‘Medication programme’ aims to cut waste at govt hospitals

Star: PETALING JAYA: As healthcare costs soar, the Health Ministry has found that a substantial amount of medicine dispensed by government hospitals goes unused or expired.
Through its “return medication programme” implemented last year, the ministry now wants to find out more about the causes of this waste and reduce it.
According to Datuk Eisah A. Rahman, the ministry's senior director of pharmaceutical services, the medicine returned to the pharmacy at Kuala Lumpur Hospital for the first half of the year was valued at RM128,818 while at the Sarawak General Hospital, it was valued at RM82,436.
The returned medicine last year at Seberang Jaya Hospital in Penang, Tuanku Fauziah Hospital in Perlis and Tuanku Ja'afar Hospital in Seremban was valued at RM27,899, RM53,769 and RM190,616 respectively.
The ministry is collating data from the other government hospitals.
Eisah said the current figures alone reflect the amount of medicine wasted.
“If we take into account all the hospitals, it would be a substantial amount,” said Eisah.
There are 135 hospitals in the country with the ministry spending RM1.6bil on medicine in 2010, an increase of 14.48% from the previous year.
Eisah said one reason behind the campaign was to help reduce the possibility of the prescription drugs being misused by others.
Most government hospitals and clinics have counters or containers where patients can return or deposit unused medicines.
“There is still lack of awareness about the programme,” she said, adding that Australia, Canada and the United States had similar programmes.
She said that only medicine that had not expired would be reused.
Eisah admitted that a large amount of the returned medicine had to be disposed of, and this was done in a proper way to reduce harm to the environment.
“Improper disposal through the water sewage might pollute our water supply,” she said.
Eisah said the most common medication returned comprised those used to treat cardiovascular diseases, diabetes, anti-hypertensive agents and anti-cholesterol drugs.
Eisah also said a study in the United States showed that one-third of all medicine prescribed ended up unused or expired.
“The amount of medicine dispensed is based on the prescription. Theoretically, they should be finished, and we encourage patients to finish their medicine. If for some reason they can't, then they can return them to us,” she said.

Queen Elizabeth II Hospital in Sabah to have top-notch cardiac centre

Star: KOTA KINABALU: Sabah will have a heart surgery centre equipped with sophisticated equipment on par with the National Heart Institute when the cardiac services unit at the Queen Elizabeth II Hospital (HQE II) is fully operational at the end of this month.
Health Minister Datuk Seri Liow Tiong Lai said the HQE II started a heart surgery service in April and at the end of this month, it would have another operation unit costing about RM5mil.
"This is a huge achievement and its good news for Kota Kinabalu residents, in particular, and the people of Sabah, in general, as they are getting top-notch facilities," he told reporters after inspecting the upgrading of HQE II in Damai Luyang here on Sunday.
Liow also announced an additional allocation of RM3mil to tide over the costs of services at the heart surgery centre, including analysis and diagnosis on heart related ailments.
He said the new heart surgery centre was part of the HQE II improvements besides upgrading of car parks, elevators and structures from levels 6 to 8 costing about RM76mil.
When completed, the number of beds for patients at the hospital will increase from 130 to 384 beds besides the 71 beds, which are rented to a private hospital, Sabah Medical Centre, he added.

First Natural Medicine Programme To Be Launched Next Year

Bernama: KUALA LUMPUR, Aug 1 (Bernama) -- In a joint effort between Malaysian and Taiwanese institutions, an Executive Diploma programme in Natural Medicine will be launched in Taiwan after the Chinese New Year next year.
It will be the first programme to be jointly developed and conducted in the field of natural medicine by the Institute of Professional Development, Open University Malaysia (IPD-OUM)), the Integrative Health Academy (IHA) and the Taiwan Natural Medicine Education Organisation (TNMO).
IHA director Dr Cyril Gunapala said the programme would be taught in Mandarin and offered at the diploma and certificate level.
"However, other programmes will be established in the future and the subjects will be taught bilingually (in English and Mandarin)," he said after a visit by a 15-member delegation from TNMO, here, today.
The delegation visited IPD-OUM to follow up on the many discussions that had taken place to jointly develop and conduct programmes in the field of natural medicine in Taiwan, Malaysia and regional countries.
Natural medicine is a form of natural therapy that includes herbal medicine, homeopathy, and traditional Chinese medicine that has had tremendous growth.
Also present were the head of the Taiwanese delegation Prof Master Yung-Ching Ho and president of the Malaysian Association of Natural Medicine Education (MANME) Prof Dr Y.S. Cheng.

Health Minister: Total of 63 hospitals now open to housemen

Star: KAJANG: More hospitals are being made available to universities so that nearly 10,000 medical students can be trained compared to 6,500 housemen now, said Health Minister Datuk Seri Liow Tiong Lai.
The ministry has added 22 district government hospitals, bringing the total number of hospitals hosting housemen to 63, he said.
“The chosen hospitals will be able to give better service with the addition of more staff and, in return, provide new facilities to train medical students.
“Housemen need to practise their specialties at district level as there is a lack of specialists in district hospitals,” he said after witnessing the signing of three Memoranda of Agreement between the ministry and Universiti Tunku Abdul Rahman (Utar), here, Monday.
The agreements signed would allow UTAR students studying nursing, physiotherapy, biomedical science, biochemistry and microbiology to be placed at one of 13 hospitals or eight health clinics in the country.
Meanwhile, Liow said the Traditional and Complementary Medicine (TCM) bill would not be postponed as all the relevant parties, including Traditional Chinese Medicine associations and practitioners, had been consulted on the Act.
Once the bill is passed, the industry would be registered under a council and regulated the same way doctors are monitored by the medical board.
“Treatment will better regulated and practitioners can be held liable if they do not give proper treatment to their patients,” said Liow, adding that the act would also cut down on fly-by-night TCM practitioners.
Ayurvedic and Traditional Malay medicine practitioners would also be regulated under the new act.
Liow said the objective was not only to regulate and enforce the industry, but to allow the ministry to officially fund research for evidence-based TCM.

Docs: Local med students must sit for licensing exam, too

Star: PETALING JAYA: Senior doctors have called for local medical graduates to also sit for the proposed medical licensing examination which will be imposed on all foreign medical graduates.
Malaysian Medical Association (MMA) president Dr David Quek said many supervising clinicians have expressed concern about the commitment and quality of some recent graduates from local medical schools.
“There are concerns that some private schools are influenced by profit and adequate teaching facilities and teachers were not the most important criteria,” he said.
Foundation courses were also shortened to three to seven months to attract weaker students, said Dr Quek, adding that a moratorium should be imposed not only on the number of medical schools but also the student intake.
Last Thursday, Health Minister Datuk Seri Liow Tiong Lai told the Dewan Rakyat that the Medical Act 1971 would be amended to allow students to pursue medical studies at any institution of their choice overseas but they would have to sit for the licensing examination when they return home.
Currently, under the Act, only students in unrecognised foreign medical schools are subject to the Malaysian Medical Council’s (MMC) qualifying examination.
A senior doctor, who declined to be named, said local universities should not be exempted from the examination.
“The quality of medical services is in danger of deteriorating, and we need a drastic solution,” the doctor said.
Meanwhile, MMC member Datuk Dr Abdul Hamid Abdul Kadir said it was not necessary for local students to sit for the licensing examination as they were evaluated periodically.
“However, students studying locally with tie-ups to foreign schools should be subject to the exam,” he said.

Act amendment for medic students to pick varsity of choice

NST: KUALA LUMPUR: Malaysian students will be able to pursue medical studies at any institution of their choice anywhere in the world once the Medical Act 1971 is amended, the Dewan Rakyat was told today.
Health Minister Datuk Seri Liow Tiong Lai said one of the amendments would be the nullification of the Second Schedule which lists all the 375 recognised medical institutions.
Under this approach, the students would be able to choose the institutions of their choice, provided they obtain the "No Objection" certificate before hand from the Ministry of Higher Education, he said.
"After graduation, the students will have to sit for the Licensing Examination to determine their ability to function as quality and competent doctors," he said when replying to a question from Dr Tan Seng Giaw (DAP-Kepong).
Liow said that students who passed the examination would be eligible to register with the Malaysian Medical Council (MMC) to serve as doctors in the country.
"It cannot be denied that it is difficult to conduct regular monitoring of the quality of medical studies by institutions abroad in view of the geographical and logistical factors and prohibitive cost involved in sending an evaluation panel overseas," he said.
Liow said the moratorium on new medical programmes offered at local institutions of higher learning would come into force once it had been approved by parliament.
The moratorium, being worked out by the Ministry of Higher Education with input from relevant government agencies, was necessary to prevent the creation of a surplus of medical graduates, he said.
Liow also said that the number of medical graduands registered with the MMC had grown from 2,527 in 2008 to 3,150 in 2009 and to 3,257 last year.

Medical gear to be of top grade

Star: NILAI: Manufacturers of medical devices will be required to register their products with the Health Ministry soon.
This requirement comes following the soon-to-be introduced Medical Devices Act to ensure healthcare providers only use quality equipment to treat patients.
These medical gadgets, including imported ones, will also have to be registered so that they are protected under the country’s patent rights.
Health Minister Datuk Seri Liow Tiong Lai said the Medical Devices Bill would likely be tabled in Parliament during this month’s sitting or at the latest during the June session.
“It is time that such provisions are put in place. Apart from safeguarding patients’ rights, we want to ensure inferior medical products are not dumped here by fly-by-night companies,” he said at the opening of the RM30mil BioMolecular Industries Sdn Bhd nuclear medical research and production facility.
He said the ministry had discussions with stakeholders in the industry, who agreed that such provisions should be introduced for the good of all parties.
Alluding to the fact that Malaysia’s medical device industry was still developing, he said such laws were needed as the Government wanted to set high standards for the healthcare sector.
According to estimates by the Association of Malaysian Medical Industries, the medical devices market in the country grew to RM2.7bil in 2010.
It is expected to hit RM2.9bil this year and RM5bil in 2012.
At the launch, BioMolecular Industries chairman Datuk Seri Tai Hean Leng said with the commissioning of the state-of-the-art facility, which was a joint venture between Belgium’s Ion Beam Applications and Masteel Bhd, treatment for cancer, heart and neurological disorders would become more affordable for Malaysians.

Boost for Miri Hospital

Star: MIRI: The Health Ministry has allocated RM20.2mil for the implementation of four major projects at the Miri General Hospital.
They are the construction of two new operation theatres and sterilisation units at a cost of RM8.5mil, a new ward for infectious disease (RM4.5mil), the upgrading of its pathology unit to a medical laboratory (RM5mil), and the construction of a medical laboratory and store for RM2.2mil.
“All the projects will be carried out this year,” said Health Minister Datuk Seri Liow Tiong Lai during a visit to the hospital.
He said Sarawak received a total of RM1.1bil under the Ninth Malaysia Plan for 118 health-related projects and half of them have been implemented. The remainder, he said, would be continued in the 10th Malaysia Plan.
He also announced yesterday that the ministry was providing an allocation of RM360,000 to the Miri General Hospital, out of which RM260,000 would be for patients who needed treatment in hospitals in Kuching or Kuala Lumpur and RM90,000 would be to help cover the transportation cost of the hospital’s rural patients.
Asked whether there was a plan to build a cancer treatment centre or cardiovascular specialist centre at the hospital, Liow said: “We are in the process of strengthening the number of specialists we have here first.
“Currently, the hospital has 17 specialists and we are looking at increasing the number gradually.”
Apart from a visit to the hospital, Liow is also scheduled to visit various government clinics in the city including the 1Malaysia Clinic at Taman Tunku, attend a dialogue with Sarawak United Peoples’ Party (SUPP) leaders, a luncheon with Chinese community leaders and a visit to Rumah Panjang Tusi in Marudi.
He will leave Miri this evening.

Revised fees for all hospitals

Star: RAWANG: Private and government hospitals will have to adhere to a revised set of guidelines for doctors’ fees and other medical charges to be announced in March.
A National Medical Arbitration Committee has been established by the ministry to draft the fee schedule and guidelines, said Health Minister Datuk Seri Liow Tiong Lai adding that details of the new fees would be announced later.
Estimating that 30,000 doctors in the country would be governed by the new fee schedule, he explained that the ministry had received many complaints about the high hospital and consultation fees charged by private hospitals.
“The ministry will also monitor all additional hospital fees including those for food and medicine.
“This will ensure patients are not overcharged when they seek medical care,” he said, adding that the previous review of doctors’ consultation fees by the ministry was in 2004.
Liow also said the ministry was looking at cutting costs through outsourcing the sterilisation of medical instruments at government hospitals.
Separately, Health Ministry director-general Tan Sri Dr Ismail Merican said a mechanism would be included to control the cost of medical charges under the new guidelines on consultation fees and hospital charges.
“The cost of medical treatment at private hospitals will be controlled so that there will be no overcharging,” he said when asked to comment whether consumers would have to pay more.
Earlier, Dr Ismail launched the Malaysian Medical Council’s Annual Practicing Certificate (APC) online application and payment system to facilicate application of APCs by practitioners in the private sector.
Dr Ismail, who is also MMC president, said the system, which would be ready for utilisation on Jan 15, would also enable practitioners to check and update their particulars online from time to time.
He added there are 32,250 medical practitioners registered with the council last year and 4,000 new practitioners were expected to apply for registration this year.
When the Medical Act was gazetted in October 1971, there were only 837 practitioners.

Exam for docs won’t cause brain drain

Star: PETALING JAYA: A proposed amendment to the Medical Act to compel all overseas medical graduates to sit for a common licensing examination will not worsen the brain drain situation, Health Ministry director-general Tan Sri Dr Ismail Merican said.
“The Malaysian Medical Council examinations are not meant to make things difficult for them but to assess their core knowledge. They should not worry if they have passed their university examinations,” he said.
Dr Ismail, who is also Malaysian Medical Council president, said in view of the weakness in monitoring foreign institutions, the council had proposed to do away with the Second Schedule of the Medical Act, containing the list of recognised foreign medical schools.
“Students can choose any university they wish to attend abroad but they have to sit for and pass a common licensing examination before being accepted for registration,” he said, adding that this was practised in many developed countries.
The proposed examination, which would be different from the current Medical Qualifying Examination for students from unrecognised universities abroad, would ensure that doctors were “fit to practise” as safe and competent doctors, he said.
Recently, Health Minister Datuk Seri Liow Tiong Lai said the examination was one of the proposals it was looking into when amending the Act.
Although the Malaysian Medical Association and senior doctors had suggested that all medical graduates be made to sit for a common examination, Liow said it would only apply to overseas graduates.
It was not necessary for local graduates to sit for the examination as local institutions were easier to monitor, officials said.
However, senior doctors advocated otherwise, claiming that local schools could lower passing grades to make their universities look good.
Recently, The Star reported on the lack of training hospitals to meet the influx of housemen and a doctor had expressed concerns that some graduates lacked core knowledge and could jeopardise patient safety.
Asked where people could get advice on medical schools that met the country’s requirements if the Second Schedule was removed, Dr Ismail said they could get this from colleges and the council.

Liow: Specialists can help ease shortage in district hospitals

Star: SERI KEMBANGAN: The Health Ministry is hiring qualified foreign specialists on a contract basis to provide improved access to medical services at the district level.
Its minister Datuk Seri Liow Tiong Lai said putting these experts in district hospitals would help reduce congestion in general hospitals.
He said the ministry would work directly with the governments of Egypt, India, Pakistan and Sri Lanka to bring good quality specialists in six disciplines – internal medicine, paediatric, surgery, obstetrics and gynaecology, orthopaedic as well as anaesthesia.
However, this would be a short-term measure while the government trained more local doctors, he told reporters after attending a charity dinner organised by Ser­dang Lions Club on Thursday.
Liow said many district hospitals did not have specialists, so patients turned to general hospitals for medical services.
“The public’s expectation has changed and people prefer to see specialists rather than general practitioners. Currently, we need a few hundred specialists at district hospitals.”
Liow said there were some 30,000 doctors in the government and private sectors, out of which only 5,000 were specialists.
The country has enough doctors, but is short of specialists, he added.

Liow also said employers were required to buy a health insurance policy for their foreign plantation workers and domestic helpers from this year, adding that the Government had decided that employers in the two sectors would have to bear the cost of the insurance.
“For foreign workers who are already working in Malaysia, they are required to purchase their insurance policy within three months (from Jan 1),” he said in a press statement yesterday.
From Jan 1, foreign workers must buy a RM120 premium per year Foreign Worker Hospitalisation and Surgical Scheme (SKHPPA) that provides RM10,000 coverage a year, he said.
Liow said for workers who are currently working in the country, the premium cost would be based on the calculation of days left from the work permit.
“Foreign workers who failed to get the insurance would not be allowed to renew their work permit when the permit expired.”
Liow said 17 insurance companies had agreed to provide the insurance scheme, adding that 11 companies were ready to offer the scheme from Jan 1.
They are AXA Affin General Insurance Bhd, Berjaya Sompo Insurance Bhd, Jerneh Insurance Bhd, Kurnia Insurans (M) Bhd, Lonpac Insurance Bhd, Malaysian Assurance Alliance Bhd, MUI Continental Insurance Bhd, Progressive Insurance Bhd, RHB Insurance Bhd, The Pacific Insurance Bhd, Tokio Marine Insurance (M) Bhd.
Four companies will offer their scheme from Feb 1 and they are Allianz General Insurance Company (M) Bhd, QBE Insurance (M) Bhd, Overseas Assurance Corporation (M) Bhd and Syarikat Takaful (M) Bhd.

Watch on errant hospitals

Star: PETALING JAYA: Private hospitals will be monitored to ensure that they do not put patients through unnecessary procedures just because they have medical insurance, said Health Ministry director-general Tan Sri Dr Ismail Merican.
“The ministry will continuously direct private hospitals, managed care organisations (MCO), insurance companies and other interested parties to ensure that the cost of healthcare is reasonable, detailed and transparent.
“This will help patients make informed decisions on getting treatment as they will be more aware of the charges that will be incurred,” he said in a statement here yesterday.
He said the ministry would also look at ways to address the discrepancies between charges for self-paying patients and those with insurance policies as this problem had also contributed to overall healthcare costs.
He said the problem was also compounded by some private hospitals being pressured by their shareholders to charge more to fulfil their key performance index.
His statement came following a meeting last Friday with the Association of Private Hospitals Malaysia, Malaysian Medical Asso­ciation, Malaysian Medical Council, hospital chief executive officers, private hospital and MCO representatives, insurance companies and several healthcare professional groups and independent professionals.
“The purpose of the meeting was to explore ways of curbing increasing private healthcare costs,” said Dr Ismail, adding that several points were agreed upon, including making insurance policy holders aware of the medical coverage they were entitled to.
Hospitals, he said, must also inform patients about all professional and potential charges before they were admitted or treated.
He said it was also agreed that MCOs must not interfere with the clinical judgment management of patients by medical practitioners, including by general medical practitioners.

D-G: Private hospitals must report all irregularities

Star: PETALING JAYA: All private healthcare facilities are required, beginning Jan 1, to report incidents that jeopardised patients’ safety to the Health director-general.
These could be cases such as unexplained deaths, brain injuries during a hospital stay, fire causing deaths, assault or battery of patients and haemodialysis patients detected with Hepatitis B or C, Health director-general Tan Sri Dr Ismail Merican said.
“These incidents and deaths will be evaluated by special committees to ensure that lessons are learnt and disseminated in order to prevent a recurrence,” said Dr Ismail, who is also the Patient Safety Council of Malaysia chairman.
Under the Private Healthcare Facilities and Services Act, individual offenders can be fined up to RM10,000 or RM30,000 for a corporation and/or jail for not more than three months, he said yesterday.
He added that he had issued a directive to all private healthcare facilities and services following a national briefing conducted by the Medical Practices Division and Medical Care Quality Section on Dec 17. A document that outlines the processes necessary for patients’ safety titled “Achieving Excellence in Clinical Governance” was launched at the council’s meeting on Tuesday.
It would be distributed to healthcare facilities for implementation.
“The council would monitor the implementation progress on a regular basis,” he said, adding that senior management in hospitals should continue talking to front-line staff on patient safety while he and his team would conduct surprise visits to inculcate a safety culture.
The Patient Safety Council will announce the Patient Safety Goals and Targets that need to be achieved by all healthcare facilities in Malaysia in the near future, he said.
“These goals will cover key safety issues such as medication safety, safe surgery, clinical governance, infection control, prevention of falls, blood transfusion safety, clinical incident reporting, clinical care bundles, patient safety research, patient safety projects; all of which are expected to make the patient care experience a safer one,” he said.
Dr Ismail also said that initiatives to ensure medication safety must be targeted at all levels of the healthcare system since drug therapy or pharmacotherapy was the main form of treatment.

Liow: More docs need to treat obesity

Star: BANTING: The Health Ministry wants 50 new nutritionists to be roped in every year to overcome the shortage of food specialists in government clinics, Minister Datuk Seri Liow Tiong Lai said.
He added that there were only 283 nutritionists registered with the ministry although there were 800 clinics available nationwide. The ministry, he said. aimed to achieve a ratio of one nutritionist to every 10,000 people.
“Our country is deprived of nutritionists, and this may cause an increase in obesity cases in the country,” Liow told reporters after handing over 25 food hampers to a government clinic here yesterday.
Asked on the ideal number of nutritionists that should be employed in government clinics, Liow said his ministry wanted at least 5,000 of them to be employed over the next few years.
“Previously, doctors would advise patients on their diet plans. But now, we want a specialised department for nutritionists to combat obesity,” said Liow, who himself is a food science and nutrition graduate.
He said three local universities provided nutrition training courses and expressed hope that they could produce more qualified nutritionists.
He also said the country had the most cases of obesity compared to its Asian neighbours.
However, he said number of children under the age of five with ideal body weight had increased since 1999.
“In 1999, there were only 79.1% of children under the age of five who had the right body weight, but the percentage has increased to 93.2% in 2009,” he added.
Liow also advised new mothers to breastfeed their babies at least during the first four months, adding that mothers should ensure that their infants received proper nutrition.
“Awareness campaigns will be held to highlight the importance of breast-feeding,” he added.
Liow said that in 1990, 16 out of 1,000 infants born had died because they were not breast-fed, but the number had dropped to six in 2008.

Miri folk can get medicine posted to them

Star: MIRI: A home-delivery service for medicine — the first of its kind in the state — has been launched here.
Initiated by the Health Ministry, patients registered with the Miri Hospital will be able to ask for their medicine to be delivered to their home address using Pos 1Malaysia service at RM6 per delivery.
Miri Divisional Health and Medical Services director Dr Faizul Mansor said the service would eventually be extended to other towns in the state.
“Under the system, anyone who goes for medical check-ups in the Miri Hospital and gets registered as a patient and is treated by a doctor, will qualify for the service.
“When he is at the hospital, he is eligible to get one month’s medicine supply from the pharmacy after his treatment. After that, he can ask the hospital for the home-delivery service,” Dr Faizul explained.
He said the medicine can be delivered to patients for two months.
He added that there were several strict conditions including that the medicine be delivered directly to the patient concerned, and not through a third party; the address of the patient must have a government-recognised postcode; and the medicine must be in tablet form.
“Liquid medicine and powdered medicine will not be delivered in this manner,” said Dr Faizul.
He pointed out that the Miri Hospital was the nucleus hospital for the northern region of Sarawak, serving some 400,000 patients in Sarawak’s northern districts of Miri, Niah, part of Bintulu, Marudi, Limbang and Lawas.
Energy, Green Technology and Water Minister Datuk Seri Peter Chin, who launched the service, said: “This service is a big step forward in improving healthcare in Sarawak.
“Patients living far away from Miri have to spend a lot of money just to come to Miri Hospital to get their medicine. Now that this new service is in place, it will help them save travelling expenditure.”
Chin also said riverine folk living along the Baram River would soon be able to get medical treatment and health checks from mobile clinics.
He said the new and innovative services were part of the community-transformation programme initiated by Prime Minister Datuk Seri Mohd Najib Tun Razak to help improve the quality of life of people living in the far reaches of the state.
Starting next year, the Health Ministry will deploy boats equipped with proper treatment facilities and trained medical staff on the Baram River so that people living in riverine settlements can board them for health checks and medical attention.

Associations lament severe shortage of medical frontliners

Star: PETALING JAYA: Paramedics are the frontliners in the medical services industry but a severe shortage of those qualified in this field is affecting the lives of the people in emergency cases, particularly road accidents.
There have been cases where hospitals could only send out ambulances with just a driver and a junior nurse, thus depriving victims of the crucial medical aid before they reach the hospitals.
Malaysian Medical Association (MMA) president Dr David Quek said:
“Trained paramedics should be in the medical team because they are the frontliners. Unfortunately, the lack of paramedics has made the situation less than ideal for patients in cases of emergencies.”
He said there had been cases where lives could have been saved if they had been given pre-admission medical attention before reaching the hospital.
“Paramedics are needed to perform timely and life-saving emergency medical aid to the seriously wounded while they are being sent to the hospital,” he told The Star.
He said the acute shortage of trained and qualified paramedics to provide on-the-spot treatment to stabilise patients could make a difference between life and death.

St John Ambulance Malaysia (SJAM) commander-in-chief Da­­tuk Dr Low Bin Tick concurred, saying paramedics were difficult to come by.
He said based on SJAM estimates, there were only 50 qualified paramedics in the country.
Expressing concern over the startling figure, he called on the Government to train more paramedics to overcome the shortage.
“The problem arose because of the lack of career opportunities for paramedics to pursue the specialisation full-time and the low salary,” said Dr Low.
He added that there was no clear-cut career path for paramedics.

Malaysian Red Crescent Selangor branch training director S. Rama­nuja Muniandy agreed with Dr Low, adding that paramedics needed the support of the authorities in terms of career advancement.
“Paramedics would usually be employed at emergency units of hospitals and are not sent out on the field,” he said.
Ramanuja said there were many first-aiders or lay-rescuers but not qualified paramedics in the country.
“We give a lot of on-the-job, first-aid and emergency training to employees in factories and ambulance drivers in the private sector.
“However, they are not pursuing it full-time.
“A highly-trained paramedic would need to undergo at least three years of certified intensive training in these areas and be able to give efficient on-the-spot emergency treatment,” he said.
Ramanuja said Malaysia was still lagging behind Western countries like Canada and Britain in terms of giving emergency rescue and medical response to victims of a disaster.
“In Canada, paramedics have a degree in pre-hospital care,” he said.
He said ambulance services would normally focus on transporting patients to a hospital instead of giving them the crucial on-the-spot medical attention.
“The authorities should look into this matter very seriously to prevent unnecessary loss of lives,” he said.

Ministries order five-year moratorium on medical courses

Star: PETALING JAYA: The Government will impose a five-year moratorium on medical programmes as an immediate measure to prevent the glut in housemen from becoming worse.
The moratorium will prohibit the launch of new medical programmes in the country. Existing medical schools will be encouraged to focus more on quality.
It is hoped that this would put the brakes on the rise in the number of housemen.
The move – a joint effort between the Higher Education and Health Ministries – is similar to a moratorium in July which stopped the establishment of new nursing colleges and prohibited the launch of diploma programmes in nursing.
“It should stop more higher education institutions from offering new medical programmes,” Higher Education Minister Datuk Seri Mohamed Khaled Nordin said.
“We will be able to meet the national target to have a doctor to population ratio of 1:600 by 2015 and 1:400 by 2020 with the present capacity,” he told The Star.
Mohamed Khaled was referring to existing medical programmes in Malaysia’s 10 public universities; 12 local private providers; foreign medical schools; as well as students who were studying at about 50 accredited foreign universities.
The 1:400 ratio has been achieved by many Organisation of Economic Co-operation and Development member nations and is often regarded as the benchmark for a developed nation.
Mohamed Khaled said the ministries would examine the effects of the impending moratorium from time to time as private medical schools were bringing in foreign students and this could not be disrupted.
Both ministries, he said, had always worked closely to ensure quality at medical schools.
This was done through regular joint meetings to resolve issues related to healthcare, accreditation panels, professional development activities and the sharing of hospitals and support staff, among others.
He added that his ministry was committed to ensuring the quality of medical graduates and local medical schools had to possess the “appropriate resources”, such as healthy operating budgets; good infrastructure; competent and experienced medical lecturers; and a commitment to student welfare.
On Nov 27, The Star highlighted concerns about a glut on the number of housemen and the quality of fresh medical graduates.
Subsequently, Health Minister Datuk Seri Liow Tiong Lai told the Dewan Rakyat on Dec 6 about plans for the moratorium.

Delist poor quality med schools

Star: PETALING JAYA: The Malaysian Medical Association wants the Government to stop issuing licences to new medical schools and de-recognise existing ones which are of poor quality.
Its president Dr David Quek said stringent quality mechanisms should also be imposed on existing schools to ensure students are not short-changed.
“If medical schools do not have sufficient teachers or cannot offer adequate patient contact time, their student numbers should be reduced,” he said in an e-mail interview.
Recently, The Star reported that a high number of medical students graduating each year had crowded limited resources resulting in many housemen not having enough patients for adequate training with supervisors being overworked.
Sources also voiced concern that many graduates from lesser-known medical schools did not have adequate core knowledge to treat patients.
Dr Quek urged the Health Ministry to act quickly by sending “weak” new graduates for re-training.
In his blog on MMA News December 2010, he said there were 31,000 doctors and housemen and the Ministry wanted to reduce the doctor-population ratio by achieving 85,000 doctors for a projected 35 million population by 2020.
“This goal of trying to achieve so many doctors in so short a time is happening way too fast and too soon,” he said, adding that the issue was not about doctors wanting to protect their ‘turf’, rather their concern over patient safety.
While there were complaints of a glut in some hospitals, in rural hospitals in Sabah, housemen were complaining of being overworked.
A houseman, who declined to be named, said rural hospitals suffered from a severe lack of doctors and housemen had to work round the clock to care for patients.
“We have to be ‘on-call’ continuously for a whole week and go without sleep on some nights,” he said in an e-mail.
A mother of a houseman based at Hospital Universiti Kebangsaan Malaysia in Cheras also complained that her daughter’s feet had swelled after having to stand for long hours every day.
Acknowledging that there was a severe shortage of doctors in certain hospitals, Dr Quek said the Health Ministry should work out a better distribution mechanism to overcome the problem.

Too many new doctors and too few hospitals to train them

Star: PETALING JAYA: The number of medical housemen undergoing clinical training in most government hospitals has increased and this has given rise to concern that they may not get sufficient experience.
With new medical schools opening up locally and lower fees being offered at new institutions abroad, around 4,000 Malaysian medical students are expected to graduate annually from 350 universities all over the world in the coming years.
Senior Hospital Kuala Lumpur (HKL) consultant physician Datuk Dr S. Jeyaindran said each specialist was supervising four times as many housemen compared to a decade ago.
“Five years ago, one houseman looked after 10 patients in hospital wards at any one time but now it is one to four patients,” said Dr Jeyaindran, who is HKL department of medicine head and national head for medicine at the Health Ministry.
“The concern is that these interns are seeing fewer patients and hence, have fewer opportunities to carry out adequate procedures. In some hospitals, there are more housemen than patients.”
Dr Jeyaindran said they were not only concerned about the increase in numbers but also their attitude.
“Some lack responsibility towards their patients,” he said, adding that there were also those who did not know how to give an accurate diagnosis and relied too much on investigative tools instead of clinical skills and getting the proper patient history.
Malaysian Medical Council ethics committee chairman Datuk Dr Abdul Hamid Abdul Kadir said several specialists had expressed concern about the large numbers and training hospitals were finding it difficult to cope.
“In the past, it was five housemen in each department but now it could be 20 to 30 for each department,” he said, adding that some specialists were overburdened by the workload.

Health Minister Datuk Seri Liow Tiong Lai said the ministry was aware of the issue and would be increasing the number of training hospitals.
He said the ideal ratio should be one specialist supervising five housemen with one houseman taking care of 14 hospital beds depending on discipline.
There were 38 hospitals providing training to more than 3,058 housemen last year.
However, the number increased to the current 6,253 housemen since the ministry increased the duration of housemanship from one year to two.
“This led to most hospitals, including those in Sabah and Sarawak, having an excess of housemen,” he said.
Hospitals that were chosen must be able to cater to six areas in which housemen need training – medical, surgical, paediatrics, obstetrics and gynaecology, orthopaedic and accident, and emergency, he said.
Liow also said that they would be getting 58 contract specialists from Egypt, India and Pakistan next month to help supervise housemen and reduce the burden of the specialists now.
He also said that the ministry had taken steps to overcome the lack of experience among housemen by making training compulsory for two years instead of one.

More brain docs soon

Star: KUALA LUMPUR: There will be at least two neurosurgeons in each state to provide core neurosurgical works when the Government expands resident services in the discipline, said Health Minister Datuk Seri Liow Tiong Lai.
Currently, he said, eight states that still did not have resident neurosurgical services were Perlis, Kedah, Kelantan, Terengganu, Pahang, Selangor, Negri Sembilan and Malacca.
“We are now training 26 students to become neurosurgeons and once they graduate, we will be able to have at least two neurosurgeons in all these states,” he told reporters after opening the 8th Asian Congress of Neurological Surgeons and 1st Asian Neurosurgical Nursing Cong­ress here yesterday.
Liow said there were currently 74 neurosurgeons in the country with only 45 of them in the public sector.
“There is an acute shortage, especially in the east coast, northern region of the peninsula and East Malaysia.
“However, this is still a vast improvement as in 2004 there were only 36 neurosurgeons in the country,” he said.
However, he did not reveal the number of neurosurgeons needed based on the country’s population.
Liow said a comprehensive local training programme in collaboration with international faculties, which was established in 2001, had increased the number of trained neurosurgeons in the country since 2005.
He said the ministry also hoped to strengthen its six regional centres at Johor Baru, Kuala Lumpur, Sungai Buloh, Penang, Kuching and Kota Kinabalu with at least four neurosurgeons each to provide more advanced sub-speciality neurosurgical works.