigations.
“Any negligence on the part of the hospital authorities will be dealt with appropriately,” he told reporters outside the state assembly hall here yesterday.
S. Subashini, 12, was sent to the hospital after she was found with a blanket around her neck in her house at Changkat, Nibong Tebal last Saturday.
Her father G. Sivakumar, 36, alleged that the hospital had neglected to ward her in the intensive care unit despite her critical condition. Instead, she was admitted to the general ward and pronounced dead the next day at 4.05am.
The panel, headed by Ipoh Hospital physician Datuk Dr K. Chandran, comprises forensic pathologist Datuk Dr Bhupinder Singh, Penang Hospital psychiatrist Dr Lai Fong Hwa, Penang Hospital anaesthesiologist Datuk Dr Jahizah Hassan and private practitioner Dr B. Ravichandran.
Subbaiyah said the inclusion of Dr Chandran and Dr Ravichandran was because the state wanted to be impartial in its investigations.

Move to make sure all doctors have required skills

Star: PUTRAJAYA: Newly qualified doctors will have to undergo two years' compulsory housemanship from next year.
Currently, they only have to do a year of housemanship.
Health Minister Datuk Seri Dr Chua Soi Lek, who announced the Cabinet decision yesterday, said the move was considered important to increase the knowledge, skills and experience of graduate medical officers.
“This will improve the quality of services and healthcare standards,” he said.
A rotation system of four months in six departments will be implemented. With the newest inclusion being the accident and emergency department, the rest are medical, paediatric, general surgery, orthopaedic, obstetrics and gynaecology.
“We have observed that in the past few years, about three to five per cent of graduate medical officers do not get full registration because they have weaknesses in knowledge or skills,” he told reporters before chairing his ministry’s post-Cabinet meeting.
“We cannot let this continue. We hope the move is seen as a positive one by future graduates and we are confident the rakyat (people) will support us.”
After the two-year housemanship, the doctors would have to serve their three years' compulsory service with the Government or its agencies, he said.
Dr Chua said the ministry would apply to the Government to place them under the U43 grade upon completing the two years' housemanship compared to the current U41. The U43 pay scale is RM500 more than U41.
He said the doctors would be able to pursue their specialist courses or Master’s after serving two years' compulsory service compared to the current situation whereby they can only apply to further their studies after three years.
About 1,200 local medical students graduate annually.
Dr Chua also announced the Cabinet’s decision to disallow the future setting up of private cord blood banks because while it was a new service with huge potential to treat specific diseases, there were still ethical issues to be scrutinised.
He said the existing centres would have to apply for a licence from the ministry within the next two months and would be registered under the Private Healthcare Facilities and Services Act 1998.

Housemen to serve an extra year

NST: PUTRAJAYA: Medical graduates will have to serve an additional year of housemanship beginning next year.
During the period, housemen will undergo four months' training each in the fields of medical, paediatrics, general surgery, orthopaedics, gynaecology and emergency.
Health Minister Datuk Seri Dr Chua Soi Lek said the cabinet gave its nod to the one-year extension as it would provide future doctors with more experience, skills and knowledge.
He added that the extended training would also benefit the people as it would enhance the quality of the local healthcare industry.
Each year, some 1,200 medical students graduate from local public and private universities.
Dr Chua also said four companies handling private cord blood banking had been given two months to register with the Health Ministry.
The cabinet has given approval to the ministry to monitor their operations and ensure that they followed guidelines and maintained standards issued by the National Stem Cell Service Committee.
Dr Chua said their registration was made compulsory following complaints from the public.
The problems surfaced with the appearance of advertisements claiming that stem cells could cure various illnesses, although at present it has only been proven effective in helping cure leukaemia and thalassaemia.
He said the cabinet also approved an annual allocation of RM16.8 million for cord blood banking in public hospitals.

Not all in favour of anti-smoking proposal

NST: KUALA LUMPUR: The proposal by the Health Ministry to ban smoking in more public areas, including open-air eating premises, received mixed reactions.
The Malaysian Muslim Restaurant Owners' Association (Presma) and Malaysian Association of Hotels (MAH) commended the proposal.
"It's a good move to protect second-hand smokers, especially children. But the government should be firm and prohibit smoking in all public areas," said Presma president Jamarulkhan Kader.
MAH executive director B. Sarjit Singh said the proposal was welcome but more awareness campaigns should be carried out.
However, the Malaysian Indian Restaurant Owners' Association president Datuk R. Ramalingam Pillai said it would be difficult for them to implement the ruling.
"We welcome the move but it will be a problem because we sell cigarettes in the premises," he said.
Last week, the New Straits Times reported that the Health Ministry was finalising the Tobacco Product Control Bill which will see smoking being banned in National Service training camps nationwide, open-air eating premises, health centres and factory buses.
The bill is being drafted and would be presented to the cabinet by early next year.
Health Ministry parliamentary secretary Datuk Lee Kah Choon said restaurant owners should change their mindset as more customers would visit their premises when the ruling was implemented.
He said the ministry was looking forward to banning smoking in more public places in the future.
Lee said smokers in the country spent at least RM15 million daily on cigarettes.
The amount was based on the estimated expenditure of three million smokers nationwide which could increase to four million by the year 2020.
He said the figure was alarming and more aggressive efforts were needed to curb the situation.
"It's a waste of money and the government has to bear the cost of treating the diseases caused by smoking," he said at Klinik Kesihatan Tanglin yesterday.
Lee had launched the Stop Smoking Infoline which offers help and information for smokers , with tips to quit the habit.

China food on alert list

Star: KUALA LUMPUR: Honey, oyster sauce and dried mushrooms are among food products from China which have been placed on the food alert list for contravening regulations in Malaysia.
Data from the Health Ministry Food Quality and Safety Division indicated, in samples taken on specific dates, that pesticide residue was detected in the dried mushrooms on four occasions from April to July this year.
Drug residue was found in the honey sample taken in June while the cancer-causing agent 3-MCPD was found in oyster sauce tested in May.
There were 32 Chinese products placed under the ministry's Food Safety Information System (FoSIM) level five alert, where products are held, tested and then released, from January to October this year.
There are six levels of alerts – the first is auto clearance and the sixth is auto rejection.
Other products included frozen eel, seaweed, frozen royal red prawns, shitake mushrooms and salted turnip. All other China-imported food items were put on level four alert which requires examination.
Food found to have contravened the Food Act 1983 and Food Regulations 1985 was either destroyed or returned to the country of origin.
Malaysia imports US$680mil (RM2.3bil) worth of food items from China yearly.
Thailand had 17 food products on the list while nine food products from India contravened regulations including groundnut kernels in which aflatoxin, a cancer-causing agent, was found on six occasions from sampling done from March to September.
Six products from Indonesia including natural honey, kicap manis, prawn crackers and chilli sauce were also put on the watch list.
Roasted seaweed from Singapore was found to contain metal contaminants on four occasions from July to September.
In all, 103,480 imported food consignments were tested until September. A total of 49 consignments were rejected or destroyed.
Minister Datuk Seri Dr Chua Soi Lek told reporters yesterday that the quality of imported food was safe because of constant monitoring at 36 entry points with the cooperation of the Customs Department and other agencies.
Dr Chua said the monitoring and inspection of food and premises was also carried out.
“Some operators do not practise cleanliness. That is why food poisoning happens from time to time, including at school canteens. They think that if the food is cooked, it is safe to be eaten,” he said, adding that factors like how the food was kept and the equipment used also contributed to food poisoning.
From January to June this year, a total of RM416,260 in fines was collected from 2,290 cases. The ministry also shut down 2,957 unsanitary food outlets.

Teach kids 'to deal with stress'

NST: KUALA LUMPUR: More students will kill themselves if they are not taught how to deal with competition and modern day stress.
Psychologists yesterday warned that the trend was on the rise in Japan, Hong Kong and Singapore, and that it was only a matter of time before it becomes a norm in Malaysia.
Monash University and Sunway Medical Centre consultant clinical psychologist Paul Jambunathan said more children were becoming obsessive and compulsive due to competition and pressure.
"That's because society expects a lot more from them. The focus now is on academic excellence and many children are unable to meet the needs," he said.
He added that parents wanted their children to excel academically while schools were all out to out do each other.
Jambunathan was commenting on the death of 12-year-old Subashini Sivakumar of SRJK (T) Ladang Simpah, Nibong Tebal, who was found hanging two days ago from the ceiling of her room with a blanket tied around her neck.
She is believed to have been in a state of depression for achieving 4Bs, 2Cs and a D in the examination. She had promised her parents she would score 4As.
Jambunathan said no one had taught her to deal with stress or showed her that suicide was not the answer to "failure".
"But she felt her results were not good enough. I feel she might have been trying too hard to meet other people's expectations", he said.
He said children learn to resolve their problems from their surroundings and models including cartoon characters.
Children also watch movies that focus on suicide, gangsterism, shooting and other negative aspects of life, he added.
HELP University College clinical psychologist Dr Ng Wai Sheng agreed that suicides were on the rise because of competition and stress.
"If the social support systems are not strengthened, we will end up with increased social emotional problems," she said.
"When her goals were not met, she felt like a failure", she said, adding that Subashini, her parents and teachers, were victims of an increasingly competitive world.
She said people needed to realise that suicide was not just confined to people with mental problems but could involve normal people caught in stressful situations.
Kuala Lumpur Hospital child and adolescent psychiatrist Dr Toh Chin Lee said parents should know the strengths of their children and develop them accordingly.
"They should be realistic about their expectations. Parents should remember that scoring As is not the only thing for a child," he said.
He added that children who could not take academic pressure should be allowed to excel in other fields.

Health staff for NS camps

Star: PUTRAJAYA: Each of the 81 national service camps will have four medical assistants and nurses stationed there starting from the Dec 29 intake.
Right now, there is none.
Health Minister Datuk Seri Dr Chua Soi Lek said the move involved about 300 health personnel, to be loaned from public hospitals and clinics operating near the camps.
“The health personnel will be rotated on a three-month basis. They will be given a two-day course to expose them to the kinds of sicknesses or injuries trainees may incur.
“We have also recommended to the National Service Council that in the long-term, they should train health personnel of their own,” he told reporters after meeting council chairman Tan Sri Lee Lam Thye here yesterday.
Dr Chua said it was decided that a sick trainee who did not recover after 24 hours be referred to the nearest hospital immediately.
As for placing doctors at these camps, he said there was no clinical justification to do so at present.
”The medical assistants and nurses are trained to take medical history and make diagnosis of simple complaints,” he said.
He added the mobilisation of these staff was not expected to stress the existing personnel or level of service at public hospitals and clinics.
“We have some 40,000 medical assistants and nurses throughout the country. Those placed at national camps will be entitled to the usual allowances,” he said.
The next intake for the 110,000 trainees will begin on Dec 29. Each camp has about 400 trainees at one time.
The programme had come under fire last year after several deaths involving trainees. As at May, there had been 12 fatal incidents.
He also reminded camp commandants and trainers not to smoke in front of their charges.
Lee said the council would bring up the proposal to train its own health personnel at a meeting with the National Service Department on Dec 13.
He reminded trainees to answer all 31 questions in the declaration of health status forms.
“This is compulsory. The forms will also have to be counter-signed by their parents,” he said, adding that only those who were fit would undergo the programme.

Minister: Show plans benefit patients

NST: KUALA LUMPUR: Companies offering health packages have been asked to convince the health ministry that they were not just out to make profits.
Health Minister Datuk Seri Dr Chua Soi Lek wants managed care organisations (MCO) to show proof that those who signed up for their packages had gained from them.
"The health packages must be fair and beneficial to patients when they seek treatment at designated hospitals. Patients should not be shortchanged," he told the New Straits Times.
He said people signed up for packages because of the escalating health cost. They also wanted doctors to do the necessary tests and treatment.
"Of late, the ministry has been receiving a lot of complaints about how patients with health packages have been shortchanged by the MCO. Doctors, too, have complained that their fees have been reduced and a limit had been imposed on clinical examinations," he said.
MCO is a commercial body that enters into a contract with healthcare providers to provide programmes or packages within an agreed monetary arrangement.
Examples of MCO are health insurance companies, third party administrators, health maintenance organisations, preferred providers organisations, and the panel doctors system.
Dr Chua said MCO had been operating in health-related business in the country since the mid-90s and there had been several issues raised about their operation.
Among them is the disclosure of patient information and the practice of capping chargeable fees and limiting tests and procedures.
MCO are required to register with the ministry. They can register online at http://medpcs.moh.gov.my

Chua: Eat right, exercise regularly

NST: KUALA LUMPUR: Nearly 70 per cent of Malaysians aged over 18 do not exercise and have been sedentary in their lifestyles over the past decade, giving rise to health risks.
This alarming indicator comes from a recent Health Ministry survey that found that only 30.9 per cent of Malaysian adults exercised. Of this, only 11.6 per cent did so adequately.
Health Minister Datuk Seri Dr Chua Soi Lek said overeating or poor eating habits contributed to an increase in the prevalence of many chronic diseases like diabetes, obesity and cardiovascular illnesses.
"The proportion of overweight Malaysian adults increased from 16.6 per cent in 1996 to 29.1 per cent last year, while obesity had increased from 4.4 per cent to 14 per cent during the same period."
Dr Chua added that there was an increase from 8.3 per cent in 1996 to 14.9 per cent last year for diabetic adult Malaysians above 30.
"For the same age group, the proportion of those who were hypertensive increased from 29.9 per cent to 42.6 per cent for the same period," he said at the "Sierramas Community Fun Run" at the Sierramas Resort Homes in Sungai Buloh yesterday.
Dr Chua put the blame for the obesity problem on the attitude and change in lifestyle of the people following the socio-economic development of the country after independence.
"There have been dramatic changes in our lifestyle, especially in the last two decades. Food used to be scarce and malnutrition a problem, but we are now consuming less complex carbohydrates like cereals, grains and tubers and consuming more sugar, red meat, eggs, animal products, fats and oils.
"There are also changes in food consumption patterns with increased eating frequency, eating out more often and meals at odd or the wee hours of the day."
He added that despite the efforts and resources of the government to improve health, it was the people themselves who could determine whether to stay healthy. "This is a matter of choice and will-power."
Dr Chua called on Malay-sians to engage in regular physical exercise which was not confined to games but also walking up stairs, dancing, jogging and cycling. This could be done at no cost at all.
"Let us walk the extra mile, take extra fibre and forgo the extra servings. The choice or decision is ours."

Ministry finalising bill to ban smoking in more places

NST: GEORGE TOWN: The Health Ministry is finalising the Tobacco Product Control Bill, which will see smoking being banned in more places in the near future.
Besides a proposal to ban smoking in National Service training camps nationwide, the ministry is looking at expanding the list to include open-air eating premises, health centres and factory buses.
Its parliamentary secretary Datuk Lee Kah Choon, however, said the matter was pending discussions.
"The enlargement of non-smoking areas is constantly under review.
"If all goes well, we hope to present the bill to cabinet for approval by early next year," he said yesterday.
Lee said the bill would consolidate the law on tobacco control together with the Framework Convention on Tobacco Control's requirements.
"The bill is our commitment to reduce diseases and to slow the rise of chronic diseases and early death."
He, however, said until such time the new act came into force, which he said could take a long time, similar amendments would be made to the Control of Tobacco Product Regulation 2004 under the Food Act 1983.
"It will take a long time for a bill to be gazetted into an act, sometime years, because it has to go through numerous processes: the Attorney-General's Chambers, parliament and the Yang di-Pertuan Agong.
"If amendments are made to the existing law, we can implement and enforce the smoking ban on such places faster and I can assure you enforcement will be strict then," he said, adding that once the new act came into force, the existing law would be made obsolete. "The amendments are to cater for the interim period until the new act comes into force."
He also said it was looking at making it mandatory for cigarette manufacturers and importers to make sure that health warnings covered at least half the cigarette packet.
It is understood that the warnings must cover more than half of the front and back of the cigarette packets and may include a graphic illustration of the hazards of smoking.
Many countries, including those in the European Union, require cigarette manufacturers to carry graphic photographs illustrating the consequences of smoking to health.
Singapore has, since Aug 1, required cigarette packs to carry graphic warnings, including images of a cancerous lung and a brain oozing blood after a stroke.

Five-prong strategy to treat drug users

NST: KUALA LUMPUR: There is no quick fix in treating drug users.
That is why doctors in private practice have introduced a five-prong strategy, which includes looking at drug addiction as a medical problem that needs medical care.
"Five years ago there was hardly any treatment for drug addicts, especially in the private sector. Drug addiction was not even in the realm of medical service," said Dr Steven K.W. Chow.
But to date, he said, nearly 500 doctors had signed up to offer community-based drug addiction treatment programmes, nearly double from the 298 who registered under the National Drug Substitution Therapy (NDST) register in March.
Dr Chow, who is president of the Federation of Private Medical Practitioners' Associations, Malaysia, said that the doctors would be trained to be able to roll out drug substitution services, while ensuring they were equipped with support services like counselling.
"Although 500 is a good figure, this is far from enough compared to the number of drug addicts in the country," said Dr Chow, who was speaking at a Press conference after the launch of the 1st International Conference on Addiction Medicine, which incorporated the 4th National Conference on Addiction Medicine.
This is because since 1988 until last year, the number of drug addicts totalled 300,241, and according to the World Health Organisation, for every one identified drug addict there are three or four others unidentified, which could place the figure to between 900,000 and 1.2 million Malaysians.
The five-prong strategy, termed SMART, which is to be implemented over the next three years, also includes:
- a strategic plan to fight drug addiction;
- to upgrade the level of awareness as drug addiction was society's problem;
- to prevent relapses; and
- to train doctors, counsellors and parents how to handle the problems at an early stage.
Currently, the government, via the Health Ministry and partner non-governmental organisations including the Malaysian AIDS Council, are carrying out Drug Substitution Therapy using methadone and a combination of buprenorphrine and naloxone.
On reports that some drug users on methadone therapy had grown addicted to the substitute, Dr Chow said that an electronic monitoring system, the Natio-nal Drug Substitution Therapy system, monitored treatment given.
"It also prevents patients from hopping from one doctor to another to prevent abuse as all private practitioners dispensing methadone are registered on it."

Drug addiction can be treated as a medical problem

Star: KUALA LUMPUR: Addiction can now be viewed as a treatable disease with the introduction of medicine to replace “hard” drugs such as heroin.
Health Ministry deputy director-general Datuk Dr Ramlee Rahmat said this would result in more drug users coming forward to get help in their fight against addiction.
He added that discrimination against drug users would lessen if the addiction was treated as a medical problem.
The ministry, he said, also provided treatment at its hospitals such as counselling those addicted to drugs, including users of amphetamine-type stimulants (ATS).
“The ministry is encouraged by the results of the methadone maintenance therapy programme,” said Dr Ramlee who opened the First International Conference on Addiction Medicine yesterday.
The conference was organised by the Federation of Private Medical Practitioners’ Associations of Malaysia.
The ministry's harm reduction method comprises methadone maintenance therapy and the needle syringe exchange programme. It focuses on preventing or reducing actual harm associated with risk behaviour. Some drug users will not stop using drugs despite the risk of HIV/AIDS and other blood-borne diseases.
In Phase II of the methadone maintenance therapy programme, the ministry has 58 participating centres – comprising 25 hospitals, 26 health clinics and seven private practitioners.

Serdang Hospital Saddled With RM500,000 Unpaid Bills By Foreigners

SERDANG, Nov 13 (Bernama) -- Foreigners owed the Serdang Hospital here some RM500,000 in unpaid bills and this had caused its services to deteriorate, said Parliamentary Secretary to the Health Ministry Datuk Lee Kah Choon.
He said that foreigners still failed to settle their medical bills despite being charged low fees.
"Nearly 30 percent of the total number of patients seeking treatment at the Serdang Hospital are foreigners," he told reporters after visiting the hospital here today.
He added that the hospital could not operate all its wards due to a staff shortage. To date only 381 beds had been used while the other 239 beds will be used in stages.
The Serdang Hospital has a support staff of 400 and has to double that number to meet the needs of its increasing number of patients.
Lee. however, said that the hospital had adequate doctors and specialists.
The RM690 million hospital began operation on Dec 15, 2005 with 620 beds.
It also acts as the teaching hospital Universiti Putra Malaysia's medical Faculty.
He said the hospital's strategic location near Bangi, Puchong and Putrajaya makes it the hospital of choice for over two million people.

Serve with a smile, health staff urged

Star: KUANTAN: Service with a smile can make a lot of difference when dealing with the sick.
This was the message Mentri Besar Datuk Seri Adnan Yaakob had for health services employees.
He said dispensing medication with a smile could do wonders and help speed up the recovery process.
“The health services department is people-oriented and one must display a certain level of pleasantness and sincerity,” Adnan said in his speech before presenting excellence service awards to some 700 recipients at Wisma Belia yesterday.
Also present were State Health, Social and Orang Asli Affairs Committee Chairman Datuk Ishak Muhammad and state department director Datuk Dr Rosnah Ismail.
Adnan said they must continue to provide efficient services by being professional, innovative, pro-active and exercise common sense.
He also said he hoped the service awards would spur the recipients to improve further.
Dr Rosnah, in her speech, said the department had obtained MS ISO 9001:2000 certification in 2005 and would undergo a review at the end of the month so as to qualify for the quality standard for the next three years.
Three hospitals and two district health offices in Kuantan, Bentong, Jerantut and Rompin had also achieved such international standard, she added.

Healthcare insurers must register

Star: KUALA LUMPUR: All insurance companies providing healthcare facilities must register with the Health Ministry by March 31 next year.
Minister Datuk Seri Dr Chua Soi Lek said the companies should not think that they were not regulated by anyone except Bank Negara.
“Bank Negara deals with the financial regulations.
“But all health and health related matters come under the Health Ministry, including insurance companies which provide healthcare facilities,” he told the press after launching Vamed's 20th anniversary celebrations here last night.
He said all healthcare providers were regulated under the Private Healthcare Facilities and Services Act 1998 and doctors by the Medical Act 1971.
“This is a warning. If they do not comply, they can be fined up to RM500,000.
“Hospitals that provide healthcare to patients through such insurance schemes must also register with us, or they can be fined up to RM300,000,” he said.
He added that he was “not happy” with recent cases of insurance companies that “arm- twisted doctors to not only cap their fee but reduce their charges.”
It was recently reported that an insurance company had proposed a new Healthcare Service Provider Agreement, which doctors had claimed was unethical and would limit patients' access to healthcare.
The new terms included doctors not being properly reimbursed for emergency and critical care outside of office hours and a limit to the number of chargeable visits allowed for specialists in certain disciplines.
“When people are sick and go to a doctor, and they (insurance companies) put all sorts of caps on the charges ... that is not fair,” he said.
For online registration, go to medpcs.moh.gov.my

Younger women are getting breast cancer

NST: IPOH: Breast cancer is on the rise and the patients are getting younger, said Ipoh Hospital surgery department head Dr Stephen Jacob.
"The trend we are seeing now is that when the younger ones contract breast cancer, it tends to be more aggressive.
"It spreads all over and there's a shorter time between the time of diagnosis and death," he said.
For example, there was a 26-year-old patient who underwent a complete treatment for breast cancer but died after the cancer spread to the rest of her body, he said.
In Ipoh Hospital, 26 women died of breast cancer in 2006 and the number increased to 27 women within the first 10 months of this year, he said.
The statistics are limited to those who died in the wards and do not include those who died at home or elsewhere, he added.
On average, about 20 per cent of cancer patients at the hospital suffer from breast cancer.
There were 189 patients admitted for breast cancer treatment at the hospital last year.
Men were also susceptible to breast cancer but such cases were extremely rare, said Dr Stephen, who encountered "one or two" cases during his 15 years as a surgeon.
"We need to get people to come to us early.
"If they come early, they can be cured," he said when highlighting a half-day forum on breast cancer awareness to be held at the hospital tomorrow.
It will be on from 8am to 1pm at the hospital's ambulatory care centre.

‘Lack of human warmth’ behind negligence cases

Star: MUAR: The commercialisation of medical care has produced doctors and nurses who are impersonal to patients and this will lead to negligence, Health Minister Datuk Seri Dr Chua Soi Lek said yesterday.
The lack of human warmth in dispensing medical care was due to the shortage of doctors, nurses and supporting officers and also the over-reliance on machines, he added.
"The medical officers and staff depend more on machines for diagnosis and this affects their attitude towards their patients," he said after a seminar at the Johor MCA Public Service and Complaints Bureau here.
Dr Chua said universities offering medical courses should look into the issue immediately and put greater emphasis on courses concerning the doctor-patient relationship.
He was commenting on a New Sunday Times report on medical negligence in the country's healthcare industry.
Health Ministry statistics show that four out of every 10 negligence cases are from the field of obstetrics and gynaecology.
Second in the medical field with the most negligence suits is orthopaedics (18 per cent), followed by medical (13), surgery (11), paediatrics (7) and others (10).
From 2000 to 2006, 61 negligence cases involving government healthcare providers, mainly doctors, have been settled in and out of court.
Dr Chua said an independent body comprising professionals and local leaders had been set up to investigate errors which resulted in death and promised that there would be no cover-up by his ministry.
"A mechanism is also present for patients to make complaints," he added.

2.6 million locals expected to suffer from diabetes

NST: PETALING JAYA: The number of Malaysians having diabetes mellitus by the end of this year is expected to reach 2.6 million with the majority in the Type 2 category.
According to the national mortality and morbidity survey by the Health Ministry, the rise from 8.7 per cent in 1997 to 10.2 per cent this year represents about a 25 per cent increase in the total number of cases over the last 10 years.
The rise corresponds with worldwide projections by the World Health Organisation which anticipates the numbers to increase by 120 per cent by the year 2025, affecting 300 million people.
University Malaya Medical Centre director Prof Dr Ikram Shah Ismail, who is also Malaysian Diabetes Association (MDA) president, said:
"There are many Malaysians with this incurable disease who risk diabetic complications like a heart attack, stroke and kidney failure."
He said the root cause of such fatalities was the unwillingness to practise good diabetes management.
There was a need for the people to take a right attitude by having a balanced diet, managing body weight, taking medication and undergoing regular medical follow-ups from young to reduce the risk of diabetic complications, Ikram said at the launch of World Diabetes Day 2007 yesterday.
The ministry's deputy director of disease control, Dr Zainal Ariffin Omar, who launched the event, said there was an increase of diabetes in children.
There were 837 cases in 1999 compared with 1,305 in 2004.
"The main causes of diabetes are lifestyle changes and family genetics which have led to obesity, lack of exercise and nutritional imbalance.
"Although incurable, the disease can be controlled with a combination of exercise, diet and drug therapy," he added.
Diabetes mellitus Type 1 is a disease that results from the permanent destruction of insulin-producing beta cells of the pancreas, normally since birth.
This category represents two per cent of the cases in Malaysia.
Diabetes mellitus Type 2 or adult-onset diabetes is a metabolic disorder characterised by insulin deficiency in the human body.
This accounts for 98 per cent of cases in the country.
In conjunction with the event, Ford Malaysia also launched its RM30,000 Ford Diabetic Children's Fund to help underprivileged children diagnosed with diabetes to get monitoring tools and to help them lead a normal life.

Lee: Help workers with mental woes

Star: PETALING JAYA: Employers should initiate an employee assistance programme for the prevention and early intervention of mental health problems among workers, said National Institute of Occupational Safety and Health (Niosh) chairman Tan Sri Lee Lam Thye.
“This is because the workplace is not immune from employees who succumb to stress-related problems which could lead to sudden anger, violence, depression and suicide,” he said.
He said the neglect of mental health and psychological factors at the workplace would also directly affect the efficiency and output of any enterprise.
Lee even suggested that insurance providers offer coverage to mentally ill patients, saying it was unfair to deny them such coverage.
“In addition, there should also be income tax relief for parents or other caregivers looking after the mentally ill,” he said in a statement.
As for government hospitals, Lee said there should be better healthcare services for them, as well as efforts to make psychiatric drugs more affordable.
“Society should also be more open and not discriminate against persons who had recovered from mental illnesses. They must be given the chance to re-integrated into society,” he said.

Snap! You wake up ciggie-free

NST: 'Sleep' an hour and wake up a non-smoker? Can it really be that easy? A doctor and a couple of hypnotherapists tell TAN CHOE CHOE that this is true
KUALA LUMPUR: He had been puffing away for over 30 years and tried desperately to stop for the last 10.
Nicotine patch, mints, nicotine gum; you name it, Dr Omar Abdul Hamid has tried it all.
Each Ramadan, he'd renew his efforts to stop smoking.
"The longest I managed to stay away from ciggies was a mere two weeks. That was during last year's fasting month," said Dr Omar, 53, the managing director of Darul Ehsan Medical Centre in Shah Alam.
But he was desperately craving for a cigarette fix in that "seemingly never-ending two weeks".
On top of it, he was becoming a "grumpy bear" to those around him.
"I had terrible withdrawal symptoms -- I was restless, irritable, easily angered, and I couldn't sleep or think properly!"
Inevitably, he succumbed to the craving and started to smoke again.
But all that became history when he took up a friend's advice and tried hypnotherapy to stop smoking about two months ago.
"My best friend, who is also a physician, introduced me to hypnotherapy. He told me he was taking a course in clinical hypnosis at this school in Pusat Bandar Damansara."
Dr Omar said that he was keen to try anything at that point.
"I was sceptical but also desperate, so I thought 'why not?'"
With that in mind, he met Sheila Menon, the principal of the Malaysian branch of the London College of Clinical Hypnosis, where his friend was studying.
"Dr Omar came to us with a high desire and motivation to stop smoking.
"On a scale of one to 10 -- with one being 'no, I like my smoking habit and I want a cigarette now' and 10 being 'I want to quit this very minute' -- he told us he was a nine," said Sheila.
So she recommended that he try the one-session-stop-smoking therapy -- which takes no more than two hours -- with Peter Mabbutt, a hypnotherapist and founder fellow of the British Association of Medical Hypnosis.
"Seven to eight out of every 10 patients who have gone for this therapy session will stop smoking. Dr Omar and my own husband are good testimonies of its efficacy," said Sheila, whose college is also the first of its kind in Asia.

So how does it work?
The founder of this technique, Michael Joseph, the principal of LCCH in London, said it works uniquely for each individual.
"The therapist first obtains information from the patient about his or her smoking pattern, then while hypnotised, employs (usually strong, direct) suggestions that he stop the habit."
Sheila describes the process as "bringing back the non-smoker that is within the patient" -- the feelings and memories before the person first started smoking.
Joseph has been employing this one-session-stop-smoking technique for over 30 years.
"People were sceptical at first, some even hostile. But since those early years, LCCH has trained thousands of practitioners, many of them doing sterling work in the community now."
Before starting, Sheila said it's important to understand what a patient associates a cigarette with -- like the feelings of absolute control when lighting up; personal reward after a successful deal; or momentary freedom from a boring meeting.
"Most people don't smoke because of nicotine -- you can get that in the first few puffs. Yet why do smokers hold to that last drag?
"It's due to psychological, social or emotional problems, or just simple habit."
Sheila said Joseph's technique worked by helping the patients rationalise the reasons behind why they were smoking and to point out the logic behind the reasons why they could not stop the habit.
"We're using the memory that they have of themselves as a non-smoker and using it to help build a new image of themselves today as a non-smoker, replacing (their smoking) habits with new healthy habits."
Then the hypnotherapist will suggest to the patient during hypnosis to utilise that image when thinking of himself in the future.
Dr Omar's session lasted about two hours but he was only hypnotised for less than an hour -- about 45 minutes.
"We spent the early part of the session talking about my habit, my smoking history. Then Peter (Mabbutt) told me he would hypnotise me and gently told me to go to sleep.
"It was strange because I did go to sleep, yet I was aware. I still remember what he said to me before and during the hypnosis, not all, but bits and pieces of it.
"But mostly, I remember thinking that I could hear him, although I couldn't move and my eyes were closed. You have to try it to know what I'm saying," said Dr Omar of his experience.
He hasn't picked up a cigarette for over two months -- not even during the most tempting time of the year, the Hari Raya holidays.
"To friends who offered me a ciggie, I just told them what Peter suggested: 'Thank you, (but) I'm not a smoker'."
And best of all, he's experienced no withdrawal symptoms whatsoever.
"I also don't suffer from insomnia any more. I'm sleeping better, eating better, and I feel great."
Joseph, who was in town to attend the Master Class in Smoking Cessation Through Hypnosis, especially for doctors, healthcare professionals and students of LCCH, Malaysia, said thousands of people stopped smoking every year, with or without any help whatsoever.
He said everybody already had, within themselves "all the strength and willpower they need to become non-smokers".
"It is the skill of the therapist to find and liberate this 'power' within that will allow them to conquer their habit."
It was important to understand that a hypnotherapist could not "make" anyone do anything they already were not fully capable of doing, he added.

Maids who bring diseases with them

NST: KUALA LUMPUR: Less than a quarter of the Indonesian maids working in the country underwent medical check-ups in their country before being employed here.
This was revealed by Indonesian Health Department authorities who have recorded only 78,000 women as having undergone medical check-ups as a prerequisite to being employed as maids in Malaysia.
Immigration Department foreign labour division director Abdul Rahman Othman said this represented only 24 per cent of the 320,000 Indonesians working in Malaysia as maids.
This, he said, could possibly expose employers, family members and those who came in contact with the maids to diseases like hepatitis B and tuberculosis.
"Those who were not registered with the Indonesian Health Department are believed to have got medical certificates illegally.
"So, there is a high risk of contracting contagious diseases from these people," he told a dialogue session at the 13th Malaysian Association of Foreign Maid Agencies' annual general meeting.
Also present yesterday were Immigration deputy director-general Yusof Abu Bakar and association president Datuk Raja Zulkepley Dahalan.
Abdul Rahman said this was the reason why the department was not planning to reduce the number of compulsory medical check-ups.
Answering a query from the floor, he said a Medical Examination Monitoring Agency (Fomema) report stated that two per cent (6,400) of the foreign maids in the country had hepatitis B or tuberculosis.

Design of toilets merits serious discussion

NST: PETALING JAYA: Gone are the days when toilets were just toilets. Now, they have morphed into restrooms used for a variety of purposes.
Participants at a half-day public colloquium organised by the Institution of Engineers Malaysia (IEM) yesterday were told that toilet design was not an exact science, but has evolved to suit the changing needs of society.
Fong Tian Yong, adviser to the Housing and Local Government Ministry, said the toilet revolution began in Korea in order to upgrade the country's toilet facilities in preparation for hosting the 1988 Olympics and the 2002 World Cup.
Similarly, he said, China is now investing in toilets in preparation for next year's Beijing Olympics.
As far as design issues were concerned, Fong said toilets in the West were usually dry while the ones in Malaysia were always wet and had smaller space.
"Equipment-wise, toilets in Malaysia are not user-friendly, with no hooks to hang bags and unsuitable piping for body cleansing. There is also weak enforcement and no uniformity and method in toilet management."
City Hall Drainage and River Management Department director Hooi Yoke Meng said toilet designs should take into account the culture, behaviour and social habits of users.
He said Muslims need water for cleaning the body after using the washroom and airport toilets needed to be bigger as people bring in a lot things, including their suitcases and trolley.
Toilet doors for the disabled should be sliding for easy accessibility. Women's needs include facilities for breast-feeding and changing diapers.

USM's placenta bandage to be exported next year

NST: KOTA BARU: Universiti Sains Malaysia's "biological bandage", an amniotic membrane to treat lacerations and scalding, is expected to be on the international market by next year.
The country's leading research university signed a memorandum of agreement with Cryocord, a Malaysian medical biotechnology company specialising in cord blood banking and stem cell research, to market the product in Indonesia, Cambodia and Vietnam, among others.
The membrane is useful in treating first- and second-degree burns, with the healing taking between three and five days without leaving scars.
It is derived from the placenta and was developed by USM's National Tissue Bank (NTB) 15 years ago. Now, 12,000 amniotic membranes have been used to treat patients.
NTB co-ordinator Dr Suzina Sheikh Ab Hamid said the amniotic membrane was being used in government and private hospitals nationwide.
"Since we did not have any channels to market the product outside the country, the amniotic membrane is only used in local hospitals. We were involved in researching and marketing the product.
"Now, we can focus on doing more research on the product and improve its quality since Cryocord will handle the marketing."
Dr Suzina said NTB was also planning to expand its role as the supplier of skin graft and cornea tissues by offering medical biotechnology services in South-east Asia.
At the signing ceremony, USM was represented by its vice-chancellor, Datuk Prof Dzulkifli Abdul Razak, and Dr Suzina, while Cryocord was represented by its managing director Dr James Then and executive director Henry Low.

Act to make all docs report abuse

NST: KUALA LUMPUR: As part of its increased efforts to curb child abuse, the government plans to widen the mandatory reporting of suspected child abuse under the Child Act 2001.
"At present, it is only mandatory for government medical officers and child minders to make a report if there are signs a child has been abused.
"An amendment will also cover private medical practitioners, teachers and non-governmental organisations linked to the welfare of children," said Women, Family and Community Development Minister Datuk Seri Shahrizat Abdul Jalil.
She added that the amendments would be tabled in parliament by the end of this year or early next year, after the tabling of the new Disabled Persons Act.
A Child Protection Policy that promoted child-safe and child-friendly environments would also be submitted to the cabinet this year, she said.
She was speaking at the 53rd national Children's Day celebration, organised by the Ministry of Women, Family and Community Development.
Some 2,000 guests attended the celebration, opened by the prime minister's wife Datin Seri Jeanne Abdullah.
Shahrizat said the government would get tough with those who "are careless and neglect the safety and protection of children".
"We have been very sensitive in dealing with such cases, but from now on we are going to get tough," she said, adding that cases of child abuse and mishandling had increased from just over 1,600 in 2004 to nearly 2,000 last year.
The child abuse and neglect cases reported include physical, sexual or emotional abuse, incest and abandoning of babies.
Jeanne said the deaths of Nurin Jazlin Jazimin, Ooi Ying Ying and Preeshena Varshiny were reflective of the dangers that existed in the world today.
She added the theme for this year -- Safety and Protection of Children is our Priority -- was apt, given the issues at hand.
"Let us not turn a blind eye or a deaf ear when we see a child in trouble. It is not solely the duty of the police, but everyone's responsibility to ensure the safety of our children," she said.
Jeanne also presented the Hang Tuah Award for bravery to 11-year-old Muhammad Zulfahmi Zuraidi who saved his two younger brothers from their burning home last year.
The award carries a cash prize of RM5,000.
On June 17, his parents had left him in charge of his two brothers, then aged 6 and 7. He smelled something burning and went into the boys' room to find their beds on fire.
Muhammad Zulfahmi's first reaction was to try and douse the flames with pails of water.
But he soon realised that he would not be able to save his home, and picked up the two boys and fled. The house was razed and the family of five lost all their belongings.
"We lost all our belongings, but my parents and I are glad that we are all safe," said Muhammad Zulfahmi.

Patients must be told about the risks

NST: THERE were undisputed elements of negligence in the treatment of baby Lai Yok Shan, which caused her to lose her left forearm.
Health Minister Datuk Seri Dr Chua Soi Lek reportedly said she should have been treated by a specialist, not a trainee doctor.
This case isn't about higher patient expectations or large amounts of money spent and not getting the desired results -- but a clear case of negligence and of medical error.
Similar stories of medical negligence have been repeatedly highlighted by the media over the years.
The statistics may not look alarming -- 62 negligence cases over seven years and less than 200 cases at court. But, each story of negligence, of a life affected by medical error, is one story too many.
Yet, Dr Tim Hegan of the Medical Protection Society said medical negligence wasn't getting more rampant and the quality of healthcare wasn't sliding.
What then is causing these cases of negligence, time and again? Dr Hegan said it was because of a lack of communication between doctors and patients.
"Doctors should explain to patients what the outcome of a treatment could be and show them that it might go wrong, or there might be an infection or a scar. We try to encourage our doctors to do that and maybe that isn't happening here as much," he said.
Medical Defence Malaysia executive director Dr Eddie Soo said doctors sometimes refused to talk to patients or patients' relatives.
"It's vital that the doctor talks to the patient, explains what's the diagnosis and the treatments available," said Dr Soo, who is also a consultant orthopaedic surgeon with a private hospital.
"Sometimes surgery's not the only answer. The patient must be given a choice -- it's his life, his suffering, his money."
In a landmark ruling by the Court of Appeal last year in the case of Foo Fio Na versus Dr Soo Fook Mun & Anor (see also Page 22), it was affirmed that doctors had a duty to disclose the risk to their patients before performing critical operations and it's for patients to decide whether to go for surgery.
Foo was awarded RM1.2 million in damages, including interest.
She was paralysed 25 years ago following an operation on the spine by Dr Soo to treat her dislocated cervical vertebrae after a car accident.
"If doctors don't really listen to their patients, they won't make the right decisions," said Dr Ponnusamy Muthaya of the Medico-Legal Society.
"Some don't give proper advice or explanation and, more often than not, doctors don't get informed consent from patients before starting any course of treatment."
But sometimes it was not communication, but sheer exhaustion that caused medical error, said Dr Ponnusamy.
"Doctors in the public healthcare system are often overworked. Some countries allow their doctors to work a maximum number of hours, after which they must go off-duty.
"But in Malaysia, we're more worried about bus drivers who work continuously, but are not as worried about our doctors working 18 to 20 hours. Why?"
Dr Soo said the privatisation of healthcare had led to increased competition among doctors and this sometimes resulted in unnecessary procedures or surgeries.
"I get patients who come and tell me that doctors don't say much but just tell them to go for operation.
"If doctors only want to make money, they should go into business, not medicine," said Dr Soo.
There's also a lack of focus on the prevention of error among healthcare workers "from doctors to ambulance drivers", said Dr Ponnusamy.
"There is no mechanism to prevent medical errors from occurring during treatment, where risks are identified and assessed from A to Z and measures are put in place to avoid or minimise risks," he said.
In a statement, the Association of Private Hospitals Malaysia said medical audits were carried out regularly by doctors and hospital management in larger hospitals to ensure good clinical governance.
But Dr Ponnusamy said most hospitals did not have proper medical audits.
And they are not compelled to report cases of medical error or negligence to the Health Ministry, unless it's related to the death of an infant or mother.
APHM said a "sudden mortality conference" was held among doctors for all cases of death, irrespective of normal or sudden or unexplained -- as required under the Private Healthcare Facilities and Services Act 1998.
"Sudden or unexplained deaths are reported to the police. Post- mortems are also conducted. This review is always carried out on a monthly basis," said APHM.
But, not all negligence incidents caused deaths, said Dr Ponnusamy. What about medical errors which caused non-fatal but devastating results such as permanent paralysis?
In addition, Dr Ponnusamy said some people in the medical field did not have the aptitude for the job.
"Patients question everything and medical information is available with a click of the mouse.
"So if a disease isn't treated the way they think it should, they may rightly or wrongly conclude that the doctor has been negligent."

When docs get it wrong

NST: A baby loses her forearm due to the alleged negligence of a trainee doctor, HIV-tainted blood is given to a woman, and a surgical gauze is left in a woman's abdomen after surgery. These and other incidents highlight medical negligence that is on the rise. TAN CHOE CHOE talks to the experts and the ministry for facts and figures
THE highest number of medical negligence cases in Malaysia occurs in the delivery room.
Health Ministry statistics show that about 4 out of every 10 negligence cases are from the field of obstetrics and gynaecology (O&G).
From 2000 to last year, 61 negligence cases involving government healthcare providers, mainly doctors, have been settled in and out of court.
O&G accounted for 27 of them, or 44 per cent.
Over RM3.47 million has been paid out as compensation. O&G alone accounted for RM1.54 million.
In view of the seriousness of medical negligence, the Attorney-General's Chambers set up a medical negligence unit in 2001 to tackle such cases.
From 2002 until October this year, figures from the unit show there are 186 negligence suits pending in court
Of these, O&G tops the list, accounting for about 41 per cent of the suits.
Media reports of alleged medical negligence in recent years also mostly involve O&G cases.
The most gripping is arguably the death of Felda settler Norizan Ismail last year, four years after she allegedly contracted HIV during blood transfusion after giving birth at a district hospital in Johor.
Then there's Lim Que Moi's story, where a piece of surgical gauze was left in the abdomen during an ovarian surgery in Malacca.
And who can forget the ordeal of baby Lai Yok Shan, who lost her left forearm to gangrene after a houseman inserted an intravenous needle filled with antibiotics into the arm muscles instead of a blood vessel.
Second in the medical field with the most negligence suits is orthopaedics (18 per cent), followed by medical (13), surgery (11), paediatrics (7) and others (10).
This trend is also reflected in the private sector but there's no data to verify this.

But if it's any indication, Medical Protection Society (MPS), the largest indemnifier of private doctors in Malaysia, is recording the highest number of negligence cases in O&G.
However, its head of international medical services, Dr Tim Hegan, declined to reveal figures.
"Many factors could influence (the statistics)... the denominator is up to how many doctors we've got in each group," he said.
"If you're a mum, what you want is a perfect baby. If you don't get it, you'll try to look for an explanation. That's worldwide."
British-based MPS, which has been in Malaysia for more than 40 years, is a world-leading indemnifier of health professionals with about 245,000 members worldwide.
In Malaysia, the medical defence organisation provides coverage for more than 3,000 private doctors, the majority in the private sector.

Dr R. Gunasegaran, an O&G specialist with a private hospital here, said national health indices showed the maternal mortality rate, the infant mortality rate and the neonatal mortality rate had been declining sharply.
"These are the indices to measure how healthcare is doing and these have always been declining, meaning that healthcare has improved. So obviously, there is no worsening of healthcare."
Comparing the indices with the negligence statistics, he found them "a bit of a mismatch" -- the quality of care is improving but litigation is rising.
"It could be because of patient's perception and demand of maternity care."
It may also be that the medical profession has become "a victim of its own success".
"Twenty or 30 years ago, when someone went into labour, there was a fear that the outcome would be quite poor, that you may not have a live mother or a live baby.
"But because we've improved that much, people now expect zero defects," said Dr Gunasegaran.
"There's no perfect outcome. There are risks, both maternal and neonatal, but they are largely minimised."
The total of negligence cases in public hospitals that has been settled by the government averages about nine cases a year in the past seven years, except for a spike last year of 16 cases.
But settled or not, Dr Gunasegaran thinks these cases do not necessarily reflect actual negligence.
"They (the ministry) settle (the cases) on the legal advice that it's better to shorten the whole process by coming to some kind of agreement.
"Like any other legal thing, (when) it's settled, it doesn't mean somebody is wrong, it's settled because (the involved parties) want to move on."
Last year, the ministry's Medical Practice Division received 251 complaints, primarily on unsatisfactory quality of service (54.58 per cent). Most were directed at doctors (49.06 per cent).

MPS is also seeing a gradual increase in overall claims and in the last two years, they average over 200 per year.
Does this mean medical negligence is more rampant?
Not really, said Dr Hegan.
"It's likely to do with increased patients' expectation, as well as their knowledge of their rights and ability to sue and make complaints. (Negligence claims) are increasing in other countries, too. It's a global trend.
"It's not that healthcare is getting worse or doctors are doing funny things. It doesn't relate to that."
This increase could also be due to a better complaints mechanism, said Dr Gunasegaran.
"We've made it very easy for the public to complain. Stop any guy on the street and ask him where he can complain if he's got a medical problem, he'll tell you the MMC (Malaysian Medical Council) or the Health Ministry.
"For other types of complaints, like transport, the person probably won't know where to go."
Interestingly, MPS is recently seeing a rise in claims related to cosmetics surgery. It is recording the second highest number of claims received.
"If I go in (to surgery) to look beautiful and I don't look beautiful when I come out... also, the money thing is important," said Dr Hegan.
"People often sue not because something went wrong and often it isn't. It's because of the amount of money they've paid and the outcome isn't what they wanted."

Suicide data to be ready in August

NST: KUALA LUMPUR: Official statistics on the incidence of suicides in the country will be published from next year.
The first data, comprising suicide cases reported this year, will be released by the National Suicide Registry Malaysia in August.
The data is being compiled by the Psychiatry and Mental Health Services, the Forensic Medicine Services, the Mental Health Registry Unit and the Clinical Research Centre.
The Accident and Emergency Departments of all major hospitals, university hospitals and the police have also been roped in to provide information on suicide cases.
The launch of the registry comes in the wake of a Health Ministry forecast that in the next 10 to 15 years, suicide will emerge as the second highest cause of death in the country after heart diseases.
Kuala Lumpur Hospital's Department of Psychiatry and Mental Health and Mental Health Registry Unit chairman Datuk Dr Abdul Aziz Abdullah said there were no accurate figures on suicides in Malaysia.
Recent estimates put the figure at between nine and 13 per 100,000 people compared with eight in the 1980s. However, health experts say the figure could be higher.
Of particular concern is the suicide rate in the Indian community in peninsular Malay- sia. It is estimated that 30 to 35 Indians in 100,000 commit or attempt suicide as against 15 Chinese and six Malays.
There are no statistics for Sabah and Sarawak or among the Orang Asli.
Dr Abdul Aziz said only confirmed and highly probable suicide cases would be put in the registry.
As such, the real figures could be higher because some suicides might be categorised as accidental death because it was taboo in some communities to spare the psychological burden on survivors or to avoid loss of life insurance payments.
"Whatever it is, there is always the question of reliability whenever suicide figures are presented or discussed. The ministry and others are aware of the gap in information about suicide and have been emphasising the need for a national surveillance system," he told the New Straits Times.
He said the data collected by the registry would be used to identify areas that health providers should focus on.
A website, www.nsrm.gov.my, is being set up for this purpose.
Dr Abdul Aziz said the main causes of suicide in Malaysia were financial problems, depression, drug and alcohol abuse, poverty, childhood abuse and mental problems such as schizophrenia.
Some of the factors that triggered suicides included stress, job loss, examination woes and relationship problems.
Over the last decade, threats and harassment from loan sharks have also resulted in a number of suicides and attempted suicides.
Poisoning, hanging, jumping from high-rise buildings and inhaling carbon monoxide are among the methods used.

Increasing awareness on dementia

Star: PETALING JAYA: Filial piety may be the cause of late detection of Alzheimer's Disease among Malaysians, Alzheimer's Disease Foundation Malaysia (ADFM) patron Datin Seri Wendy Ong said.
“Many families, especially in the rural areas, still consider Alzheimer's as part of the aging process and do not seek help and treatment until the situation worsens,” she said.
She said this when opening a public forum entitled “Dementia is Everyone's Business” organised by ADFM yesterday. The forum was held to create awareness and share information on caring for those suffering from dementia.
Wendy Ong, who is the wife of Housing and Local Government Minister Datuk Seri Ong Ka Ting, urged those diagnosed with early dementia to seek medical treatment.
She said this could help caregivers be better prepared and cope with the problem.
“Early treatment will also enable them to maintain a reasonable quality of life,” she said.
Based on international statistics, she said 5% of people between the ages of 65 and 80, and 20% of those aged above 80 will have dementia.
“It is a disease that hits people as young as 45 years old.
“As our population ages, we are going to experience more and more cases of dementia, especially Alzheimer's Disease,” she said.
Speaker Willie Kwa, an ADFM exco member, said it was hard having to look after people with early dementia because they were sometimes rational and other times confused and would talk gibberish.
“Quite often they lose the ability of knowing what they are doing, and have very short attention span and frequent memory lapses,” said Kwa, a retired mental health practitioner for the elderly in Britain.

Easier access to healthcare for all

Star: SEGAMAT: Healthcare will be more accessible with the deployment of more mobile clinics around the country.
Health Minister Datuk Seri Dr Chua Soi Lek said the Cabinet had approved an additional 96 mobile clinics to the present 151.
He said the 96 would be introduced in stages over the next three years.
Dr Chua said that although the standard of healthcare in the country had improved considerably since independence, there were still those who did not have access to proper healthcare services, such as the rural folk and urban poor.
“In some urban areas, development was so rapid that there was no land for us to build polyclinics or community clinics.
“The scenario especially applies to older developments, where there was no provision for the developer to reserve land for clinics,” he said.
He added that the issue did not arise in new developments as developers now had to gazette land for public clinics in their plans.
Dr Chua said the 151 mobile clinics had a reach of 1.1 million people and treated about 100,000 patients last year.
“Each team consists of one doctor, one nurse or medical assistant and one pharmaceutical assistant. The mobile clinic is equipped with basic facilities and also a basic lab to conduct tests like urine samples,” he said.
He added that the mobile clinics would be more appealing to doctors who did not want to be based in rural areas.
“Doctors can go with the mobile clinics and travel from town to the rural areas and still get to go home (at the end of the trip),” Dr Chua told newsmen after launching Pharmaniaga’s mobile clinic in Labis, near here, yesterday.
The mobile clinic, part of Pharmaniaga’s corporate social responsibility programme, is a converted ambulance and will be manned by volunteer doctors and nurses from Mercy Malaysia.
Pharmaniaga chairman Datuk Mohamed Azman Yahya said that the mobile clinic would provide healthcare services free of charge.

Panel: Review healthcare pact of firm

NST: KUALA LUMPUR: A committee of doctors from eight private hospitals in the Klang Valley wants the government to review ING Insurance Bhd's new Healthcare Service Provider Agreement (HSPA).
The Joint Inter-Hospital Healthcare Committee (JIHC) says the new agreement will adversely affect a patient's access to quality private healthcare.
The HSPA is a commitment between healthcare service providers and ING under its employment benefit scheme. More than one million people are covered under the scheme.
JIHC spokesman and Federation of Private Medical Practitioners Association of Malaysia's president Dr Steven K.W. Chow said ING recently proposed new terms to private healthcare specialists as part of their exercise to set up a panel network of specialists in the Klang Valley, stipulating the scope of services that could be offered to patients.
He claimed that the new terms were unethical and would limit the patients' access to healthcare. He said, among others, doctors would not be properly reimbursed for emergency care and critical care outside of office hours, and there would be a limit to the number of chargeable visits allowed for specialists in certain disciplines.
"But the issue goes beyond fees. We want ING to come up with a HSPA that is more patient-centred and less profit-driven," he said.
In September, specialists and private practitioners received a letter from ING stating the new terms, and saying that those who did not accept by Sept 30 would not be listed on ING's panel. So far, Pantai Medical Centre and Sunway Hospital have had their services terminated and are no longer on the panel.
"We do not find it proper for any managed care organisation to demand discounts in order for doctors and hospitals to be on their panel," added Dr Chow.
ING senior vice-president for employee benefits Phoon Yew Sang said the new HSPA would not affect the patients, and any discounts negotiated with the hospitals would be passed back to their customers and not go to ING.
"This has nothing to do with access to quality private healthcare. Hospitals that have given us discounts are as good as those who haven't. Without discounts, our customers' maximum coverage limit would be reached more quickly," Phoon said.
He said members could still go to non-panel hospitals, but there would be no cashless facility and ING would reimburse them later based on what was customary and reasonable.

Free medical screening for some Socso members

NST: KUALA LUMPUR: Some Socso contributors will be eligible for free medical screening from January, and could even receive the appropriate care.
Human Resources Minister Datuk Seri Dr Fong Chan Onn said the Pro Health Programme was for Social Security Organisation members who did not receive Socso benefits or pensions.
Details of the scheme, such as which age groups can benefit, are being worked out by Socso, which has 4.6 million active members.
Fong said that after the success of the central region's return-to-work programme for injured and disabled workers, it would be expanded to Malacca and Penang by next month.
He said two-thirds of the 312 workers who underwent rehabilitation that started in January had returned to work.
He said the programme's success hinged on the five care managers who worked with all parties concerned: the workers, their families, the employers and rehabilitation centres.
Five more care managers will be employed for the extension of the scheme as one manager can handle only 50 cases.
Fong said he was happy with the 66 per cent success rate of the programme, comparing it with Australia's 30 per cent and Scandinavia's 10 per cent.
He also announced a cabinet decision that those who recruited foreign workers needed to first advertise and register the vacancies on the electronic labour exchange for at least two weeks. Before they could recruit foreigners, they must show they had tried to hire local workers, he added.
This will give the government a clearer idea of jobs available in the different sectors, such as plantations, services, manufacturing and construction.
He said while foreign estate workers may be necessary as locals were not keen on such jobs, the other sectors needed to improve their productivity.

Ministry to set minimum content for Tongkat Ali drinks

Star: PUTRAJAYA: The brew claiming to contain Tongkat Ali may not be living up to the aphrodisiac values attributed to the plant and producers could be charged with misleading the public under a new health standard if they make such claims.
To banish doubts about the potency of the beverages, the Health Ministry will set a minimum content of Tongkat Ali (Eurycoma longifolia) in drinks such as tea and coffee.
Minister Datuk Seri Dr Chua Soi Lek said that analysis by the ministry, universities and the Forest Research Institute of Malaysia (FRIM) showed that the Tongkat Ali content is at a minimal level in many drinks and did not have any effect at all for the consumer.
“The advertisement says it is coffee with Tongkat Ali. And the consumer pays more for it,” he told reporters at his ministry's Hari Raya open house here yesterday.
He said once the standards are set, manufacturers could be charged if their products did not have the required level of the Tongkat Ali, which is said to contain aphrodisiac qualities.
It was reported in July that a FRIM study of 10 popular Tongkat Ali coffee brands showed that seven of them contained only 0.25% to 1.6% of the plant extract and was not sufficient to benefit one’s health.
Dr Chua said his ministry hoped to draw up the standards over the next few months and will discuss it with the Domestic Trade and Consumer Affairs Ministry to have it included under the Trade Description Act.

Quack surgeons’ victims pay the price for botched jobs

Star: KUALA LUMPUR: A 28-year-old woman here went to a beautician for collagen injection to look younger. She ended up with a disfigured face with her cheeks hardened and slumped.
The salesgirl, known only as Ms Chan, had taken the advice of her model friend to seek the help of a beautician in Segambut for a collagen injection to look youthful.
She decided to take her friend's advice and went to the beautician in February because specialists and plastic surgeons were expensive.
Her treatment had cost only RM150 for one session, which included four injections. All the treatments took place at the beautician's house.
Almost nine months and four sessions later, Chan's cheeks became hard and drooped. Both sides of her face also become disproportioned.
Her worry led her to seek the help of MCA Public Complaints and Services Department head Datuk Michael Chong.
“She is the fifth case of victims of quack beauticians and surgeons.
“The other four involved breast augmentation and also facelifts,” he said in a press conference.
Chong said that despite his numerous warnings to the public, women continued to seek cheap methods to look youthful and beautiful.
He added that most of the treatments or surgery usually took place in a house or shop.
“They are paying the price for their vanity. Some of the women who came for help had gangrene on their breasts or their faces had become distorted.
“Chan, for example, is worried whether the substance that has been injected into her face will cause cancer,” said Chong.
He said he had helped Chan to seek specialist help. The specialist suspected that the substance used on Chan was very likely to be silicon or paraffin instead of collagen.
“I’ve advised her to lodge a police report. I will see what can be done to ease her pain,” he said.