Sarawak MMA members told to supporty 1Care

The Star Online KUCHING: A controversial proposal to revamp public health that will involve mandatory private sector participation, loomed large at a Malaysian Medical Association (MMA) gathering.

The 1Care, which was recently renamed Malaysian Health System Study, had such bad publicity that the Government had to send its top officials to engage the Opposition in forums held to raise awareness of the proposal nationwide.

At MMA’s Sarawak branch committee installation dinner, its new chairman Dr Donald Liew reassured his members that the non-governmental body would continue to engage and advise the Government on the study.

“Ever since 1Care was presented to the Economic Council in 2009, MMA fought hard to be included in subsequent discussions to formulate a better healthcare model for our country,” Liew said in his maiden speech as state chairman.

He said the existing healthcare model was a financial burden, but cautioned the Government against forcing through legislation without adequate consultation with doctors.

“To remain relevant, MMA members must contribute to this transformation of our healthcare system. This is a huge task, and the challenge is spiralling costs. Since the Health Ministry is carrying out roadshows, all ought to attend and make an effort to formulate constructive contributions,” Liew said.

The proposed revamp is essentially a restructure of public healthcare. It proposes to redistribute finances and responsibilities.

When a forum on the matter was held here earlier this year (when the plan was still known as 1Care), government officials explained that private clinics could be turned into part and parcel of public health care.

The proposal called for clinics – government and private – to act as gatekeepers. Patients would visit their designated clinics while doctors at clinics would be responsible for determining whether further treatment was required at hospitals.

The move was aimed at tackling overcrowding at public hospitals, and leverage on the fact that private clinics were numerous and scattered throughout the country. However, 1Care came under almost immediate criticism.

Liew told MMA Sarawak members to brace themselves for “a new way of practising medicine in our country”.

The Government has not said when the new proposals would be implemented or whether further revisions would be made.

In a recent paper by Sarawak General Hospital director Dr Abdul Rahim Abdullah, which was included at MMA’s installation night booklet, he wrote that injecting funds into the existing healthcare model would not solve problems.

It would be akin to “pouring water into a leaking container,” said Dr Abdul Rahim’s paper titled “Transforming Health System”.

“There are significant mismatches in workload and resources between the public and private sector. Just over 10% of primary care clinics are publicly owned, but handling 40% of total patients visits. Meanwhile, about 80% of hospital admissions are in public hospitals, but only 55% of doctors are within the public system.”

The clinic-as-gatekeeper approach is officially known as the “regional area approach”.

Under it, a combination of public and private clinics would be allocated to patients within a specific area.

Through this, the proposal aims at better utilising doctors in the private sector. These private clinics would be paid by the Government.

Patients, however, can still bypass such systems by paying private fees, out-of-pocket or from private insurance.

Dr Liew’s 2012-2013 executive committee included Dr Albert Wong as vice chairman, past chairmen Dr John Chew and Prof Dr Sim Kui Hian as committee members