Thursday, August 17, 2006

Angry doctors issue ultimatum to MMA leaders

NST: KUALA LUMPUR: In all his 20 years as a doctor, Datuk Dr Teoh Siang Chin has not seen so much anger being vented by medical practitioners.
They are unhappy with the Private Healthcare Facilities and Services Act 1998, which makes it compulsory for doctors to upgrade their clinics and have equipment for emergencies.
As president of the Malaysian Medical Association, Dr Teoh is also feeling the brunt from the several thousand members, who have issued this ultimatum to MMA office bearers: resolve this issue or resign en bloc.
"We just cannot believe the amount of anger they are venting," said Dr Teoh when asked to comment on doctors planning to stage protests against the Act which came into force on May 1, this year.
The MMA leadership is caught in the middle between a group of angry doctors and the ministry which is firm on its implementation of the Act and Regulations 2006.
Dr Teoh said the MMA has already submitted a 37-page memorandum to Health Minister Datuk Dr Chua Soi Lek a month ago.
On Tuesday, Dr Chua said, he would take into account what was in the memorandum when proposing amendments to the Act as he acknowledged that there has been a lapse of 13 years since it was mooted before being passed, and now to be enforced.
Dr Chua, who is to meet MMA leaders and doctors on Aug 24, agreed that some sections in the Act needed amendments as they were no longer relevant to current times.
While awaiting the amendments, the minister has asked the over 7,500 private practitioners to register. So far less than 10 per cent have done so.
The MMA is also equally concerned that only a small number of doctors have registered to date.

Dr Teoh said: "We know it’s their rice bowl and some have been practising for 30 years. They have been very professional about their work but the demands in the Act have really angered them."
Among them are the RM1,500 registration fee with which they have to submit details such as the plan of the organisation, which includes the location of doors, windows, air-conditioners, ventilators, toilet, staff identification, billing procedures, infection and vector control and basic emergency care services.
Dr Teoh said many of the requirements were not relevant for lone practitioners.
"I agree that the hesitation in registration may be due to the lack of clarity regarding the details of the requirements for registration. Many doctors have not got a copy of the Act and the information they get is from the MMA and the ministry’s road shows," he said.
(Dr Chua admitted that some of the confusion was also due to those who conducted the road shows were not able to give the best answers to questions raised by doctors.)
On Dr Chua’s statement that the MMA was a party to the discussions on the Act, Dr Teoh said: "We would like to point out that this was only in the early stages, the last briefing being in 2003. There have been no meetings to discuss the final version of the Regulations."
He said some of these regulations would inevitably lead to defensive medicine and additional bureaucracy.
He said many doctors’ attention would be diverted from patient care as the real and opportunity cost of registration, renovations and upgrades required by the specifications of toilets and taps (among others) may be in excess of RM20,000.
"These costs will inevitably be passed on to the consumers," said Dr Teoh.
He said for clinics in rented premises, some of the structural changes were impossible and the frustration vented by many experienced GPs practising in the same clinic for decades was surely a prelude to them prematurely giving up practice, which would be a great loss to the communities they have served for so long.

Federation of Private Medical Practitioners Association president Dr Steven Chow said they were against the call for boycotts and street protests.
"We urge all private practitioners not to join this call for such drastic action as it will be counter-productive to the positive development thus far. The association is in the advanced stage of working out an agreement with the ministry to approach issues arising from the implementation of this Act," he said.
He said the ministry has agreed to consider most of the proposals and recommendations made by them for amendments to the Act and the Regulations.

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