Saturday, August 31, 2013

Hilmi: We have 3m obese Malaysians

New Straits Times

GEORGE TOWN: THERE are about three million obese Malaysians and the number is increasing, said Deputy Health Minister Datuk Seri Dr Hilmi Yahaya.
Also, about five million people have varying degrees of diabetes, he added.
"Malaysia is not only the country in Southeast Asia with the most number of fat people, we also have the dubious distinction of having the highest number of diabetics in the region.
"All these statistics are based on reported cases, but we still have many undetected ones," he said after opening the national gathering of pharmacy students 2013 Universiti Sains Malaysia community outreach programme at the Mutiara Idaman flats in Jelutong here yesterday.
He was commenting on the New Straits Times front-page report on Monday highlighting the rise of obesity among schoolchildren.
He agreed with the NST findings, which blamed environmental factors for obese kids.
"We need to change and improve our lifestyle. I strongly believe it begins at home and parents must take the lead to set a good example on good eating and healthy habits.
"The government never ceases to take steps to ensure the people stay safe and healthy but at the end of the day, it is still up to the individuals to decide if they want to be healthy or expose themselves to life-threatening illnesses."

KUNA : Leptospirosis claims 28 lives in Malaysia


Malaysia Ministry of Health reported a total of 28 death cases of leptospirosis as of August 24, from a total of 2,925 infected cases in the country.
Health Minister Datuk Seri Dr S. Subramaniam said the latest statistic has brought the total number of rat urine disease cases to 2,925 so far this year. In 2012 48 death cases were reported out of 3,665 cases, and in 2011 55 death cases out of 2,268 infected.
"The leptospirosis situation in Malaysia showed that rats were the main reservoir for the disease, although other wild animals could also be infected by the leptospira bacteria.
"We urge members of the public to avoid patronizing food premises which are dirty, to maintain good hygiene and to avoid holding recreational activities by pools, ponds or rivers.
"Handle your waste or garbage properly so that rats cannot feed on them or that could contribute to an increase in the rat population," Dr. Subramaniam said.
He also urged those who had been exposed to the risk of leptospirosis and had symptoms such as fever and body aches to seek medical attention immediately.

Health insurance sector to reach US$5b by 2020

Malaysian Reserve

Malaysia’s health insurance sector is expected to more than triple by 2020 to reach US$5 billion (RM16.53 billion), presenting growth opportunities for the sector, according to a new study by Roland Berger Strategy Consultants.
The study called “SEA — The New Frontiers for Health Insurers” also said that health insurance industry in South- East Asia (SEA) is expected to grow to US$24 billion by 2020 at a compound annual growth rate of 15%, four times its previously valued size of US$6 billion in 2010.

“In Malaysia, we estimate that only 20% to 30% of the target population (household with monthly disposable income of over RM3,500) for health insurance has yet to subscribe to one product,” said Roland Berger head of financial services in SEA, Philippe Chassat, in Kuala Lumpur yesterday.

As disposable incomes rise, personal health becomes a priority and the next six years will see increasingly affluent consumers in the region driving demand for health policies to pave access to more advanced healthcare, said Chassat.

The report said health expenditures in Malaysia are expected to grow at 9% per year and the figure would double to US$880 per capita by 2020 from US$379 per capita in 2010.

“While 56% of healthcare funding in Malaysia is publicly backed, rising cost of the healthcare system will trigger private insurance protection buying,” said Chassat.

The study also discovered that insurers do not enjoy as favourable a referral rating as banks, where banks have a 70% referral rating compared to 48% for insurers.

In light of this, the study said insurers need to master four key challenges to succeed, especially in stepping up their distribution channels in addition to better targeting their client segments.

Chassat said bancassurance presents growth opportunities for distribution, where 47% of the mass-affluent in Malaysia would consider buying their health insurance products at their banks.

Friday, August 30, 2013

1Malaysia Clinics giving GPs ‘migraine’ — MMA chief

 BorneoPost Online 

KUCHING: The sprouting of 1Malaysia Clinics (K1M) across the country has posed a big challenge for private clinics.
Malaysian Medical Association (MMA) president Dato Dr NKS Tharmaseelan said general practitioners (GPs) now viewed K1M as their biggest competitor.
“We propose the government sets up more 1Malaysia Clinics in rural areas, not in urban areas that already have too many clinics.
“The government (through the K1M) is now the biggest competitor to GPs. How to survive?” he asked at MMA Sarawak’s 41st annual dinner here on Saturday.
There are more than 200 K1Ms nationwide serving about 1.5 million people, and between 40 and 50 more K1M may be opened next year. The first K1M opened in 2010.
Dr Tharmaseelan also expressed his concern over the presence of too many medical colleges in the country.
He blamed it on poor coordination between the Ministry of Education and Ministry of Health.
The country has 40 medical colleges, he said, and the result might be many unemployed doctors soon.
To solve the problem of having many doctors, he said MMA had proposed to the government to build more hospitals, turn district hospitals to training centres, accredit private hospitals as training centres, and have doctors run K1Ms – not assistant medical officers.
Deputy Health Minister Datuk Seri Dr Hilmi Yahaya, who officiated at the function, said MMA suggestions would be given due consideration.
On another matter, Dr Hilmi said the country was besieged by diseases of affluence and non-communicable diseases (NCD). There are about 2.6 million adult diabetics, 5.8 million are hypertensive, 6.2 million have high cholesterol levels and 2.5 million are obese.
Besides having to grapple with these diseases, the government also need to address public concerns such as long waiting times, insufficient staff, crowded facilities and accessibility issues in the rural areas.
“About 60 per cent of doctors are in the public sector, and with other paramedics and allied health workers, they manage about 47 per cent of outpatient visits and 75 per cent of inpatient episodes.
“Illnesses treated in public facilities are more chronic and severe, while there are more senior and experienced health care providers in the private specialists sector. The ministry hopes to address the concerns of efficiency of the overall health service,” he said.
Also present were Assistant Minister of Public Health Dr Jerip Susil, Health director Datu Dr Zulkifli Jantan, Sarawak General Hospital director Dr Abdul Rahim Abdullah and MMA Sarawak branch Dr Donald Liew.
Several awards were presented during the dinner to honour outstanding doctors in Sarawak, and also to reward high-achieving medical students from Unimas.

Thursday, August 29, 2013

Do not use these three traditional medicines

The Star ePaper

PUTRAJAYA: Three traditional remedies have been found to contain scheduled poisons, said the Health Ministry.
According to its senior director of pharmaceutical services, Datuk Eisah A. Rahman, the public has been advised not to buy or use the three products containing sildenafil and dexamethasone.
The National Pharmaceutical Control Bureau had received information from its Singapore counterpart, the Health Sciences Authority, that the three products are Li Long Mei Guo Mo Bang (sildenafil), Africa Black Ant (sildenafil) and Ginseng Tu Chong Wan Lin Heong (dexamethasone).
Eisah said in a statement yesterday that checks found that all the three products were not registered with the Drug Control Authority.
“The use of sildenafil and dexamethasone is not allowed in traditional medicine,” she added.
Sildenafil, commonly marketed under the brand Viagra, is a drug used in the treatment of erectile dysfunction, and can only be supplied by a doctor or obtained from pharmacies with a prescription.
Dexamethasone is a potent antiinflammatory drug often used in the treatment of allergy, and is also a prescription medicine. — Bernama

Tuesday, August 27, 2013

Health Ministry hoping for bigger allocation in 2014 Budget

The Malay Mail Online
PUTRAJAYA, Aug 27 — The Ministry of Health is confident of receiving a bigger allocation in the 2014 Budget to carry out a variety of important programmes, including the development of infrastructure in hospitals throughout the county.
“We have already put in our request because we need more funding. Our infrastructure in terms of hospital space is still inadequate. There are many hospitals that are overcrowded, so we need to reduce the pressure on those hospitals.
“With a bigger allocation we are also looking for more investment into preventive care at all levels, including at the clinic levels (clinic kesihatan level), as we can optimise care of patients.
“We are committed to increase the budget for preventive health care. The treatment component, even though we are spending 66 per cent, but still not enough. That is the most difficult part of it,” he said at a press conference after launching the Malaysian Health System in Transition (HiT) Country Report, here, today. 
Also present were World Health Organisation (WHO) Representative to Malaysia, Brunei Darussalam and Singapore Dr Graham Harrison, Director, Asia Pacific Observatory on Heath Systems and Policies, WHO Western Pacific Regional Office, Mania Dr Dale Huntington and Director, Division of Family Health Development Ministry of Health and lead author of Malaysia HiT report Toh Puan Dr Safurah Jaafar.
Dr Subramanian said the total health expenditure in 2010 was 4.4 per cent of GDP at RM33,657,000,000 with 55 per cent of total health expenditure spent by the government.
“If we are to increase this to 6.1 per cent GDP which is the average for upper middle income countries internationally, where will we find the funds for this.
“Finding an amicable solution to this question will occupy the whole of the government and other stakeholders in health for the coming review of our nation health system,” he said.
Thus, he said that the ministry was now focusing on increasing public awareness on health issues, especially early detection and prevention of diseases which could save lives or avoid more serious health problems and besides that reduce government expenditure on public health.
According to him, in line with national development, Malaysian life expectancy has also improved, as well as the drastic reduction of maternal, infant and child mortality.
He said, WHO had recognised Malaysia as among countries that provided the best health services to her people.
Commenting on the HiT report, Dr Subramaniam said the report was a comprehensive review of the country’s health system and policy reform, including providing an objective account of the strengths and points out areas that need strengthening in the health system. – Bernama 

'Merdeka' enables Malaysia to focus on healthcare

New Straits Times

KUALA LUMPUR: Fifty-six years after gaining independence from Great Britain, Malaysia has seen tremendous development and progress in every field including education, industrial, agriculture, petrochemical and healthcare.

When it comes to infrastructure, as an independent nation, Malaysia can plan and construct huge infrastructural projects to meet the requirements of its people, such as highways and ultra-modern airports like the Kuala Lumpur International Airport (KLIA).
The world-famous skyscrapers, such as the Petronas Twin Towers at the Kuala Lumpur City Centre (KLCC), symbolize such progress.
Being an independent and sovereign nation has enabled Malaysia to lay stress on expansion and development of the nation's healthcare.
The government has initiated various measures to improve the public healthcare sector including refurbishing existing hospitals, building and equipping new hospitals as well as setting up more polyclinics.
Among the revolutionary innovations in the healthcare sector is the 1M (One Malaysia) Clinic, the brainchild of Prime Minister Datuk Seri Najib Tun Razak.
Najib wants to ensure that health services can be made accessible for all Malaysians, particularly those in the lower income group.
Najib is aware that the urban poor are unable to receive treatment offered by private clinics, either because such clinics are located too far from where they live or because their services are too expensive.
But now, more than five decades after gaining independence, the poor have a practical alternative.
The 1M Clinic is one of the initiatives under the 1Malaysia concept mooted by Najib.
What are these 1M clinics?
They are community clinics that are strategically located and remain open every day for 12 hours from 10am to 10pm.
These clinics, which are manned by nurses and medical assistants with at least five years’ experience each, provide quality treatment for only RM1 per person. Non-Malaysians have to pay RM15 per person.
The move to charge a flat fee of RM1 at these clinics is among the government's initiatives to ease the high cost of living for the people.
The first 1M Clinic was opened on Dec 28, 2009 in Lembah Pantai here.
According to the Health Ministry's statistics, there are now some 230 1M clinics nationwide, serving about 1.5 million people.
Last July, Health Minister Datuk Seri Dr S.Subramaniam said 40 to 50 more 1M clinics will be set up nationwide next year onwards to meet the public demand, particularly in the rural areas.
He said the clinics would be concentrated in areas inhabited by a large number of people from the low-income group.
"It is a successful 1Malaysia product and can benefit the people by ensuring a good level of healthcare," he was reported as saying by the media at a recent function.
Dr Subramaniam said the Health Mibnistry will ensure that the best system of delivery and services are made accessible to the people as Malaysia's healthcare sector is acknowledged as being among the best in the world.
He also said that the ministry would try to deploy at least one doctor at each 1M Clinic while currently there are only 22 such clinics that have a doctor each.
Why do people visit these 1M clinics?
Civil servant Zaida Zainol has the answer.
"A relatively short waiting time, low and affordable consultation fee, a convenient location and friendly services are among reasons why the 1M clinics are well received by the Malaysians.
"The 1M Clinic has provided a relief from the increasing cost of living," she added.
Zaida, 40, from Bandar Tasek Puteri near here, described the clinics as the government's best initiative in providing essential healthcare for its people.
Her neighbour, housewife Mariam Abdullah said the clinic is a convenience for the Malaysians in terms of the RM1 fee and their convenient location.
Both of them regularly visit the 1M Clinic located at the Bandar Country Homes in their neighbourhood.
Trader Zakierin Abdullah said the clinic is open even during the public holidays.
"The clinic services all Malaysians charging a fee of only RM1. This includes treatment for cough, cold, fever, small injuries and follow-ups for diabetes and hypertension," he said.
He said the opening hours – 10am to 10pm – are also convenient for the working people.
Zakierin said treatment and medicines at private clinics may cost up to RM50 for each visit.
"The medication provided is by no means inferior, notwithstanding the fact that only a miniscule fee of RM1 for registration is charged.
"1M Clinic is beneficial to the people, especially those from the lower income group," he added.
For social activist Amin Iskandar, being independent is something that each nation wants.
"The people, led by their leaders, can decide what is best for them. They can march forward towards further progress without being restrained by the colonialists.
"That is the glory of achieving Merdeka," he added. -- BERNAMA

Monday, August 26, 2013

Many doctors unwilling to serve in Sarawak

BorneoPost Online
KUCHING: Many doctors including Sarawakian professionals shun serving in the state and this had resulted in a relatively high 1:1,500 doctor patient ratio.
Deputy Health Minister Datuk Seri Dr Hilmi Yahaya said Peninsular Malaysians who completed their residency or after serving two or so years in Sarawak had the tendency to request for a transfer out of the state.
The entire situation is worsened when Sarawakian doctors also preferred to serve in West Malaysia instead of their home state, he told a news conference after an official visit at the Sarawak General Hospital here on Saturday.
Dr Hilmi did not go into the reasons why most doctors had favoured hospitals in Peninsular Malaysia as their workplace.
He, however, said the ministry had offered allowances and incentives to encourage doctors to be stationed in Sarawak.
“Even though the ministry does not encourage them to pick where they want to serve, we do not force them into making certain decision either.”
In Peninsular Malaysia, he said the doctor-patient ratio stood at 1:700, still slightly higher than the objective of achieving 1:600.
Dr Hilmi said the ministry had policies in place to send West Malaysian medical students, who completed their training to serve in Sarawak.
“But two years later, they put in a transfer request back to West Malaysia.”
Meanwhile, Assistant Minister for Public Health Dr Jerip Susil, who was among those present at the news conference, said the state government had continued offering extra allowances for medical officers who chose to serve in Sarawak.
“This is different from the federal allowances, which means they will earn more. We aim to retain more Sarawakian professionals.”
Also present was state health director Datu Dr Zulkifli Jantan, who disclosed that the department received 70 medical officers from Peninsular Malaysia so far this year.
He said the number marked an encouraging increase against that of 40 last year.
“We are looking forward to taking in more medical officers to serve in Sarawak,” added Dr Zulkifli.

Saturday, August 24, 2013

Specialist hospital for kids expected to be ready in 2017

The Star Online

KUALA LUMPUR: Malaysia will soon have a dedicated specialist hospital for children, a move that will bring the nation closer to developed nations in providing quality health services to the people.
The hospital, to be known as the Universiti Kebangsaan Malaysia (UKM) Permata Children’s Specialist Hospital would provide treatment in niche areas in paediatric medicine and surgery.
It aims to be in the same league as hospitals including the Great Ormond Street Hospital for Sick Children in London, Los Angeles Children’s Hospital and The Royal Children’s Hospital in Melbourne.
Prime Minister Datuk Seri Najib Tun Razak said providing quality healthcare services, aside from education and housing were among the Government’s commitment to facilitate the growth and development of children to prepare them to face the complexities of future challenges.
Some children looking at amodel of  permata specialist children hospital at HUKM Cheras. 
Some children looking at a model of the Permata Children’s Specialist Hospital at Hospital UKM 1 in Cheras.
“Since Independence, the Govern­ment has provided the people with comprehensive healthcare services.
“The Health Ministry has provided universal health coverage at a minimum cost where in 1Malaysia clinics, a fee of only RM1 is charged. This is a testimony of the Government’s commitment and concern to the rakyat’s needs,” he said yesterday at the hospital’s ground-breaking ceremony.
The RM606mil project will be built on the grounds of Hospital UKM l in Cheras and is expected to be ready in 2017.
It is expected to have a staff strength of 1,900, including 135 specialists and medical officers.
The hospital is the brainchild of Permata Negara patron Datin Seri Rosmah Mansor, who has taken keen interest in the wellbeing and development of children and has launched a list of initiatives for children under the Permata banner.
Najib said health indicators show that Malaysia is at almost the same level as developed nations, with 2011 statistics showing that infant mortality rates for those aged below one year being 6.6 for every 1,000 births, a figure similar to that recorded in the United States and Europe.
“Health index is an indication of a country’s success, not only in terms of providing satisfactory healthcare but also in socio-economic aspect,” he said, adding that he had agreed with the construction of a specialist hospital for children as healthcare services were one of the 12 areas under the National Key Economic Area.

Friday, August 23, 2013

Selfish patients clogging up A&E

Borneo post

KUCHING: About 80 per cent of the cases attended to by emergency personnel at the Accident and Emergency clinic (A&E) of the Sarawak General Hospital (SGH) here are non-critical cases which do not need immediate attention.

This was disclosed by SGH director Dr Abdul Rahim Abdullah to The Borneo Post yesterday in response to complaints from the public on the perpetual overcrowding at the A&E clinic.

He added that in 2011, out of the 106,591 cases treated at the A&E department, 82,927 were non-critical cases making up 77.8 per cent of total cases while 17.2 per cent or 18,378 cases were semi-critical cases.

Only 5,286 cases or five per cent of the total cases registered at the A&E clinic were critical cases which warranted immediate treatment.

The situation had not been better in 2012 with 107,740 registered cases, out of which 85,182 or 79 per cent were non-critical cases, 17,832 were semi-critical cases and 4,726 or 4.4 per cent were critical cases.

On the average, the A&E clinic treats about 300 patients daily while on busy days the figure could surge to over 400 and could come down to about 250 on a quieter day.

“But it is always more than 250 cases,” said Dr Abdul Rahim.

Although the hospital authorities know that they can turn away most of these cases, the doctors and medical personnel still treated the patients.

“In other countries such as United Kingdom, the patients will not be given treatment but asked to go back.

“But for us here, since they are already here and they don’t mind waiting, we still treat them,” said Dr Abdul Rahim.

He added that the hospital was forced to increase the number of medical personnel to cater to “non-critical” patients.

Presently, at any time, there are 12 nurses, 12 medical assistants and seven doctors serving at A&E clinics.

“We even engage two locums at the A&E clinic who will see patients between 8pm to 10pm
as an extra effort to serve the public,” said Dr Abdul Rahim.

He lamented that the large percentage of non-critical cases seeking emergency treatment was a blatant abuse of the facility by the patients.

“There are those who come for treatment at A&E so that they don’t have to queue up at the polyclinic the next day.”

Dr Rahim said most of the non-critical cases involved patients with flu, sore throats, fever and running nose.

He urged those who did not need emergency medical attention not to abuse the A&E facility because medical personnel trained to treat emergency cases had to attend to non-emergency minor illness while those who were facing life-threatening situations had to wait.

Dr Abdul Rahim pointed out the Polyclinic at Jalan Masjid opens until 8 pm and 1Malaysia clinics until 10 pm.

He appealed to those with non-critical illness to seek treatment at these clinics rather than going straight to A&E adding that if the cases were serious, the medical personnel at the polyclinics would refer them to the A&E.

Sunday, August 18, 2013

Doctors call for 30% hike

The Star Online

PETALING JAYA: Doctors in private clinics and hospitals are asking for a 30% increase in consultation fees, saying it is impossible for them to survive with rising operating costs.
Malaysian Medical Association president Datuk Dr N.K.S. Tharmaseelan said the proposed hike was more than a decade overdue.
He claimed that doctors were now paid less than plumbers, electricians, hairstylists and food outlet operators.
General practitioners get between RM30 and RM50 per consultation while specialists charge between RM50 and RM80.
Dr Tharmaseelan said: “It is a misconception that doctors are rich and greedy. Many doctors are scraping the barrel with rising utility, rent and salary costs, and quite a few have even quit practice as it’s just too expensive to maintain a clinic.
“On average, the operating cost for a general practitioner to run a clinic in Kuala Lumpur is about RM20,000 per month.”
There are over 7,600 private clinics and hospitals nationwide. The association represents over 3,000 members.
Dr Tharmaseelan added that a general practitioner charged cough and cold patients between RM45 and RM50, including medication.
“It does not make sense that people are paying more for a haircut or a meal than for treatment,” he said.
He said that a rise was necessary for doctors to cover their “basic costs” in light of mandatory rulings like paying minimum wage.
“We are also required by law to have medical indemnity insurance, hire radiographers and engage waste disposal contractors at our clinics.
“It’s been three decades and our fees have remained unchanged,” he said.

He said the MMA submitted the new fee schedule to the Health Ministry two years ago but the proposal was rejected because the Government felt it was steep.
He said the MMA could not agree to the Government’s 14% fee increase proposal made last year as it would result in a bleak future for its members.
Malaysian Medical Council member and senior medical practitioner Dr Milton Lum said: “A plumber charges between RM50 and RM100 just to check my pipes – that’s way more than what a general practitioner charges (for a consultation).
“These days, RM100,000 medical bills are not uncommon but doctors only receive a fraction.
“Between 75% and 85% of the bill goes to the hospital and managed care organisations,” he said.
Federation of Private Medical Practitioners Associations Malaysia president Dr Steven Chow said the existing schedule amounted to only 2.3% per year since 2000.
“Bearing in mind the inflation rate, the 30% hike is a fair request,” he said.

Too many doctors, too little training

The Star Online

The future remains uncertain for aspiring doctors unless more training hospitals are opened.
COME next year, some 5,000 doctors are expected to be jobless.
This is because there are not enough government hospitals to train the large number of medical graduates being churned out, says Malaysian Medical Association (MMA) president Datuk Dr N.K.S. Tharmaseelan.
“There are just too many doctors and too many medical institutions flooding the market,” he claims, adding that there are now about 40,000 active doctors in the country.
“Some 5,000 doctors are graduating yearly but where are they going to do their housemanship and compulsory training?
“Currently in government hospitals, there are some 60 doctors in one unit so how are they going to learn?” he asks, adding that soon there will not be enough posts for medical officers in government hospitals.
According to the 2011 Health Ministry Annual Report, 21,765 out of 28,309 vacancies for medical officers have been filled, he says.
“This means that by now, the 6,544 available posts would have almost been filled. Where will the fresh graduates go next year?”
Dr Tharmaseelan calls on the government to build more hospitals, increase the number of beds in existing ones and equip the district hospitals with training facilities to accommodate the influx of aspiring doctors.
“There were 130 government hospitals in 2007 and 132 in 2011 – that’s an increase of only two hospitals in four years. It’s definitely insufficient. If this continues, doctors will soon join the flock of some 15,000 unemployed nurses,” he claims.
He adds that although the Health Ministry has assured the association that there are some 1,000 vacancies for doctors this year, the future remains uncertain for aspiring doctors unless more training hospitals are opened.
He believes the problem of unemployed doctors would be worse if the compulsory two-year government service is stopped.
“There is talk that after completing their housemanship, the doctors won’t need to serve at government hospitals anymore. MMA is concerned because this will result in doctors who are not adequately trained,” he says. MMA is urging the Education Ministry to monitor closely the many medical colleges that have sprouted recently, adding that entry requirements are too low for most.
“Students from colleges that are not recognised can sit for an examination to make them eligible to practice locally.
“We have an Air Asia ‘everyone can fly’ syndrome – it seems that everyone can become a doctor. Adopting Henry Ford’s industrialisation of car production to training doctors will result in poor quality medical practitioners,” he adds.
He attributes the glut to a lack of co-ordination between Education Ministry and Health Ministry, with the former bent on allowing medical colleges to mushroom without considering the Health Ministry’s needs.
He adds that medical colleges should have their own hospitals instead of sending their graduates to train in government hospitals.
“Another way to prevent unemployment from setting in is for doctors to become specialists and ‘super specialists’ in niche areas of medicine,” he says.
MMC member and senior medical practitioner Dr Milton Lum points out that there are currently almost 9,000 housemen nationwide.
“How many of them can the government hospitals absorb? Unemployment is not a possibility – it’s a probability.
“In one to two years’ time, government hospitals won’t be able to take in housemen anymore so medical graduates will have to leave the country to find work because they can’t get registered here,” he says, adding that less than 50 hospitals in the country are equipped with the necessary training facilities.
Quoting a Health Ministry study done last year, he says housemen now see less than three new patients daily.
“When I was doing my housemanship 40 years ago, I was seeing between 15 and 25 patients daily.
“Medical graduates today are not getting enough exposure and experience which will definitely result in a drop in quality for doctors,” he cautions, adding that in recent years, the MMC had received more than 100 complaints concerning doctors yearly. Before 2005, the council only received about two or three complaints.
Federation of Private Medical Practitioners Associations Malaysia (FPMPAM) president Dr Steven Chow says there are more than 33 local medical schools in “full production” excluding overseas institutions.
“The total number of posts for doctors available in the Health Ministry, universities and other public institutions is about 25,000.
“We are already seeing difficulties in getting enough training posts for housemen and medical officers.
“This will worsen with influx from neighbouring countries in due course,” he adds.
Comenting on the “glut of doctors”, Health director-general Datuk Dr Noor Hisham Abdullah says the phrase is “very relative”.
The Health Ministry, he says, is working closely with the Malaysian Medical Council (MMC) and the Education Ministry in managing the supply of doctors for the country.
The country has been producing more doctors yearly with almost 85% of the ministry’s vacancies for doctors already filled, he adds.
“However, the posts available do not commensurate with the needs of the country.
“Malaysia will definitely need more doctors when we reach the status of a high income country.
“By 2020, the population is expected to reach 34 million so Malaysia will need a total of 85,000 doctors to attain the ratio of 1:400,” he says, adding that the ministry will apply to Public Service Department (JPA) for additional posts for doctors.
More doctors are needed to accommodate the fast expanding private healthcare services, health tourism, new health facilities, higher level of care by the Health Ministry, rise in specialisation and sub-specialisation of medical practice, expansion of more complex speciality services like cardiothoracic and hepatobiliary surgeries, and the emergence of new infectious diseases, lifestyle-associated diseases and chronic disease patients.
“More are joining the post graduate and sub-speciality programmes and coupled with the brain drain of medical practitioners, we need doctors.”

Saturday, August 17, 2013

The skinny on slimming pills


GROWING TREND: Healthcare professionals are alarmed that more Malaysians are resorting to pills to beat the bulge * Slimming products containing sibutramine are still being consumed by Malaysians despite being banned * Side effects, including intestinal problems, could persist years after ceasing consumption * Other causes of weight gain, like cardiac failure and abdominal tumours, should be ruled out before taking pills
The trend of people using slimming products has triggered alarm bells among  healthcare professionals. practitioners. Malaysian Pharmaceutical Society president Datuk Nancy Ho said  the idea of slimming concept had been oversold and many consider it a prerequisite towards being beautiful.
Many slimming products, she said, contain sibutramine, an appetite suppressant that could cause central nervous system stimulation (CNS) effects, manifesting itself as  insomnia, raised heartbeat, nervousness, irritability, hyperactivity, aggressiveness and dry mouth.
“It has been banned and should not be used in any weight-loss product. It used to be a prescription-only medicine before the ban. Slimming products of this nature must be used under the strict super vision of a medical doctor. she said.
“In fact, body shape is often determined by genes. The important message is to live a healthy lifestyle to prevent obesity because it obesity is the underlying cause for many non- communicable diseases,” she said.
MPS has an ongoing MyWeight MyHealth programme to counsel members of  the public on weight management. “The public is urged to seek professional help. Many community pharmacists have been certified,” after training,” she said, noting that prevention was better than cure.
Sibutramine was previously approved as an for anti-obesity drug be fore it was banned by the Health  Ministry on Dec 23, 2010. However, despite the ban, there have been numerous reports of  consumers suffering side effects  from slimming products containing sibutramine.
Meanwhile, Malaysian Medical Association president Datuk Dr  N.K.S. Tharmaseelan said more people were getting into the craze to look slim was increasing and many were taking the easy way out by popping pills.
“Slimming pills, if not approved  by the Health Ministry, may pose a problem to one’s health even if  they are herbal in nature. “They should not be taken with out consulting a doctor.”  
He said obesity and being overweight were not necessarily caused by excessive weight alone, but could be because of cardiac failure, renal failure, abdominal tumors and hormonal problems associated with menstrual cycles.
Growing concerns over the widespread availability of illegal slimming products prompted the government to impose new measures to curb the import of such goods.
Last month, the New Straits Times had reported that the Custom Department, Health Ministry  and Malaysian Communications and Multimedia Commission were hot on the trail of syndicates bring ing in illegal pharmaceuticals.
The Health Ministry was collaborating with the agencies to review and implement new inspection procedures for checking Malaysia-bound parcels, a move which could significantly prevent the illicit flow of the pharmaceuticals into the country.

Thursday, August 15, 2013

Subramaniam puts for down on drug prices


Health Minister Dr S Subramaniam has assured Malaysians that the government will "put its foot down" to protest against possible increase in medicine prices should the Trans-Pacific Partnership Agreement (TPPA) be inked.

Speaking to reporters after launching a book about herbal medication yesterday, Subramaniam said that his ministry is "protesting" against moves to any increase in medicine prices.

The likely increase in generic medicine prices has emerged at the forefront among many other concerns voiced by the civil society groups regarding the TPPA negotiations, which Malaysia is a part of.

"We have stated our view on this matter (to the Ministry of International Trade and Industry)," Subramaniam said.

However, he said that his ministry is not party to the TPPA negotiations.

"But we are engaging with the ministry (Miti). They are keeping us informed of the issues," he said.

Civil society groups, including the opposition, have been skeptical about the benefits of Malaysia signing the TPPA.

However, International Trade and Industries Minister Mustapa Mohamed had repeatedly said that the government would not rush into signing the international trade pact until issues such as medicine prices are resolved.

Tuesday, August 13, 2013

'Exclude tobacco from pact'

The Star Online

PETALING JAYA: Tobacco should be excluded from the Trans-Pacific Partnership Agreement (TPPA) in order to protect the health of Malaysians, said the Malaysian Medical Association (MMA).
According to MMA president Datuk Dr N.K.S. Tharmaseelan, the overall objective of the TPPA was to increase and facilitate free trade of goods and services, but it should not apply to tobacco.
“Tobacco is the only product that kills half its users prematurely, causes numerous diseases and reduces productivity.
“There is simply no justification for tobacco to enjoy the privileges of free trade,” he said in a statement.
Dr Tharmaseelan said tobacco should be completely “carved out” of the TPPA to uphold the Government’s sovereign right to protect the health of its citizens.
TPPA is a US-sponsored trade agreement that is being negotiated by 12 countries – Australia, Brunei, Canada, Chile, Malaysia, Mexico, New Zealand, Peru, Japan, Singapore, Vietnam and the United States.
It was reported that the International Trade and Industry Ministry would hold more briefings to address public concerns about TPPA.
“MMA is not against the TPPA as a whole, but we seek assurances that all sides will benefit without one gaining unfair advantage over the others,” Dr Tharmaseelan said, while urging the Government to seek the consensus of all Malaysians before signing the agreement.
Other concerns raised by the MMA over the TPPA was that medicine would become more expensive and that educational and research activities would become more difficult.

Malaysian mothers user Facebook to share breast milk


KUALA LUMPUR, Aug 11 — From a social networking service for friends, families and even businesses to stay connected, netizens are now milking Facebook’s uses for a more creative objective - to share breast milk.
In Malaysia, a Facebook page for local mothers who are either in need of breast milk or have surplus to donate to others, has been gathering steam in recent times, drawing today over 6,000 “likes” from web users.
The page - “Human Milk 4 Human Babies - Malaysia” - is the Malaysian chapter of a global milk-sharing network on Facebook called the Human Milk 4 Human Babies (HM4HB) that was founded in 2010 by Emma Kwasnica, a breastfeeding activist living in Vancouver, Canada.
The HM4HB website states that the milk-sharing network is spread across 52 countries, including Singapore, Indonesia, Thailand and the Philippines.
Young mother Nurlailtatul Munira Razmi joined the network three months ago when she stumbled across a Facebook post from a mother who wanted to donate breast milk to premature babies. 
After Nurlailatul Munira was satisfied with the mother’s health status, the 32-year-old school counselor received a coolbox, which contained over 50 cups of breast milk, that was posted from the milk-mother living in Kuantan, Pahang, to her home in Perlis. 
“My son, he’s a premature baby, who depends 100 per cent on a mother’s milk,” Nurlailatul Munira told The Malay Mail Online in a recent interview.
“He needs a lot. I can’t produce much, so I had to look for a milk-mum,” she added. 
Nurlailatul Munira said that she has never met the milk-mother in person, but only chatted to her on Facebook after receiving the breast milk that sustained her four-month-old son from the age of three weeks until three months. 
He is now on formula milk after the doctor gave the green light, Nurlailatul Munira added, noting that the milk-mother had also recently fallen ill.
The HM4HB-Malaysia Facebook page has an online bulletin board that contains the personal particulars and contact details of mothers who wish to donate breast milk or who are looking for donations.
If one is unable to find a match, she can contact the network administrators who will then broadcast messages on the Facebook page.
“The World Health Organisation’s Infant Feeding Recommendation places in order of preference the mother’s own milk and donated breast milk above formula milk in their hierarchy,” Danielle Sweetman, one of the HM4HB-Malaysia administrators, told The Malay Mail Online in an email interview earlier this week.
“This is because breast milk contains a huge range of natural compounds, nutrients, minerals and antibodies, while formula milk contains only a portion of those items, which are chemically manufactured, and no antibodies,” she added.
Sweetman said that most mothers express breast milk and store it in bottles or bags before donating it, though there have been a few cases where the mother nurses the child directly.
Religion, however, appears to be a significant factor in milk-sharing among mothers in Malaysia, a country frequently roiled by racial and religious tensions. 
On the HM4HB-Malaysia online bulletin board, many Muslim mothers say that they are only looking for other Muslim milk-mothers, or that they only wish to breastfeed milk-babies whose mothers also share the same faith. 
Sweetman stressed that according to the Malaysian Islamic Development Department (Jakim), it is “not haram (forbidden) for a Muslim baby to take milk from a non-Muslim mum”, but it is "makruh, which means it is not highly encouraged, but acceptable”.
She noted that pork is “haram” in Islam, but acknowledged that eating pork was not much different from eating other meats in terms of how it would affect breast milk.
“Nutritionally, the consumption of pork would be considered similarly as the consumption of other meats - give or take some calories, nutrients and also preparation of the meat,” said Sweetman.
She also pointed out that in Islam, a child who takes the breast milk of a woman other than his mother is akin to being her actual son.
“The woman’s husband becomes his milk-father, the woman’s children become his milk-siblings, the woman’s family becomes his family and thus they are unable to marry each other, just like blood family,” said Sweetman.
“This implication means it is easier to commit in this familial relationship with people of the same religion because they are aware of the hukum (law) already and don’t need much explaining,” she added.
Administrative coordinator Siti Rokiah Mustaffa said that she had to look for a Muslim milk-mother to breastfeed her one-year-old daughter because of the family-like ties that would be formed between them, but has yet to find one.
“Our religion is quite difficult. If I’m a Muslim, I must look for a Muslim,” the 31-year-old mother, who lives in Selangor, told The Malay Mail Online.
Zarina Mohd Ramly, a 39-year-old assistant manager in corporate care, said that her eight-month-old son was given express breast milk by two Muslim milk-mothers.
“Muslims have certain things that we can’t eat like pork,” she told The Malay Mail Online.
“What you eat is also being brought into the milk of the mother. So we need to make sure,” she added, but noted that it was not an iron rule to avoid non-Muslim milk-mothers.
The HM4HB-Malaysia Facebook page also featured a “very rare” story in 2011 about a Muslim mother who allowed her baby to take breast milk from a non-Muslim milk-mother. 
“The Quran for one, does not mention anything about receiving a non-Muslim mother’s breast milk as haram,” a Muslim woman called Afiza was quoted as saying.
“And to be honest, I am not worried about the diet of Andy’s milk-mother as whatever a mother eats, her milk is still liquid gold according to many sources,” added the mother, whose full name was not given.

Sunday, August 11, 2013

Bitter pill to swallow, 24-hour clinics closing doors earlier

The Star Online

PETALING JAYA: Twenty-four-hour clinics are closing earlier amidst safety concerns and dwindling number of patients at night.
Malaysian Medical Association (MMA) president Datuk Dr N.K.S. Tharmaseelan said “quite a few” clinics had ceased operating round-the-clock because of security reasons.
“Many are considering stopping their night and 24-hour services because clinics have become easy targets for robbers,” he said.
He said some clinics had even relocated after being robbed, adding that many doctors now took security into consideration when deciding on the location of their new clinics.
Dr Tharmaseelan said there had also been a drop in patients seeking treatment at night because they, too, were afraid.
“Rather than go to a clinic at night, some patients ignore mild symptoms and wait till the morning,” he said. “This may lead to serious health consequences.”
Dr Tharmaseelan said in addition to hiring locums, clinics now needed to employ security guards and install security equipment like CCTVs and alarm systems.
“With fewer patients, these additional costs have resulted in an increasing number of doctors closing down their night clinics,” he said.
“The public will suffer as a result. Many clinics that offered cheap and accessible service have stopped operating 24 hours to ensure the safety of the doctors and patients.”
The MMA has about 12,000 members with about 4,000 in private practice.
There are some 750 clinics operating round-the-clock nationwide.
Malaysian Medical Council (MMC) member and senior medical practitioner Dr Milton Lum said doctors were in a vulnerable position because they were expected to treat everyone who showed up at their clinics as genuine patients.
“Just last month, a gynaecologist had her fingers chopped off (outside her clinic),” he said.
The gynaecologist, Dr Delaila Ahmad, was robbed of her handbag which contained important documents and RM18,000 cash, in Subang Jaya, at about 1.20am by two parang-wielding men.
Her thumb and little finger were severed in the incident.
“Increased police presence will help assure the public that it is safe for patients to come out,” Dr Lum said.

Friday, August 09, 2013

Manipal Health Enterprises acquires 70-bed hospital in Malaysia


Manipal Health Enterprises, the healthcare arm of the Manipal Education and Medical Group, announced the acquisition of a 70 beds hospital in Klang, Selangor district of Malaysia. This acquisition by Manipal Hospitals also includes a new 200 beds tertiary care hospital which is presently under construction in a nearby location, which will be commissioned by last quarter of the FY 2014-15. The facility is being implemented in accordance with the Malaysian health care guidelines, MSQHA and also Joint Commission International (JCI).

The hospital will focus on a healthy combination of wellness, prevention and curative care covering the secondary and tertiary levels of healthcare service for both the domestic and an emerging overseas patient traffic into Malaysia from neighboring countries.

The hospital, was set up by Datuk Dr Poraviappan A/L Arunasalam, an eminent obstetrics and gynaecology consultant in Klang about 14 years ago. Today, the hospital has a leading panel of consultants spread across specialties including ENT, General Surgery, Pediatrics and Gynaecology etc. and is equipped with best in class equipment including 64 Slice CT and 1.5 T MRI) and other facilities to provide cutting-edge healthcare to the community it serves.

“This acquisition is a part of the company’s evolving strategy to expand its footprint in India and in identified countries of Middle East, Africa and Asia Pacific. In the near term, significant capacities will be created to add on to the present group capacity of 15 hospitals, 5000 beds and a patient traffic of about two million annually. This is in line with the company’s endeavour to provide “accessible and affordable” healthcare while living up to its values of patient centricity, clinical excellence and ethical values,” said Swaminathan Dandapani, executive chairman of Manipal Health Enterprises.

“Manipal is a well-established name in Malaysia, with over 25 per cent of the doctors in the country being alumni of the Manipal University. The access to this pool of talent, trained in India at Manipal University and at Melaka, has been a key driver for Manipal to venture into setting up hospitals in Malaysia,” said Rajen Padukone – CEO and MD of Manipal Health Enterprises.

“The existing employees and doctors would continue to be engaged with the hospital in Malaysia. Dr Poravi will continue to provide help and guidance as required to the new dispensation. Ramkumar Akeila will be leading the operations as CEO and MD who would add to the best practices and benchmarks established by Manipal group hospitals will be followed as a standard operating procedure in the newly acquired hospital in Malaysia which would help to achieve the recognition of a globally respected healthcare corporation,” he added.

The Manipal group has already two campuses in Malaysia - a Medical school at Melaka since 2001 and a newly formed (in 2012) Malaysia International University at Nilai, Kuala Lumpur.

Health Ministry to open up 10,000 nursing positions

The Star

GEORGE TOWN, Aug 8 — The Health Ministry has requested for 10,000 nursing positions to be opened up nationwide.
Deputy Health Minister Datuk Seri Dr Hilmi Yahaya said today the ministry has already submitted this request to the Public Service Department.
“We are not short of nurses but we want to get more nurses back in the health industry and we need to build up our nursing staff due to the increase in patient intake at public hospitals,” he said.
There are 3,000 clinics and 140 hospitals under the ministry.
Dr Hilmi said each year about 1,600 nurses graduates nationwide.
“Nurses have to continuously practice their skills by staying in the industry or they may get out of touch, that’s why we are opening up more positions to get nursing graduates who are not in the industry to come back,” he said.
As for doctors, generally, the country has sufficient doctors as local universities produce about 3,700 medical graduates each year.
“Once they complete their housemanship, they will be absorbed into public hospitals,” Dr Hilmi said at his Hari Raya open house here.
Despite not being given a choice on posting location, he said many doctors resisted being posted to east Malaysia so there is a shortage of doctors there.
“Those who are from west Malaysia don’t want to be posted to east Malaysia even though there is a special allowance while those who are from there want to come to west Malaysia because of the allowance,” he said.
On an unrelated matter, the ministry is starting a MySihat initiative in co-operation with health-related non-governmental organisations.
“Diseases like diabetes are on the rise so we need to start this initiative to encourage a healthy lifestyle,” he said.
In line with that initiative, Dr Hilmi distributed Hari Raya healthy eating booklets with recipes at his open house.

Tuesday, August 06, 2013

'Imported dairy products here safe'

New Straits Times

HEALTH MINISTRY'S ASSURANCE: No evidence of contaminated ingredient in country, says Subramaniam

THE Health Ministry has given  assurance that there has been no evidence of contaminated whey protein concentrate (WPC80) in the dairy products imported to Malaysia.
Minister Datuk Seri Dr S. Subramaniam said the ministry was in close contact with the New Zealand authorities and had been monitoring latest developments involving the issue.
"There is no evidence of contaminated WPC80 reaching Malaysian shores.
"We are in touch with the New Zealand authorities and we will act according to the information given," he said after launching the Malaysia Pledge on Responsible Advertising to Children here yesterday.
He said the ministry had not received any information that "Nutricia Karicare follow-on formula products for children from 6 months old", which were suspected of containing contaminated WPC80, was sold in the country.
"We received information from the New Zealand authorities that the product may be contaminated, but we have not detected its import into the country."
Dr Subramaniam added that Danone Dumex's recall of specific batches of its products was voluntary and done as a precautionary measure.
He was asked to comment on an alert by the International Food Safety Authorities Network, under the World Health Organisation, regarding the existence of WPC80 in products manufactured by New Zealand's Fonterra, which are suspected to be contaminated with the Clostridium botulinum bacteria.
The bacteria can cause botulism, which is potentially fatal.
Fonterra Brands Malaysia managing director David Ross said products under its brand did not use WPC80 as a whey protein source.
"There are two parts in Fonterra's operations: our ingredient business, where we supply dairy ingredients to other food companies, and our own consumer dairy brands, namely Anlene, Anmum, Fernleaf and Anchor.
"We have advised eight companies, which were supplied with WPC80, on the quality issue."
Danone Dumex said yesterday all recalled packs would be destroyed under the standard procedure.
"Replacement or refund for the specified batches will be done irrespective of consumers' ability to present the purchase receipt and whether the packet has been opened or not."
For more information, contact Denone Dumex at 1800-38-1038.

Sunday, August 04, 2013

Health Ministry: Only 'Nutricia Karicare' product possibly contaminated by botulism

The Star Online
PETALING JAYA: The Health Ministry has identified 'Nutricia Karicare follow-on formula products for children from 6 months old' as the sole product that is possibly contaminated with bacteria that could lead to botulism.
As a precautionary measure, all imports of this product will undergo a “hold, test and release” inspection effective immediately.
This is following the latest information obtained from New Zealand’s Primary Industries Ministry through the High Commission here that only one product is suspected to contain the whey protein concentrate (WPC) which is the source of the contamination.
In a statement Saturday, the Ministry said it was verifying whether the product is available in the Malaysian market.
"As a precautionary measure, parents and guardians who use the product are advised to not use it and to replace it with another brand for the time being,” said Noraini Othman, the Ministry’s Food Quality and Safety Division senior director in the statement.
The Ministry has taken into account the alert from the International Food Safety Authorities Network (Infosan) under the World Health Organisation about the WPC manufactured by Fonterra from New Zealand.
The WPC is used as an ingredient in baby formula, growing-up milk powder and sports drinks.
There have been no food safety incidents reported on this particular product as of now.
The Ministry, she added, was also working closely with the New Zealand High Commission here and will issue updates on the latest developments.
“We hope with this explanation, the public need not worry because food safety monitoring and enforcement is always carried out to ensure the safety of consumers are always guaranteed,” she said.
She added that if consumers felt wary of the safety status of a food product in the market, they can inform the Health Ministry through the nearest district health office or state health department, or go to the website at