Malaysian Insider: FEB 7 — I recently began my nine-week placement in psychiatry, and I have really been swept away by the complexity as well as the manifestations of disease of the human mind. This article is not to teach you psychiatry, or to argue its importance in the medical profession. I just want to give you an interesting five minutes’ read, and then I hope you will put some thought into the issue.
First, we need to arm you with some facts.
In the United Kingdom, the largest expenditure by category by the National Health Service is on mental illness. Here, the government has to spend more money treating mental illness than heart problems. They spend £200 (about RM1,000) per person on mental illness, but only £144 per person on heart problems.
It is quite natural for you to think that the British government is being a little bit silly in this instance. Really? Spending more money treating people with depression instead of saving people with heart attacks and cancer? Why would they do that?
Another fact then. One in four adults in the United Kingdom will suffer or has suffered from mental illness at one point in their lives.
Now you’re shocked. One in four? That seems like quite a lot, more than 15 million people in the United Kingdom’s 62-million-strong population. Surely that can’t be right.
Mental illness involves a spectrum of diseases, which include and are not limited to depression, alcoholism, drug abuse, eating disorders, dementia and learning disabilities. All these problems, and many more that haven’t been mentioned, are difficult to deal with, sometimes incurable, and may persist for many years.
While a heart attack is terrifying in the short term, a child with schizophrenia has a 20 per cent chance of being schizophrenic for the rest of his or her life. We are talking about possibly 70-80 years of suffering.
Now that you know that things like alcoholism, drug abuse and dementia are considered mental illnesses, I’m sure you can name at least four or five people that you know or have heard of with these problems. It’s now starting to make sense, why such a large amount of money is spent on mental illness, and why psychiatry is not just about studying what the public thinks are “crazy people”. It could happen to anyone.
These problems are real and they surround us. In fact, more terrifying than having a heart attack or cancer, most people may not realise that they are suffering from a mental illness. They may have hallucinations, or be uncontrollably addicted to whiskey, and you can put them through all the scanners in the world but you will not be able to find a single thing wrong with them. Nobody can see it, nobody can cure it, and very few people looking in from the outside can believe that it is as awful as described. It is lonely and frightening to be a mentally ill patient.
That’s all very well, but what does this have to do with you?
In Malaysia, more people have mental illness than have cancer. For the 24 million people in Malaysia, there are only seven child psychiatrists, not all of whom have had formal training.
Also, more importantly, facts aside, the general public does not have much awareness about mental illness. There is stigma and stereotypes born from fear of what we do not understand, and lack of awareness about the warning signs and what we can do to help the people we know and love who may be going through such problems.
So educate yourself today, and get rid of the stigma and fear, because it is time we improve our care services for those who have thus far been suffering in silence.
Malaysian Medical News: keeping you up to date with news sourced from various online sites, put in one place for your convenience, with a searchable archive
Tuesday, February 07, 2012
Malaysian health reform socio-economics — David KL Quek
Malaysian Insider : FEB 7 — Is the Malaysian health system really in trouble that it requires such a drastic revolutionary change? Is 1 Care for 1 Malaysia Health Reform the answer? Will this proposed radical change make our health system more efficient and effective as touted by officials?
Or, is this proposed reform too ambitious and sweeping that it could possibly lead to severe disruptions to our current health system that we are so used to?
More importantly, would this health reform plan become another government-linked corporate entity which, instead of benefiting the public, only enriches a few favoured cronies or insiders? The difference now is that this will be a humongous multibillion-ringgit exercise and the fattest cow to milk to date!
Sadly, at this juncture in time — in the name of social development, modernisation, and economic necessity even — there have been so many government-linked projects being scandalised and mired in corruption accusations and profligate leakages.
Thus, it would be foolhardy to implicitly trust the government to do the right thing despite the economic rationale or correctness, indeed despite even the most honourable intentions! We are dealing with the health choices and rights of the public, which could become severely disrupted and endangered if or when hurried reforms turn out to be another debacle of catastrophic proportions! We cannot afford a failed social experiment of this magnitude!
Economics and health care rights
Let’s examine the proposed 1 Care Health Reform. What indeed is this new concept that we are dealing with? The Ministry of Health has stated and defined the objectives of this 1 Care transformation as follows:
“1 Care is the restructured national health system that is responsive and provides choice of quality health care, ensuring universal coverage for the health care needs of the population based on the spirit of solidarity and equity.”
Theoretically, the above concept is a fully acceptable ideal. But it should not become just a neat slogan. Everyone should have equitable access to health. No one can or should deny this universal premise. No one should be disadvantaged or discriminated against when compared to another just because of his or her ability to pay more, or who can afford more. Most importantly, no one should ever be denied life-saving or symptom- or pain-relieving medical care just because of cost considerations. In reality however, this is not so simple.
Those who can afford to pay more would almost surely be able to purchase health and medical care at will, just because this is the way the free market works. Those who have more disposable or discretionary income and means almost always have a greater purchasing power to a wider variety and urgency of goods and services. This applies to every economic sphere and not just for health care. That is the way of world these days. Most people except perhaps those living in command socialist economies accept some degree of ease or disparity in their capacity to access healthcare, according to their individual means. This is socially unfair but also universal in its reach.
But again this is an undeniable truism, despite its distasteful and off-putting implications: the less endowed or less informed are almost always less demanding and have lesser recourse to demand or to expect more for any services or goods. If you earn more and have more money, you are able to afford more goods and services (sometimes known as “utilities”). If not, you would have to sacrifice not just the more luxurious aspects of the accompanying extras, but sometimes, even forego some basic necessities!
Thus, those who wish for more goods and services would have to work doubly hard and to strive harder when given a chance to gain, earn or excel. In competitive society, everyone is expected to achieve productivity for themselves to the best of his or her abilities. However, the playing field is often uneven and is never equal. Therefore the inherent inequalities of income and lifestyle must be considered when we wish to examine how fairly society provides goods and services for its citizens. This is particularly relevant when we consider healthcare services for society at large.
It is now well accepted that modern free-market society expects every individual to strive to provide for him/herself in the spirit of self-interest and self-betterment. Free competition would arguably allow the best and the most able to achieve more and thus provide the impetus for self-achievement and wealth accumulation. Free-market economics imply that society as a whole will be able to lift itself up by its own bootstraps to ever higher levels of development, both socio-economically as well as in terms of human development, so it is believed.
Increased wealth, unequal as this may be concentrated in the hands of some or a few, will somehow trickle downwards so that most of society at the various strata would benefit or reap some rewards, for themselves and their families. This creates “healthy” competition as well as competitive behaviour, which some argue contributes towards faster societal progress, because self-interests and individual desire for goods/services, almost always trump communal or other interests, outside the self or family.
But clearly there is a downside to this laissez faire market economic model. Increasingly we know that the rich and the powerful have grown ever richer and more powerful, and poverty appears to entrench and deprive the poor even more tenaciously than before in the poverty cycle — so much so that the wealth gap widens inexorably. The poor and the have-nots continue their inescapable slide down the poverty trap — the spiral of marginalisation, impoverishment and deprivation, whilst the rich grow ever richer.
Difficult as it is to consider, that is what the globalised world has now become — more and more market- and consumer-driven and more individual-focused. The wealth gap or income disparity between the rich and the poor (or GINI index4) continues to widen and serve as a serious challenge for governments worldwide.
Although with rising GDP growth, some benefits do trickle down to reach the lower strata of society, disgruntlement and discontent among society’s underbelly of the aggrieved and dispossessed, often strains society’s stability and fester public dissatisfaction. Worse, if the poorer segment of the population continues to grow and widen — this socially unjust disparity between the haves and the have-nots could be destabilising and could cause serious class conflicts.
Thus, there have been growing research and studies into the economics of income inequality, with many different models and indices being developed to try and describe these as close to reality as possible. It is hoped that these indices can help focus efforts to reduce these gaping inequalities as well as perceived inequities and perhaps develop better socioeconomic strategies and paradigms toward achieving greater social justice and cohesion.
Therefore social reform, which can eliminate or reduce such disparities, is always welcome in the name of social equity and fairness. Clearly this applies to healthcare discrepancy as well. So some reform is in order, at least nominally to reduce the gap of accessibility and perhaps too, to staunch the falling standards of health care. Just how this is to be realised is somewhat contentious, and the details of the government’s proposed reform remain unclear, and need to be better fleshed out. Here are where many outside the ambit of the Health Ministry and the policymakers find grave disquiet, disagreements and contentions.
Universal coverage — the ideal health care goal
Health financing options for any particular country are determined largely by the stage of its economic development — the poorer or less developed the country, the more likely it is for healthcare financing to be dominated by out-of-pocket payment options — healthcare is considered to be a luxury, instead of being a right or a privilege of being a citizen, a resident or a taxpayer.
For the poorer nation, there is normally no social protection against ill health, because out-of-pocket payments create financial barriers that prevent the poor from seeking and receiving needed health services. Which is why, our own pro-poor almost fully-subsidised public health system has been acclaimed and acknowledged as one of the best around the world, and not just for the developing world! Many underdeveloped nations have sent many cycles of delegates to learn from our much emulated public health system. So the premise that we are doing poorly in terms of healthcare is a myth, we are not. Of course, this is not to say that our health system is beyond reproach or improvement. There is much that can be made better.
Universal coverage as a guarantee for most if not all citizens is usually only provided by more developed or socially enlightened economies. But the mixes of payment options vary tremendously, with the more mature and socially equitable nations offering more tax-based or strictly demarcated or allocated social insurance for health. But such overall taxes tend to be very high and approach close to 50 per cent or more of earned incomes. Their tax bases are also broader, usually more than 70 per cent of the working populations are taxpayers, which enable such governments to implement collection mechanisms such as dedicated health insurance on a more inclusive and more comprehensive risk pooling (community-rated) manner. Examples include the Scandinavian countries of Norway, Sweden and Norway, and Canada and Australia.
Countries such as the United Kingdom are “blessed” in that a National Health Service was implemented decades ago, just after the Second World War, before free-market capitalistic practices have become entrenched. Other European countries have health systems, which are largely dominated by centrally controlled single-payer healthcare services with a sprinkle of private offerings for the wealthy. But most of these centrally controlled systems evolved over decades, often taking even longer than 50 years. For the more recent experiences of Taiwan, Thailand and South Korea, this evolved over the past 30 years, also through fits and starts. Despite this, health and medical care are often purchased services from private entities by the central authorities based on negotiated reimbursement plans, and varying co-payment options to decrease overutilisation of services, and ameliorate moral hazards.
The US is somewhat of an anomaly among developed economies in that it follows a free-market system of free choice and self- or employer-purchased insurances or managed care (MCOs) or health maintenance organisation (HMOs) options (to provide what is popularly known as managed competition). Unfortunately, this has failed to stem the tide of healthcare cost escalations, which has now exploded to a hefty 17 per cent of its GDP (some US$2.8 trillion (RM8.7 trillion)!) and its famously lack of universal coverage for its teeming uninsured — this number has now reached 47 million of its 300 million population (some 16 per cent of the population!).
This is also why the World Health Organisation has been pushing every nation towards achieving this goal of universal coverage for all. But this implies that governments, policymakers and the public are enlightened enough to agree to and allocate sufficient tax revenues toward health care, as well as to agree to some form of cost-sharing and risk-pooling. They must thus, also agree to the imposition of mutually-acceptable or negotiated social health insurance schemes to cover all the residents within their borders.
Universal coverage implies secure access for all to appropriate promotive, preventive, curative and rehabilitative health services at affordable costs. Besides financial risk protection, the extent of the population covered (e.g. who is covered) and the extent of health service coverage (e.g. what is covered) must also be properly defined, although this must clearly fit within the framework and context of affordability and means.
It therefore implies that governments provide sufficiently robust systems of emergency, catastrophic care and safety net services, so that the indigent and those impoverished can still partake of the health services without unnecessarily having to delay, to choose, or to sacrifice basic essentials for health, or vice versa. In other words, such barriers to healthcare access must be eradicated for as many people as possible, if not for everyone.
It further infers and probably necessitates that the country’s tax collection practices are mature, socially redistributive and reasonably equitable, so that the majority of the population can be adequately covered. Perhaps one of the most important considerations from the point of accountability is that administrative and service costs should be kept as low as possible, and not be allowed to bite into the already limited funds for whatever healthcare programmes!
* Dr David Quek is past president of the Malaysian Medical Association, but the opinions expressed are strictly his own and do not reflect those of the MMA.
Or, is this proposed reform too ambitious and sweeping that it could possibly lead to severe disruptions to our current health system that we are so used to?
More importantly, would this health reform plan become another government-linked corporate entity which, instead of benefiting the public, only enriches a few favoured cronies or insiders? The difference now is that this will be a humongous multibillion-ringgit exercise and the fattest cow to milk to date!
Sadly, at this juncture in time — in the name of social development, modernisation, and economic necessity even — there have been so many government-linked projects being scandalised and mired in corruption accusations and profligate leakages.
Thus, it would be foolhardy to implicitly trust the government to do the right thing despite the economic rationale or correctness, indeed despite even the most honourable intentions! We are dealing with the health choices and rights of the public, which could become severely disrupted and endangered if or when hurried reforms turn out to be another debacle of catastrophic proportions! We cannot afford a failed social experiment of this magnitude!
Economics and health care rights
Let’s examine the proposed 1 Care Health Reform. What indeed is this new concept that we are dealing with? The Ministry of Health has stated and defined the objectives of this 1 Care transformation as follows:
“1 Care is the restructured national health system that is responsive and provides choice of quality health care, ensuring universal coverage for the health care needs of the population based on the spirit of solidarity and equity.”
Theoretically, the above concept is a fully acceptable ideal. But it should not become just a neat slogan. Everyone should have equitable access to health. No one can or should deny this universal premise. No one should be disadvantaged or discriminated against when compared to another just because of his or her ability to pay more, or who can afford more. Most importantly, no one should ever be denied life-saving or symptom- or pain-relieving medical care just because of cost considerations. In reality however, this is not so simple.
Those who can afford to pay more would almost surely be able to purchase health and medical care at will, just because this is the way the free market works. Those who have more disposable or discretionary income and means almost always have a greater purchasing power to a wider variety and urgency of goods and services. This applies to every economic sphere and not just for health care. That is the way of world these days. Most people except perhaps those living in command socialist economies accept some degree of ease or disparity in their capacity to access healthcare, according to their individual means. This is socially unfair but also universal in its reach.
But again this is an undeniable truism, despite its distasteful and off-putting implications: the less endowed or less informed are almost always less demanding and have lesser recourse to demand or to expect more for any services or goods. If you earn more and have more money, you are able to afford more goods and services (sometimes known as “utilities”). If not, you would have to sacrifice not just the more luxurious aspects of the accompanying extras, but sometimes, even forego some basic necessities!
Thus, those who wish for more goods and services would have to work doubly hard and to strive harder when given a chance to gain, earn or excel. In competitive society, everyone is expected to achieve productivity for themselves to the best of his or her abilities. However, the playing field is often uneven and is never equal. Therefore the inherent inequalities of income and lifestyle must be considered when we wish to examine how fairly society provides goods and services for its citizens. This is particularly relevant when we consider healthcare services for society at large.
It is now well accepted that modern free-market society expects every individual to strive to provide for him/herself in the spirit of self-interest and self-betterment. Free competition would arguably allow the best and the most able to achieve more and thus provide the impetus for self-achievement and wealth accumulation. Free-market economics imply that society as a whole will be able to lift itself up by its own bootstraps to ever higher levels of development, both socio-economically as well as in terms of human development, so it is believed.
Increased wealth, unequal as this may be concentrated in the hands of some or a few, will somehow trickle downwards so that most of society at the various strata would benefit or reap some rewards, for themselves and their families. This creates “healthy” competition as well as competitive behaviour, which some argue contributes towards faster societal progress, because self-interests and individual desire for goods/services, almost always trump communal or other interests, outside the self or family.
But clearly there is a downside to this laissez faire market economic model. Increasingly we know that the rich and the powerful have grown ever richer and more powerful, and poverty appears to entrench and deprive the poor even more tenaciously than before in the poverty cycle — so much so that the wealth gap widens inexorably. The poor and the have-nots continue their inescapable slide down the poverty trap — the spiral of marginalisation, impoverishment and deprivation, whilst the rich grow ever richer.
Difficult as it is to consider, that is what the globalised world has now become — more and more market- and consumer-driven and more individual-focused. The wealth gap or income disparity between the rich and the poor (or GINI index4) continues to widen and serve as a serious challenge for governments worldwide.
Although with rising GDP growth, some benefits do trickle down to reach the lower strata of society, disgruntlement and discontent among society’s underbelly of the aggrieved and dispossessed, often strains society’s stability and fester public dissatisfaction. Worse, if the poorer segment of the population continues to grow and widen — this socially unjust disparity between the haves and the have-nots could be destabilising and could cause serious class conflicts.
Thus, there have been growing research and studies into the economics of income inequality, with many different models and indices being developed to try and describe these as close to reality as possible. It is hoped that these indices can help focus efforts to reduce these gaping inequalities as well as perceived inequities and perhaps develop better socioeconomic strategies and paradigms toward achieving greater social justice and cohesion.
Therefore social reform, which can eliminate or reduce such disparities, is always welcome in the name of social equity and fairness. Clearly this applies to healthcare discrepancy as well. So some reform is in order, at least nominally to reduce the gap of accessibility and perhaps too, to staunch the falling standards of health care. Just how this is to be realised is somewhat contentious, and the details of the government’s proposed reform remain unclear, and need to be better fleshed out. Here are where many outside the ambit of the Health Ministry and the policymakers find grave disquiet, disagreements and contentions.
Universal coverage — the ideal health care goal
Health financing options for any particular country are determined largely by the stage of its economic development — the poorer or less developed the country, the more likely it is for healthcare financing to be dominated by out-of-pocket payment options — healthcare is considered to be a luxury, instead of being a right or a privilege of being a citizen, a resident or a taxpayer.
For the poorer nation, there is normally no social protection against ill health, because out-of-pocket payments create financial barriers that prevent the poor from seeking and receiving needed health services. Which is why, our own pro-poor almost fully-subsidised public health system has been acclaimed and acknowledged as one of the best around the world, and not just for the developing world! Many underdeveloped nations have sent many cycles of delegates to learn from our much emulated public health system. So the premise that we are doing poorly in terms of healthcare is a myth, we are not. Of course, this is not to say that our health system is beyond reproach or improvement. There is much that can be made better.
Universal coverage as a guarantee for most if not all citizens is usually only provided by more developed or socially enlightened economies. But the mixes of payment options vary tremendously, with the more mature and socially equitable nations offering more tax-based or strictly demarcated or allocated social insurance for health. But such overall taxes tend to be very high and approach close to 50 per cent or more of earned incomes. Their tax bases are also broader, usually more than 70 per cent of the working populations are taxpayers, which enable such governments to implement collection mechanisms such as dedicated health insurance on a more inclusive and more comprehensive risk pooling (community-rated) manner. Examples include the Scandinavian countries of Norway, Sweden and Norway, and Canada and Australia.
Countries such as the United Kingdom are “blessed” in that a National Health Service was implemented decades ago, just after the Second World War, before free-market capitalistic practices have become entrenched. Other European countries have health systems, which are largely dominated by centrally controlled single-payer healthcare services with a sprinkle of private offerings for the wealthy. But most of these centrally controlled systems evolved over decades, often taking even longer than 50 years. For the more recent experiences of Taiwan, Thailand and South Korea, this evolved over the past 30 years, also through fits and starts. Despite this, health and medical care are often purchased services from private entities by the central authorities based on negotiated reimbursement plans, and varying co-payment options to decrease overutilisation of services, and ameliorate moral hazards.
The US is somewhat of an anomaly among developed economies in that it follows a free-market system of free choice and self- or employer-purchased insurances or managed care (MCOs) or health maintenance organisation (HMOs) options (to provide what is popularly known as managed competition). Unfortunately, this has failed to stem the tide of healthcare cost escalations, which has now exploded to a hefty 17 per cent of its GDP (some US$2.8 trillion (RM8.7 trillion)!) and its famously lack of universal coverage for its teeming uninsured — this number has now reached 47 million of its 300 million population (some 16 per cent of the population!).
This is also why the World Health Organisation has been pushing every nation towards achieving this goal of universal coverage for all. But this implies that governments, policymakers and the public are enlightened enough to agree to and allocate sufficient tax revenues toward health care, as well as to agree to some form of cost-sharing and risk-pooling. They must thus, also agree to the imposition of mutually-acceptable or negotiated social health insurance schemes to cover all the residents within their borders.
Universal coverage implies secure access for all to appropriate promotive, preventive, curative and rehabilitative health services at affordable costs. Besides financial risk protection, the extent of the population covered (e.g. who is covered) and the extent of health service coverage (e.g. what is covered) must also be properly defined, although this must clearly fit within the framework and context of affordability and means.
It therefore implies that governments provide sufficiently robust systems of emergency, catastrophic care and safety net services, so that the indigent and those impoverished can still partake of the health services without unnecessarily having to delay, to choose, or to sacrifice basic essentials for health, or vice versa. In other words, such barriers to healthcare access must be eradicated for as many people as possible, if not for everyone.
It further infers and probably necessitates that the country’s tax collection practices are mature, socially redistributive and reasonably equitable, so that the majority of the population can be adequately covered. Perhaps one of the most important considerations from the point of accountability is that administrative and service costs should be kept as low as possible, and not be allowed to bite into the already limited funds for whatever healthcare programmes!
* Dr David Quek is past president of the Malaysian Medical Association, but the opinions expressed are strictly his own and do not reflect those of the MMA.
System needed to monitor quality of nursing grads
Star: PETALING JAYA: A comprehensive system is needed to monitor the quality of nursing graduates and ensure they remain competent years after, a non-governmental organisation said.
Malaysian Society for Healthcare Delivery president Vimala Suppiah expressed worry that quality levels could be affected given the high number of nursing graduates being churned out at some private institutions.
“Nursing is a technical job. We do not know if they are getting proper practical work training.
“Staff nurses and matrons have complained of poor quality nursing graduates,” she said.
The number of private nursing diploma graduates, who took the Nursing Board examination, had increased from 4,025 in 2008 to 7,665 in 2010 but the passing percentage had decreased from 86.5% to 70.1% for the same period.
However, Health Ministry and public institution graduates had a passing percentage of between 94% and 99%.
The high number of private nursing graduates has resulted in many finding it difficult to get jobs, especially given the limited number of positions available in the private and government sector.
According to government statistics, a total of 37,702 students were enrolled in nursing diploma courses in 61 private institutions of higher learning (IPTS) in 2010.
As at December 2010, the total number of trained working nurses in the country stood at 61,110 with 21,118 working in the private sector.
A check with several IPTS showed that it was easy to enrol for a three-year nursing diploma programme even if the student did not have credits in all Science subjects.
Malaysian Society for Healthcare Delivery president Vimala Suppiah expressed worry that quality levels could be affected given the high number of nursing graduates being churned out at some private institutions.
“Nursing is a technical job. We do not know if they are getting proper practical work training.
“Staff nurses and matrons have complained of poor quality nursing graduates,” she said.
The number of private nursing diploma graduates, who took the Nursing Board examination, had increased from 4,025 in 2008 to 7,665 in 2010 but the passing percentage had decreased from 86.5% to 70.1% for the same period.
However, Health Ministry and public institution graduates had a passing percentage of between 94% and 99%.
The high number of private nursing graduates has resulted in many finding it difficult to get jobs, especially given the limited number of positions available in the private and government sector.
According to government statistics, a total of 37,702 students were enrolled in nursing diploma courses in 61 private institutions of higher learning (IPTS) in 2010.
As at December 2010, the total number of trained working nurses in the country stood at 61,110 with 21,118 working in the private sector.
A check with several IPTS showed that it was easy to enrol for a three-year nursing diploma programme even if the student did not have credits in all Science subjects.
Health Ministry to hire graduate nurses
Star: PUTRAJAYA: The Health Ministry is working on creating vacancies at government hospitals to absorb the large number of unemployed graduate nurses.
Health Minister Datuk Seri Liow Tiong Lai said a special committee, led by Health director-general Datuk Seri Dr Hasan Abdul Rahman, had been set up to find a solution to the issue.
“We are working on a programme to promote those who are already in the system and the vacancies can then be filled up by the graduates,” he said yesterday.
Liow pointed out that the proposed programme aimed to train the current crop of nurses to specialise in one of the many fields in government hospitals and in the process, create vacancies in lower-level positions.
In the long run, however, he said private institutions of higher learning would need to streamline their syllabus to match the demands of the local health industry.
Over the past week, The Star ran several reports highlighting the difficulty faced by nursing graduates from private institutes in finding jobs.
A government study found that over 54% of private nursing diploma graduates could not find work three to four months after graduating in 2010, compared to 21.7% in 2008.
Liow said the main factor leading to the surplus of nursing graduates was that private institutes appeared to not be in touch with the areas of expertise that were in demand.
He said the Government currently runs around 30 colleges, whose graduates are trained to meet the needs of public hospitals.
On the other hand, most of the estimated 70 private nursing colleges nationwide were providing general training and in many cases, did not meet private sector demand for specialised nurses.
“We are not looking at it as a surplus. We do need nurses, and so does the private sector because it is also expanding.
“This is mostly an issue of a mismatch between training and market demand. However, we do not control the numbers (of student intake) in private colleges.
“This is something we will have to work out with the Higher Education Ministry, and hopefully all of this (syllabus and market demand) will be streamlined,” he said.
Liow did not give a deadline for the committee to find a solution, saying that it had only just been formed and held its first meeting recently.
Health Minister Datuk Seri Liow Tiong Lai said a special committee, led by Health director-general Datuk Seri Dr Hasan Abdul Rahman, had been set up to find a solution to the issue.
“We are working on a programme to promote those who are already in the system and the vacancies can then be filled up by the graduates,” he said yesterday.
Liow pointed out that the proposed programme aimed to train the current crop of nurses to specialise in one of the many fields in government hospitals and in the process, create vacancies in lower-level positions.
In the long run, however, he said private institutions of higher learning would need to streamline their syllabus to match the demands of the local health industry.
Over the past week, The Star ran several reports highlighting the difficulty faced by nursing graduates from private institutes in finding jobs.
A government study found that over 54% of private nursing diploma graduates could not find work three to four months after graduating in 2010, compared to 21.7% in 2008.
Liow said the main factor leading to the surplus of nursing graduates was that private institutes appeared to not be in touch with the areas of expertise that were in demand.
He said the Government currently runs around 30 colleges, whose graduates are trained to meet the needs of public hospitals.
On the other hand, most of the estimated 70 private nursing colleges nationwide were providing general training and in many cases, did not meet private sector demand for specialised nurses.
“We are not looking at it as a surplus. We do need nurses, and so does the private sector because it is also expanding.
“This is mostly an issue of a mismatch between training and market demand. However, we do not control the numbers (of student intake) in private colleges.
“This is something we will have to work out with the Higher Education Ministry, and hopefully all of this (syllabus and market demand) will be streamlined,” he said.
Liow did not give a deadline for the committee to find a solution, saying that it had only just been formed and held its first meeting recently.
Mismatch between training and market needs for specialised nurses
Star: PUTRAJAYA: The number of jobless nursing graduates has reached such a state that Health Minister Datuk Seri Liow Tiong Lai has ticked off private institutions of higher learning for not being in touch with market demand.
The institutions, he said, were the cause of the surplus as they have not delivered on the areas of expertise needed and thus created a mismatch between training and market needs.
Most of the private nursing colleges are offering mere “general training”, which did not cater to the private sector's requirement for specialised nurses, he said.
Among the measures to rectify the problem:
> The Government to work on creating vacancies at public hospitals.
>The Malaysian Society for Healthcare Delivery wants a system to monitor the quality of nursing graduates.
The institutions, he said, were the cause of the surplus as they have not delivered on the areas of expertise needed and thus created a mismatch between training and market needs.
Most of the private nursing colleges are offering mere “general training”, which did not cater to the private sector's requirement for specialised nurses, he said.
Among the measures to rectify the problem:
> The Government to work on creating vacancies at public hospitals.
>The Malaysian Society for Healthcare Delivery wants a system to monitor the quality of nursing graduates.
Monday, February 06, 2012
Surplus of nurses temporary, says group
Star: PETALING JAYA: The current surplus of nurses is expected to be temporary as student intakes have decreased following measures taken by the Government, Malaysian Nurses Association president Dame Ramziah Ahmad said.
She said the number of applicants for nursing courses had dropped after the Government imposed a minimum requirement of five credits, instead of three, in Sijil Pelajaran Malaysia.
“Now there are fewer people applying due to the higher requirements,” she told The Star.
Ramziah stressed that nursing students also had a role to play in getting jobs for themselves, saying that one of the challenges in training nurses these days was their poor attitude.
They not only had to be competent but also possess soft skills, she said, adding that they must also be able to communicate in English and should have a healthy body mass index.
“Hospitals are looking for high quality nurses. Nursing students and graduates have to show that they are competent in order to secure the job,” Ramziah said.
It was reported yesterday that private nursing students were finding it tough to find jobs.
A government study found that at least 54% of them failed to get a job within four months after graduating in 2010.
Ramziah also noted that certain colleges in the private sector had taken in too many students, affecting the quality of nurses being produced.
“They lack clinical training as they handle fewer patients and they have insufficient hands-on experience,” she said.
The ratio, she said, should be one lecturer to 30 students and one clinical instructor to 15 students.
The authorities have also stopped more colleges from offering nursing courses in recent years.
In 2010, the Government announced a moratorium on new nursing schools.
Former Malayan Nurses Union general secretary Anne Khoo said that poor coordination between the Health Ministry, the Higher Education Ministry and the private colleges had resulted in the huge surplus.
“The Government must strive for better coordination and know the number of nurses needed annually,” she said.
Khoo said the surplus was frustrating for nurses who could not get jobs as they faced difficulties settling their study loans.
“It has also damaged the profession as private hospitals can hire nurses at a lower salary.
“This also could affect the salaries of existing employed nurses,” she said.
She said the number of applicants for nursing courses had dropped after the Government imposed a minimum requirement of five credits, instead of three, in Sijil Pelajaran Malaysia.
“Now there are fewer people applying due to the higher requirements,” she told The Star.
Ramziah stressed that nursing students also had a role to play in getting jobs for themselves, saying that one of the challenges in training nurses these days was their poor attitude.
They not only had to be competent but also possess soft skills, she said, adding that they must also be able to communicate in English and should have a healthy body mass index.
“Hospitals are looking for high quality nurses. Nursing students and graduates have to show that they are competent in order to secure the job,” Ramziah said.
It was reported yesterday that private nursing students were finding it tough to find jobs.
A government study found that at least 54% of them failed to get a job within four months after graduating in 2010.
Ramziah also noted that certain colleges in the private sector had taken in too many students, affecting the quality of nurses being produced.
“They lack clinical training as they handle fewer patients and they have insufficient hands-on experience,” she said.
The ratio, she said, should be one lecturer to 30 students and one clinical instructor to 15 students.
The authorities have also stopped more colleges from offering nursing courses in recent years.
In 2010, the Government announced a moratorium on new nursing schools.
Former Malayan Nurses Union general secretary Anne Khoo said that poor coordination between the Health Ministry, the Higher Education Ministry and the private colleges had resulted in the huge surplus.
“The Government must strive for better coordination and know the number of nurses needed annually,” she said.
Khoo said the surplus was frustrating for nurses who could not get jobs as they faced difficulties settling their study loans.
“It has also damaged the profession as private hospitals can hire nurses at a lower salary.
“This also could affect the salaries of existing employed nurses,” she said.
Saturday, February 04, 2012
Scrap 1Care plan, urge groups
Star: PETALING JAYA: The Health Ministry should scrap plans to change the entire healthcare system under the 1Care for 1Malaysia plan, said medical experts and concerned citizen groups.
Also, it is better for Malaysia to improve the current healthcare system instead of shaping the 1Care for 1Malaysia plan after foreign models.
Federation of Private Medical Practitioners Associations Malaysia president Dr Steven Chow said the Malaysian healthcare system had achieved remarkable results despite our relatively low healthcare expenditure.
“Why do we want to totally transform a system that is already working relatively well, with something entirely new that might not suit us at all?” Dr Chow asked at a press briefing recently.
Citing data from international organisations, Dr Chow said that Malaysia’s healthcare system was comparable to countries like the US, Britain and Singapore even though our healthcare spending was lower in GDP terms.
He said the country would only need to address some of the shortcomings of the current system to improve it, such as problem of wastage and under-productivity in the public sector.
Dr T. Jayabalan, the main coordinator of the Citizens’ Healthcare Coalition, said the ministry should talk to local experts, instead of foreign ones, on the best way to improve healthcare.
Voices of dissent against the proposed 1Care for 1Malaysia healthcare reforms have been mounting since members of the Citizens Healthcare Coalition posted “supposed details” of the plan.
These details include the claim that households will have to fork out 10% of their monthly income to fund a Social Health Insu- rance that will be used to finance the new system.
Although the Health Ministry had earlier clarified that the plan was still in its conceptual stage, some parties have claimed that parts of the plan are already being imple-mented.
Also, it is better for Malaysia to improve the current healthcare system instead of shaping the 1Care for 1Malaysia plan after foreign models.
Federation of Private Medical Practitioners Associations Malaysia president Dr Steven Chow said the Malaysian healthcare system had achieved remarkable results despite our relatively low healthcare expenditure.
“Why do we want to totally transform a system that is already working relatively well, with something entirely new that might not suit us at all?” Dr Chow asked at a press briefing recently.
Citing data from international organisations, Dr Chow said that Malaysia’s healthcare system was comparable to countries like the US, Britain and Singapore even though our healthcare spending was lower in GDP terms.
He said the country would only need to address some of the shortcomings of the current system to improve it, such as problem of wastage and under-productivity in the public sector.
Dr T. Jayabalan, the main coordinator of the Citizens’ Healthcare Coalition, said the ministry should talk to local experts, instead of foreign ones, on the best way to improve healthcare.
Voices of dissent against the proposed 1Care for 1Malaysia healthcare reforms have been mounting since members of the Citizens Healthcare Coalition posted “supposed details” of the plan.
These details include the claim that households will have to fork out 10% of their monthly income to fund a Social Health Insu- rance that will be used to finance the new system.
Although the Health Ministry had earlier clarified that the plan was still in its conceptual stage, some parties have claimed that parts of the plan are already being imple-mented.
1Care proposal ready in 2 years
Star: IPOH: The proposal for the 1Care for 1Malaysia plan to revamp the country’s healthcare sytem will only be ready in two years.
MCA president Datuk Seri Dr Chua Soi Lek said time was needed to seek input from all stakeholders; the people, doctors, nurses and the private sector.
He added that some of the information on the 1Care plan that appeared in several websites, such as the clause that patients could only seek treatment six times a year, was untrue.
“These are lies to make the people hate the Government and also to make Barisan Nasional look bad,” he added.
The party president, a medical doctor by training, also noted that the Health Ministry’s healthcare services, 98% of which was subsidised, were good.
He added that a revamp was necessary following changes in disease trends in the country, such as the increasing cases of non-communicable and lifestyle diseases like diabetes, hypertension, high cholesterol level, heart diseases and cancer.
Dr Chua said Prime Minister Datuk Seri Najib Tun Razak, who also heads the National Economic Council, had given his assurance that the poor would continue to receive treatment from the Government following the revamp.
“The council discussed the matter during its meeting three days ago,” Dr Chua, who is a member of the council, told reporters after a Chinese New Year dinner in Bercham, near here, on Thursday.
In Petaling Jaya, the Health Ministry has quashed claims that parts of the controversial 1Care plan have been implemented.
Health director-general Datuk Seri Dr Hasan Abdul Rahman said in a statement the ministry was still drafting the blueprint for 1Care.
He added that consultations on the types of financial arrangements and implications to the Government, taxpayers and individuals were under way to come up with an acceptable healthcare financing model.
“Thus, any assumptions or conjecture on the financial impact on the individual taxpayer is very premature at this stage,” said Dr Hasan.
He called on critics of 1Care to engage with the ministry to better understand the proposed plan.
MCA president Datuk Seri Dr Chua Soi Lek said time was needed to seek input from all stakeholders; the people, doctors, nurses and the private sector.
He added that some of the information on the 1Care plan that appeared in several websites, such as the clause that patients could only seek treatment six times a year, was untrue.
“These are lies to make the people hate the Government and also to make Barisan Nasional look bad,” he added.
The party president, a medical doctor by training, also noted that the Health Ministry’s healthcare services, 98% of which was subsidised, were good.
He added that a revamp was necessary following changes in disease trends in the country, such as the increasing cases of non-communicable and lifestyle diseases like diabetes, hypertension, high cholesterol level, heart diseases and cancer.
Dr Chua said Prime Minister Datuk Seri Najib Tun Razak, who also heads the National Economic Council, had given his assurance that the poor would continue to receive treatment from the Government following the revamp.
“The council discussed the matter during its meeting three days ago,” Dr Chua, who is a member of the council, told reporters after a Chinese New Year dinner in Bercham, near here, on Thursday.
In Petaling Jaya, the Health Ministry has quashed claims that parts of the controversial 1Care plan have been implemented.
Health director-general Datuk Seri Dr Hasan Abdul Rahman said in a statement the ministry was still drafting the blueprint for 1Care.
He added that consultations on the types of financial arrangements and implications to the Government, taxpayers and individuals were under way to come up with an acceptable healthcare financing model.
“Thus, any assumptions or conjecture on the financial impact on the individual taxpayer is very premature at this stage,” said Dr Hasan.
He called on critics of 1Care to engage with the ministry to better understand the proposed plan.
Let group hold re-election, MMA urged
Star: SEREMBAN: The Malaysian Medical Association (MMA) council should step aside and allow a caretaker committee to conduct fresh elections for the grouping of some 10,000 doctors, former president Datuk Dr Abdul Hamid Abdul Kadir said.
“It is time for the present council to step aside and make way for a caretaker committee to conduct a re-election to solve the unconstitutional election held at the last AGM,” he claimed.
Dr Abdul Hamid said it was “strange” that the MMA had decided not to hold fresh elections and instead called for nominations for the 2012-2013 period.
“It is clear to the majority of members that the directive from the Registrar of Societies was to correct the mistakes of the election of office bearers at the last AGM in 2011, which contravened the constitution of the association and provisions in the Societies Act,” he said.
In a report on Thursday, The Star quoted Registrar of Societies Datuk Abdul Rahman Othman as saying that MMA must declare its last election null and void and elect a new set of office bearers as one of the conditions to ensure it would not be struck off for violating association rules and the Societies Act.
However, MMA president Dr Mary Cardosa explained subsequently that the association was never told to hold fresh elections, adding that MMA would hold its AGM and election of new office bearers “as usual” in May.
Dr Cardosa said a notice had been sent to all members on a special meeting to be held on Feb 12 when they would be given a clearer picture of its status following its deregistration and the six-month grace period given to the association to rectify matters.
The ROS deregistered MMA on Nov 16 after it failed to give a proper explanation on several charges of irregularities in last year’s election.
However, the deregistration was deferred by six months after the MMA appealed.
Another former president, Datuk Dr Lee Yan San, said the MMA should conduct a postal ballot to allow all members to vote for a new team.
“MMA is a very important and well-established association representing doctors and it has had good rapport with the Health Ministry which often seeks our views.
“We have sacrificed a lot of our time and energy to build up MMA to its present prestigious position. It would be a shame to see it deregistered for this reason,” he said.
Former president Datuk Dr P. Krishnan said: “I don’t understand the rationale of the MMA council calling for a special meeting merely to explain the chronology of events. This is a waste of time and money,” he said.
“It is time for the present council to step aside and make way for a caretaker committee to conduct a re-election to solve the unconstitutional election held at the last AGM,” he claimed.
Dr Abdul Hamid said it was “strange” that the MMA had decided not to hold fresh elections and instead called for nominations for the 2012-2013 period.
“It is clear to the majority of members that the directive from the Registrar of Societies was to correct the mistakes of the election of office bearers at the last AGM in 2011, which contravened the constitution of the association and provisions in the Societies Act,” he said.
In a report on Thursday, The Star quoted Registrar of Societies Datuk Abdul Rahman Othman as saying that MMA must declare its last election null and void and elect a new set of office bearers as one of the conditions to ensure it would not be struck off for violating association rules and the Societies Act.
However, MMA president Dr Mary Cardosa explained subsequently that the association was never told to hold fresh elections, adding that MMA would hold its AGM and election of new office bearers “as usual” in May.
Dr Cardosa said a notice had been sent to all members on a special meeting to be held on Feb 12 when they would be given a clearer picture of its status following its deregistration and the six-month grace period given to the association to rectify matters.
The ROS deregistered MMA on Nov 16 after it failed to give a proper explanation on several charges of irregularities in last year’s election.
However, the deregistration was deferred by six months after the MMA appealed.
Another former president, Datuk Dr Lee Yan San, said the MMA should conduct a postal ballot to allow all members to vote for a new team.
“MMA is a very important and well-established association representing doctors and it has had good rapport with the Health Ministry which often seeks our views.
“We have sacrificed a lot of our time and energy to build up MMA to its present prestigious position. It would be a shame to see it deregistered for this reason,” he said.
Former president Datuk Dr P. Krishnan said: “I don’t understand the rationale of the MMA council calling for a special meeting merely to explain the chronology of events. This is a waste of time and money,” he said.
Friday, February 03, 2012
Coughs And Sneezes - Have We Forgotten The Flu Outbreak?
KUALA LUMPUR, Feb 2 (Bernama) -- A man sneezes hard. He uses neither tissues nor handkerchief to cover the sneeze, despite the presence of many people around.
Another man coughs repeatedly without any attempt to cover his mouth. Many individuals sit down for lunch without washing their hands.
That is the scenario which this writer came across recently at a food court in a shopping complex here.
A shopper who happened to be there, posed a rather cynical query to this writer:
"Have Malaysians forgotten the 2009 flu outbreak in the country caused by the H1N1 (virus)?"
The H1N1 virus caused an influenza epidemic known as Influenza A, or swine flu, in 2009.
Based on the Health Ministry's statistics, between 15 May and 11 Aug that year, the country reported more than 2,253 cases of this flu, including cases brought from other nations, such as United States and Australia.
The first local transmission was reported on 17 June, 2009.
As of Aug 21, 2009, the unofficial number of cases in Malaysia was reported to be 5,876.
The first death related to the A (H1N1) influenza virus was reported on 23 July 2009. Since then, there have been 78 deaths reported in the country.
SWINE FLU
That episode saw Malaysians rushing to pharmacies to buy surgical face masks and hand sanitisers -- to the extent that the pharmacies ran out of these most sought-after items.
Some unscrupulous parties resorted to selling surgical face masks at RM5 each, as against the normal price of 20 sen each. Supermarkets as well as pharmacies reported brisk sale of hand sanitisers.
Maybe Malaysians have forgotten the health hazards brought about by the swine flu.
According to health authorities the swine flu virus, first detected in the United States in April 2009, spread the same way that regular seasonal influenza viruses spread.
On 11 June, 2009, the World Health Organization (WHO) declared that a pandemic of H1N1 flu was underway worldwide (pandemic means occurring over a wide geographic area and affecting an exceptionally high proportion of the population).
BE ON THE GUARD
Respiratory diseases lecturer Dr C.L. Ting said flu viruses spread mainly from person to person through coughing, sneezing or talking by people with influenza.
"Sometimes people may become infected by touching something such as a surface or object with flu viruses on it and then touching their mouth or nose.
"In seasonal flu, certain people are at high risk of serious complications. Among them are people 65 years and older, children younger than five, pregnant women, and those with certain chronic medical conditions," said Dr Ting.
He said some people are more likely to get flu complications that result in being hospitalised, and occasionally in death.
"Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. The flu can also make chronic health problems worse.
"For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may have a worsening of this condition," he explained.
AVOID INFECTING OTHERS
Dr Ting advised people to avoid infecting others.
He said: "The best thing anyone can do is to wash their hands. Handwashing helps prevent the spread of airborne flu viruses and other respiratory disease.
Handwashing with soap is among the most effective and inexpensive ways to prevent the spread of communicable diseases. Unclean hands are a vehicle to spread germs.
"Ironically, most of us know this but many fail to practice it. It is the droplets from coughing and sneezing that spread flu. That is why you should cover your mouth when you cough or sneeze.
"Observe personal hygiene by frequently washing your hands and closing the mouth when coughing. Surgical face masks are good in covering the cough or sneeze, as well as from getting the droplets from other people," he said.
And if you happen to be sick with flu, then it is better to stay home as the chances of infecting others are minimised.
HAND WASHING
Health Minister Datuk Seri Liow Tiong Lai said handwashing with soap is among the most effective and inexpensive ways to prevent communicable diseases such as influenza, colds and coughs, as well as incidences of hand, foot and mouth diseases.
It also can go a long way toward reducing the incidences of gastrointestinal infections, including diarhoea, as well as respiratory infections.
"Unclean hands are the vector for spreading germs," he was reported as saying by the media.
Another man coughs repeatedly without any attempt to cover his mouth. Many individuals sit down for lunch without washing their hands.
That is the scenario which this writer came across recently at a food court in a shopping complex here.
A shopper who happened to be there, posed a rather cynical query to this writer:
"Have Malaysians forgotten the 2009 flu outbreak in the country caused by the H1N1 (virus)?"
The H1N1 virus caused an influenza epidemic known as Influenza A, or swine flu, in 2009.
Based on the Health Ministry's statistics, between 15 May and 11 Aug that year, the country reported more than 2,253 cases of this flu, including cases brought from other nations, such as United States and Australia.
The first local transmission was reported on 17 June, 2009.
As of Aug 21, 2009, the unofficial number of cases in Malaysia was reported to be 5,876.
The first death related to the A (H1N1) influenza virus was reported on 23 July 2009. Since then, there have been 78 deaths reported in the country.
SWINE FLU
That episode saw Malaysians rushing to pharmacies to buy surgical face masks and hand sanitisers -- to the extent that the pharmacies ran out of these most sought-after items.
Some unscrupulous parties resorted to selling surgical face masks at RM5 each, as against the normal price of 20 sen each. Supermarkets as well as pharmacies reported brisk sale of hand sanitisers.
Maybe Malaysians have forgotten the health hazards brought about by the swine flu.
According to health authorities the swine flu virus, first detected in the United States in April 2009, spread the same way that regular seasonal influenza viruses spread.
On 11 June, 2009, the World Health Organization (WHO) declared that a pandemic of H1N1 flu was underway worldwide (pandemic means occurring over a wide geographic area and affecting an exceptionally high proportion of the population).
BE ON THE GUARD
Respiratory diseases lecturer Dr C.L. Ting said flu viruses spread mainly from person to person through coughing, sneezing or talking by people with influenza.
"Sometimes people may become infected by touching something such as a surface or object with flu viruses on it and then touching their mouth or nose.
"In seasonal flu, certain people are at high risk of serious complications. Among them are people 65 years and older, children younger than five, pregnant women, and those with certain chronic medical conditions," said Dr Ting.
He said some people are more likely to get flu complications that result in being hospitalised, and occasionally in death.
"Pneumonia, bronchitis, sinus infections and ear infections are examples of flu-related complications. The flu can also make chronic health problems worse.
"For example, people with asthma may experience asthma attacks while they have the flu, and people with chronic congestive heart failure may have a worsening of this condition," he explained.
AVOID INFECTING OTHERS
Dr Ting advised people to avoid infecting others.
He said: "The best thing anyone can do is to wash their hands. Handwashing helps prevent the spread of airborne flu viruses and other respiratory disease.
Handwashing with soap is among the most effective and inexpensive ways to prevent the spread of communicable diseases. Unclean hands are a vehicle to spread germs.
"Ironically, most of us know this but many fail to practice it. It is the droplets from coughing and sneezing that spread flu. That is why you should cover your mouth when you cough or sneeze.
"Observe personal hygiene by frequently washing your hands and closing the mouth when coughing. Surgical face masks are good in covering the cough or sneeze, as well as from getting the droplets from other people," he said.
And if you happen to be sick with flu, then it is better to stay home as the chances of infecting others are minimised.
HAND WASHING
Health Minister Datuk Seri Liow Tiong Lai said handwashing with soap is among the most effective and inexpensive ways to prevent communicable diseases such as influenza, colds and coughs, as well as incidences of hand, foot and mouth diseases.
It also can go a long way toward reducing the incidences of gastrointestinal infections, including diarhoea, as well as respiratory infections.
"Unclean hands are the vector for spreading germs," he was reported as saying by the media.
Organ transplant check for docs
Star: SEREMBAN: Doctors performing organ transplants must now report to the National Transplant Resource Centre every month in a move to curb possible commercialisation of human parts.
They are also required to explain to an organ donor the risks involved in such procedures. Failure to do so can be regarded as an inducement attempt.
Health Ministry director-general Datuk Seri Dr Hasan Abdul Rahman said that due to the huge disparity in the number of organ donations and the people on the waiting list in Malaysia, it had to take measures to prevent any possible commercial transactions, particularly in transplants involving unrelated living donors.
This, he added, was also to safeguard the interest and safety of the donors, and to uphold ethical practices in line with international standards.
“The huge imbalance between demand for and supply of organs from deceased donors has resulted in many people seeking for supply from living persons.
“They include strangers and sourcing organs from other countries, especially from underprivileged societies,” he said, adding that the practice of organ transplants involving living donors unrelated to recipients had triggered many arguments.
The organ donation rate in Malaysia is only around 0.64 donations per million people or about 17 donations per year. However, it is estimated that up to 11,000 people are on the waiting list.
There were 47 cadaveric donors last year, an increase from 38 in 2010. The highest demand for organs in Malaysia are for kidney, heart, lungs and liver.
Dr Hasan said these provisions were listed under the Unrelated Living Organ Donation: Policies and Guidelines, published as part of the ministry’s commitment to implement recommendations under the World Health Organisation’s Guiding Principles on Human Cell, Tissue and Organ Transplantation 2010.
This is in line with the international community’s fight against the commercialisation of human parts, human or organ trafficking and transplant tourism.
Under the guidelines, all organ transplants involving non-Malaysians should also be reported to the National Transplant Registry and receive prior approval from the ministry’s Unrelated Transplant Approval Committee (UTAC).
Doctors must also ensure that there is no coercion or any other form of inducement obtained from a prospective donor.
Dr Hasan said transplants involving unrelated living donors would only be allowed if there were no cadaveric donors or in cases of non-compatibility between family members, adding that a policy was important as those in lower socioeconomic groups had a higher risk of being manipulated.
“It will be the responsibility of the clinicians to verify the status of relationship. If this is doubtful, they shall refer such cases to the committee.”
They are also required to explain to an organ donor the risks involved in such procedures. Failure to do so can be regarded as an inducement attempt.
Health Ministry director-general Datuk Seri Dr Hasan Abdul Rahman said that due to the huge disparity in the number of organ donations and the people on the waiting list in Malaysia, it had to take measures to prevent any possible commercial transactions, particularly in transplants involving unrelated living donors.
This, he added, was also to safeguard the interest and safety of the donors, and to uphold ethical practices in line with international standards.
“The huge imbalance between demand for and supply of organs from deceased donors has resulted in many people seeking for supply from living persons.
“They include strangers and sourcing organs from other countries, especially from underprivileged societies,” he said, adding that the practice of organ transplants involving living donors unrelated to recipients had triggered many arguments.
The organ donation rate in Malaysia is only around 0.64 donations per million people or about 17 donations per year. However, it is estimated that up to 11,000 people are on the waiting list.
There were 47 cadaveric donors last year, an increase from 38 in 2010. The highest demand for organs in Malaysia are for kidney, heart, lungs and liver.
Dr Hasan said these provisions were listed under the Unrelated Living Organ Donation: Policies and Guidelines, published as part of the ministry’s commitment to implement recommendations under the World Health Organisation’s Guiding Principles on Human Cell, Tissue and Organ Transplantation 2010.
This is in line with the international community’s fight against the commercialisation of human parts, human or organ trafficking and transplant tourism.
Under the guidelines, all organ transplants involving non-Malaysians should also be reported to the National Transplant Registry and receive prior approval from the ministry’s Unrelated Transplant Approval Committee (UTAC).
Doctors must also ensure that there is no coercion or any other form of inducement obtained from a prospective donor.
Dr Hasan said transplants involving unrelated living donors would only be allowed if there were no cadaveric donors or in cases of non-compatibility between family members, adding that a policy was important as those in lower socioeconomic groups had a higher risk of being manipulated.
“It will be the responsibility of the clinicians to verify the status of relationship. If this is doubtful, they shall refer such cases to the committee.”
1Care: What ails Malaysia’s health care system?
Aliran: Aliran joins hands with fellow Malaysians in their collective concern with regard to the proposed ’1Care’ scheme to restructure Malaysia’s health care system – a move that would definitely exact a heavy toll on their physical as well as financial health.
Supposedly based on the UK National Healthcare Service (NHS), the 1Care scheme is said to be aimed at financing the supposedly increasing costs of public health care while making it still affordable to the lower-income group.
But we fear that, like most other “restructuring” schemes in the past, 1Care will deliberately result in the escalation of costs to ordinary Malaysians and the outsourcing of contracts to corporate interests – financed by public funds. The direct beneficiaries – private hospitals, health management organisations, pharmaceutical firms and those administering the national health financing fund – are likely to profit handsomely from this scheme at the expense of the public.
We recall how the costs of pharmaceuticals soared after the Government Medical Store was privatised in 1994. A similar rise was seen in the costs of general hospital support services after they were privatised.
The so-called mantra of cost-effectiveness that is often promised with such restructuring or de facto privatisation schemes is highly questionable. Critics of the 1Care scheme justifiably claim that the quality of health care treatment will plunge. The new health care financing authority may impose limits on the number of hospital visits by a patient or introduce financial incentives for GPs to limit their number of referrals to specialists in the effort to trim costs and improve profit margins. The welfare of the weak and the poor will be sacrificed without any qualms on the altar of greed and profit.
In effect, 1Care will provide massive public subsidies for private hospitals. An analogy would be the use of public funds given out as PTPTN study loans, which effectively acts as a huge government subsidy to private colleges, which have mushroomed. The cost is borne by indebted ordinary students, who have to make long-term study loan repayments. In the same way, payments out of the national health care authority’s funds (raised from the public via taxes and monthly public contributions) will serve as large subsidies to boost admissions, the occupancy and the bottom line of private hospitals and GLC-owned ‘private’ hospitals. Even government hospitals could end up behaving like private hospitals.
Malaysians will probably have to pay 6-10 per cent of their monthly income in contributions to the fund. A significant chunk of this money will go towards the administration costs of the health care financing fund. The pockets of ordinary Malaysians could be hit even further if they opt for a GP of their choice. What about those who are unemployed or unable to afford health insurance contributions? How would they be able to get medical treatment under this new scheme?
There is basically not much that is wrong with the existing public health care system that cannot be fixed with a greater allocation of government funding and more effective management of personnel and resources. At present, the government spends just over 2 per cent of GDP on public health care – a pathetic amount well short of the internationally recommended 5-6 per cent. Why not allocate more funds to our general hospitals, which already provides universal coverage to anyone who needs treatment, instead of squandering public funds on useless projects or allowing massive corruption to persist?
We call upon the government to reconsider its plan to implement this massive scheme. Spare the ordinary rakyat – already suffering from the effects of inflation – this additional heavy financial burden. Just allocate more funding to our general hospitals and ensure that it leads to a distinct improvement in the quality and efficiency of our general hospitals.
A government of the people has the responsibility and moral obligation to protect the interests of the rakyat – and this includes their health care.
Dr Mustafa K Anuar
Honorary Secretary
3 February 2012
Supposedly based on the UK National Healthcare Service (NHS), the 1Care scheme is said to be aimed at financing the supposedly increasing costs of public health care while making it still affordable to the lower-income group.
But we fear that, like most other “restructuring” schemes in the past, 1Care will deliberately result in the escalation of costs to ordinary Malaysians and the outsourcing of contracts to corporate interests – financed by public funds. The direct beneficiaries – private hospitals, health management organisations, pharmaceutical firms and those administering the national health financing fund – are likely to profit handsomely from this scheme at the expense of the public.
We recall how the costs of pharmaceuticals soared after the Government Medical Store was privatised in 1994. A similar rise was seen in the costs of general hospital support services after they were privatised.
The so-called mantra of cost-effectiveness that is often promised with such restructuring or de facto privatisation schemes is highly questionable. Critics of the 1Care scheme justifiably claim that the quality of health care treatment will plunge. The new health care financing authority may impose limits on the number of hospital visits by a patient or introduce financial incentives for GPs to limit their number of referrals to specialists in the effort to trim costs and improve profit margins. The welfare of the weak and the poor will be sacrificed without any qualms on the altar of greed and profit.
In effect, 1Care will provide massive public subsidies for private hospitals. An analogy would be the use of public funds given out as PTPTN study loans, which effectively acts as a huge government subsidy to private colleges, which have mushroomed. The cost is borne by indebted ordinary students, who have to make long-term study loan repayments. In the same way, payments out of the national health care authority’s funds (raised from the public via taxes and monthly public contributions) will serve as large subsidies to boost admissions, the occupancy and the bottom line of private hospitals and GLC-owned ‘private’ hospitals. Even government hospitals could end up behaving like private hospitals.
Malaysians will probably have to pay 6-10 per cent of their monthly income in contributions to the fund. A significant chunk of this money will go towards the administration costs of the health care financing fund. The pockets of ordinary Malaysians could be hit even further if they opt for a GP of their choice. What about those who are unemployed or unable to afford health insurance contributions? How would they be able to get medical treatment under this new scheme?
There is basically not much that is wrong with the existing public health care system that cannot be fixed with a greater allocation of government funding and more effective management of personnel and resources. At present, the government spends just over 2 per cent of GDP on public health care – a pathetic amount well short of the internationally recommended 5-6 per cent. Why not allocate more funds to our general hospitals, which already provides universal coverage to anyone who needs treatment, instead of squandering public funds on useless projects or allowing massive corruption to persist?
We call upon the government to reconsider its plan to implement this massive scheme. Spare the ordinary rakyat – already suffering from the effects of inflation – this additional heavy financial burden. Just allocate more funding to our general hospitals and ensure that it leads to a distinct improvement in the quality and efficiency of our general hospitals.
A government of the people has the responsibility and moral obligation to protect the interests of the rakyat – and this includes their health care.
Dr Mustafa K Anuar
Honorary Secretary
3 February 2012
Nursing job woes cut deep
Star: KUALA LUMPUR: Private nursing students are in a pickle with many struggling to find jobs after passing their exams.
According to a Government study, more than 54% of the private nursing diploma graduates could not find a job three to four months after graduating in 2010, compared to only 21.7% in 2008.
A total of 37,702 students were enrolled in nursing diploma courses in 61 private institutions of higher learning (IPTS) in 2010.
As of Dec 2010, the total number of trained working nurses in the country stood at 61,110, with 21,118 working in the private sector.
Parti Sosialis Malaysia central committee member Dr Michael Jeyakumar said the party had received many complaints from parents and graduates who could not find a job even after a few years.
He called for a freeze on the intake of new nursing students in private institutions until existing graduates secure jobs.
Jeyakumar said there were graduates who ended up working as receptionists or store clerks.
“With 37,500 students enrolled, we are looking at an average of 12,000 students graduating a year. The need for new nurses in the private sector is only about 1,500 a year, as only 5% to 10% of those working in the private sector will leave their existing jobs.
“It is also not easy for private graduates to get a job in the Government as only 438 IPTS nursing diploma graduates served with the Health Ministry in 2010,” he said at a press conference yesterday.
On average, a three-year nursing diploma programme at an IPTS would cost about RM50,000. Most IPTS offer full PTPTN loans to their nursing students.
Dr Jeyakumar called on the Government to absorb the loans for those who could not find jobs within a year of passing their Nursing Board exams.
He added that private institutions, whose students had low pass rates in the Nursing Board exams, should not be allowed to offer medical courses.
Government statistics showed that the number of graduates who took the Nursing Board examinations had increased from 4,025 in 2008 to 7,665 in 2010.
However, the pass percentage had fallen from 86.5% to 70.1% during the same period. Those studying in public institutions of higher learning had a pass rate of between 94% and 99%.
Higher Education Minister Datuk Seri Mohamed Khaled Nordin had announced a moratorium on new nursing schools in 2010.
According to a Government study, more than 54% of the private nursing diploma graduates could not find a job three to four months after graduating in 2010, compared to only 21.7% in 2008.
A total of 37,702 students were enrolled in nursing diploma courses in 61 private institutions of higher learning (IPTS) in 2010.
As of Dec 2010, the total number of trained working nurses in the country stood at 61,110, with 21,118 working in the private sector.
Parti Sosialis Malaysia central committee member Dr Michael Jeyakumar said the party had received many complaints from parents and graduates who could not find a job even after a few years.
He called for a freeze on the intake of new nursing students in private institutions until existing graduates secure jobs.
Jeyakumar said there were graduates who ended up working as receptionists or store clerks.
“With 37,500 students enrolled, we are looking at an average of 12,000 students graduating a year. The need for new nurses in the private sector is only about 1,500 a year, as only 5% to 10% of those working in the private sector will leave their existing jobs.
“It is also not easy for private graduates to get a job in the Government as only 438 IPTS nursing diploma graduates served with the Health Ministry in 2010,” he said at a press conference yesterday.
On average, a three-year nursing diploma programme at an IPTS would cost about RM50,000. Most IPTS offer full PTPTN loans to their nursing students.
Dr Jeyakumar called on the Government to absorb the loans for those who could not find jobs within a year of passing their Nursing Board exams.
He added that private institutions, whose students had low pass rates in the Nursing Board exams, should not be allowed to offer medical courses.
Government statistics showed that the number of graduates who took the Nursing Board examinations had increased from 4,025 in 2008 to 7,665 in 2010.
However, the pass percentage had fallen from 86.5% to 70.1% during the same period. Those studying in public institutions of higher learning had a pass rate of between 94% and 99%.
Higher Education Minister Datuk Seri Mohamed Khaled Nordin had announced a moratorium on new nursing schools in 2010.
Thursday, February 02, 2012
ROS: MMA has to call fresh elections to avoid being deregistered
Star: SEREMBAN: The Malaysian Medical Association (MMA) must declare its May 2011 elections null and void and elect new office bearers to avoid being deregistered, Registrar of Societies (ROS) Datuk Abdul Rahman Othman said.
He said the MMA office bearers were told about these requirements during meetings held after the association was deregistered in November.
“They must hold fresh elections as the council had contravened its own laws as well as provisions in the Societies Act,” he told The Star.
On Sunday, MMA president Dr Mary Cardosa was quoted as saying that the current council and executive committee would continue to function until its next AGM and elections, due in May this year, while a six-month grace period was given to the association to correct things.
Abdul Rahman said the MMA was informed of the Home Ministry directive on Nov 30, which clearly spelt out the violations committed by the MMA council in the run-up to its election.
The ROS de-registered the MMA on Nov 16 after it failed to give a proper explanation to several charges of irregularities during that election.
However, the de-registration was deferred by six months after the MMA appealed.
Meanwhile, Dr Cardosa said the MMA was never told to hold fresh elections.
“There were minor irregularities when we conducted our last elections, but we were never told that we have to declare the result null and void.
We were only told not to repeat the mistakes,” she added.
He said the MMA office bearers were told about these requirements during meetings held after the association was deregistered in November.
“They must hold fresh elections as the council had contravened its own laws as well as provisions in the Societies Act,” he told The Star.
On Sunday, MMA president Dr Mary Cardosa was quoted as saying that the current council and executive committee would continue to function until its next AGM and elections, due in May this year, while a six-month grace period was given to the association to correct things.
Abdul Rahman said the MMA was informed of the Home Ministry directive on Nov 30, which clearly spelt out the violations committed by the MMA council in the run-up to its election.
The ROS de-registered the MMA on Nov 16 after it failed to give a proper explanation to several charges of irregularities during that election.
However, the de-registration was deferred by six months after the MMA appealed.
Meanwhile, Dr Cardosa said the MMA was never told to hold fresh elections.
“There were minor irregularities when we conducted our last elections, but we were never told that we have to declare the result null and void.
We were only told not to repeat the mistakes,” she added.
Tuesday, January 31, 2012
Strict monitoring of breast implants and anti-ageing jabs
Star: PETALING JAYA: The Medical Device Act 2011 will help ensure the quality and safety of medical devices once it is enforced.
Health director-general Datuk Seri Dr Hasan Abdul Rahman said products such as facial fillers and breast implants would be register-ed with the Medical Device Authority.
“All companies dealing with medical devices will be licensed so that authorities can monitor the performance of medical devices in the market and take action once the Act is enforced.” he said.
Dr Hasan was responding to reports asking for tighter regulations of such cosmetic procedures like anti-ageing injections in Britain recently.
This followed fears that harmful dermal fillers could be the next scandal in the cosmetic surgery industry following the breast implant scare in France.
“Under the Act, a ‘designated medical device’ would be regu- lated to ensure its usage complied with certain requirements,” he said.
Dr Hasan added that anyone who used the device must possess a permit issued under the Act.
“This permit will only be issued to a person who has the necessary qualification and experience,” he said.
He added that once the Act was fully enforced, the marketing and usage of such devices would be regulated.
“For a medical device, the manufacturer must demonstrate evidence that the filler will not compromise the clinical condition or safety of users,” he said.
He stressed that although facial fillers were not regulated as medicines, the provisions under the Act would allow the ministry to put in place all the appropriate steps to address safety issues.
Health director-general Datuk Seri Dr Hasan Abdul Rahman said products such as facial fillers and breast implants would be register-ed with the Medical Device Authority.
“All companies dealing with medical devices will be licensed so that authorities can monitor the performance of medical devices in the market and take action once the Act is enforced.” he said.
Dr Hasan was responding to reports asking for tighter regulations of such cosmetic procedures like anti-ageing injections in Britain recently.
This followed fears that harmful dermal fillers could be the next scandal in the cosmetic surgery industry following the breast implant scare in France.
“Under the Act, a ‘designated medical device’ would be regu- lated to ensure its usage complied with certain requirements,” he said.
Dr Hasan added that anyone who used the device must possess a permit issued under the Act.
“This permit will only be issued to a person who has the necessary qualification and experience,” he said.
He added that once the Act was fully enforced, the marketing and usage of such devices would be regulated.
“For a medical device, the manufacturer must demonstrate evidence that the filler will not compromise the clinical condition or safety of users,” he said.
He stressed that although facial fillers were not regulated as medicines, the provisions under the Act would allow the ministry to put in place all the appropriate steps to address safety issues.
Making profit from organ donation a no-no
Star: SEREMBAN: Organ donors are not allowed to make a profit as promoting or commercialising transplants is strictly prohibited.
However, a reasonable reimbursement for the donation process is allowed.
Under the Health Ministry’s Unrelated Living Organ Donation: Policy and Procedures, a Malaysian organ donor is also entitled to free admission to a first class ward for the surgery. All hospital charges relating to the surgery will also be waived.
“Personnel in the public service who have donated their organs will be given unrecorded leave of up to 42 days to facilitate the surgery,” the ministry said.
Approval is needed from the ministry’s Unrelated Transplant Approval Committee for any procedure involving an unrelated living donor.
The committee, comprising between seven and 11 members, will evaluate and recommend if a transplant involving an unrelated living donor should be allowed.
The committee, including doctors, health personnel or anyone with knowledge about transplant ethics, will be appointed by the Health Ministry director-general for a period of three years.
“It shall be chaired by a doctor not actively involved in the field of transplantation, but who has sufficient knowledge about the matter,” it said.
An independent team, comprising at least a medical donor advocate, a psychiatrist and a medical social work officer, will also be appointed to evaluate prospective donors.
However, a reasonable reimbursement for the donation process is allowed.
Under the Health Ministry’s Unrelated Living Organ Donation: Policy and Procedures, a Malaysian organ donor is also entitled to free admission to a first class ward for the surgery. All hospital charges relating to the surgery will also be waived.
“Personnel in the public service who have donated their organs will be given unrecorded leave of up to 42 days to facilitate the surgery,” the ministry said.
Approval is needed from the ministry’s Unrelated Transplant Approval Committee for any procedure involving an unrelated living donor.
The committee, comprising between seven and 11 members, will evaluate and recommend if a transplant involving an unrelated living donor should be allowed.
The committee, including doctors, health personnel or anyone with knowledge about transplant ethics, will be appointed by the Health Ministry director-general for a period of three years.
“It shall be chaired by a doctor not actively involved in the field of transplantation, but who has sufficient knowledge about the matter,” it said.
An independent team, comprising at least a medical donor advocate, a psychiatrist and a medical social work officer, will also be appointed to evaluate prospective donors.
Too early to talk about 1Care, says ministry
Star: PETALING JAYA: Protests by a Facebook group called #taknak1care has prompted the Health Ministry to take on some of the group’s claims against the ministry’s proposed healthcare reforms under the 1Care for 1Malaysia system.
Health deputy director-general (Medical) Datuk Dr Noor Hisham Abdullah, who joined the discussion on the group’s wall, said the plan was still at a conceptual stage.
“Nothing has been decided and the rakyat will be the first to know,” wrote Dr Noor Hisham in one of his first responses.
He added that speculation and assumptions were not going to help and people must give the new system a chance to be developed.
The Facebook group, citing ministry sources and some public documents, claimed the new healthcare system would be funded by the public through a compulsory contribution of 10% of their monthly income.
It had also claimed that the public would only be allowed to see their designated general practitioner a maximum of six times a year.
Dr Noor Hisham, in response to those claims, reiterated that it was premature to speculate and make an assumption on something the ministry had not studied in detail.
He, however, implied that the scheme might be, in part, funded by employees’ wages as he wrote “your salary goes to the scheme”.
Dr Noor Hisham also said the ministry had only started the first stage of transformation, which is the strengthening of existing healthcare services.
He noted that the Health Ministry would be assisted by the World Health Organisation and experts in healthcare reform when it proceeds to the second stage, which is to study various healthcare models.
According to an earlier article in The Star by Health director-general Datuk Seri Dr Hasan Abdul Rahman, the concept paper on 1Care for 1Malaysia had been presented to Prime Minister Datuk Seri Najib Tun Razak and members of the Economic Council in August 2009.
Consequently, the Health Ministry had received the mandate to develop the 1Care blueprint.
Health deputy director-general (Medical) Datuk Dr Noor Hisham Abdullah, who joined the discussion on the group’s wall, said the plan was still at a conceptual stage.
“Nothing has been decided and the rakyat will be the first to know,” wrote Dr Noor Hisham in one of his first responses.
He added that speculation and assumptions were not going to help and people must give the new system a chance to be developed.
The Facebook group, citing ministry sources and some public documents, claimed the new healthcare system would be funded by the public through a compulsory contribution of 10% of their monthly income.
It had also claimed that the public would only be allowed to see their designated general practitioner a maximum of six times a year.
Dr Noor Hisham, in response to those claims, reiterated that it was premature to speculate and make an assumption on something the ministry had not studied in detail.
He, however, implied that the scheme might be, in part, funded by employees’ wages as he wrote “your salary goes to the scheme”.
Dr Noor Hisham also said the ministry had only started the first stage of transformation, which is the strengthening of existing healthcare services.
He noted that the Health Ministry would be assisted by the World Health Organisation and experts in healthcare reform when it proceeds to the second stage, which is to study various healthcare models.
According to an earlier article in The Star by Health director-general Datuk Seri Dr Hasan Abdul Rahman, the concept paper on 1Care for 1Malaysia had been presented to Prime Minister Datuk Seri Najib Tun Razak and members of the Economic Council in August 2009.
Consequently, the Health Ministry had received the mandate to develop the 1Care blueprint.
Monday, January 30, 2012
Ministry warns of fake medical products sold at grocery stores and night markets
Star: PETALING JAYA: They say laughter is the best medicine but many traditional drugs available in grocery stores or night markets are no laughing matter.
Most of them are unregistered products such as counterfeit medicine, fake sex stimulants, food supplements and even cosmetics.
According to Health Ministry's director of pharmacy enforcement Mohd Hatta Ahmad, the Pharmaceutical Services Division confiscated 33,274 such items worth RM22.5mil during raids, inspections and entry point screenings last year.
There has been a steady increase - in 2010, the authorities confiscated 24,852 products valued at RM21.5mil, while in 2009, 19,764 items were seized valued at RM10.4mil.
“People could be ignorant, buying these products which are within easy reach and cheap. They look legitimate and impressive with their attractive packaging,” he said.
Hatta said many of the unregistered medicine were sold at night markets, grocery stores and roadside stalls.
Another means of distribution was direct selling and a substantial amount of the unregistered medicine was confiscated from the houses of the distributors, he said.
Hatta said these so-called traditional items were often used to treat simple ailments such as cough and cold, fever and aches.
“Some of the medicine claims to be effective for joint pains. When we studied them in our labs, we found that they contained steroids or anti-inflammatory ingredients,” he said.
Some of the products even contain heavy metals which can cause kidney damage.
He said some cosmetics might contain hazardous chemicals such as hydroquinone, mercury and tretinoin, which can cause skin damage.
The fake sex stimulants were food products and supplements laced with active ingredients like tadanafil, sildenafil and verdenafil, all of which were used to treat impotence.
Hatta said they were harmful to one's health if taken without proper consultation and could even cause loss of vision.
“These products are available because there is a demand for them. If there are no buyers, there will be no sellers,” he said.
Datuk Eisah A. Rahman, the ministry's senior director of pharmaceutical services, said any unregistered product was considered to be unsafe as its quality, safety and efficacy had not been evaluated.
“When we conduct pre-approval testing of medicine, about 10% of the medicines contain contaminants, what more these types of medicine which have not even been registered and tested?” she said.
Most of them are unregistered products such as counterfeit medicine, fake sex stimulants, food supplements and even cosmetics.
According to Health Ministry's director of pharmacy enforcement Mohd Hatta Ahmad, the Pharmaceutical Services Division confiscated 33,274 such items worth RM22.5mil during raids, inspections and entry point screenings last year.
There has been a steady increase - in 2010, the authorities confiscated 24,852 products valued at RM21.5mil, while in 2009, 19,764 items were seized valued at RM10.4mil.
“People could be ignorant, buying these products which are within easy reach and cheap. They look legitimate and impressive with their attractive packaging,” he said.
Hatta said many of the unregistered medicine were sold at night markets, grocery stores and roadside stalls.
Another means of distribution was direct selling and a substantial amount of the unregistered medicine was confiscated from the houses of the distributors, he said.
Hatta said these so-called traditional items were often used to treat simple ailments such as cough and cold, fever and aches.
“Some of the medicine claims to be effective for joint pains. When we studied them in our labs, we found that they contained steroids or anti-inflammatory ingredients,” he said.
Some of the products even contain heavy metals which can cause kidney damage.
He said some cosmetics might contain hazardous chemicals such as hydroquinone, mercury and tretinoin, which can cause skin damage.
The fake sex stimulants were food products and supplements laced with active ingredients like tadanafil, sildenafil and verdenafil, all of which were used to treat impotence.
Hatta said they were harmful to one's health if taken without proper consultation and could even cause loss of vision.
“These products are available because there is a demand for them. If there are no buyers, there will be no sellers,” he said.
Datuk Eisah A. Rahman, the ministry's senior director of pharmaceutical services, said any unregistered product was considered to be unsafe as its quality, safety and efficacy had not been evaluated.
“When we conduct pre-approval testing of medicine, about 10% of the medicines contain contaminants, what more these types of medicine which have not even been registered and tested?” she said.
Seek advice if you have had breast implants, women urged
Star: PETALING JAYA: Women who had undergone plastic surgery for breast implants and facial fillers have been told to consult their surgeons and seek advice following a health scare involving such procedures in Europe.
The French-made Poly Implant Prothese (PIP) implants which is currently embroiled in a scandal in Europe are not used for cosmetic surgery in Malaysia, but at the same time, there were no statistics for breast implants in the country.
Health director-general Datuk Seri Dr Hasan Abdul Rahman said the ministry do not have statistics on Malaysian women who have had breast implants.
“It's hard to keep track of those who have had breast implants since most of them go abroad, like Thailand, to get it done as it is cheaper. Some may also go to unauthorised beauticians,” he said yesterday.
A safety notice had been posted in the division's website urging women to continue to routinely monitor their implants and to consult their surgeons if they had any concerns.
“Specialists or centres which made use of PIP implants are advised to contact the ministry's Medical Devices Control Division. The ministry will also inform the public on this issue from time to time,” he said.
In the notice, the division urged implant users to provide relevant information including the name of the healthcare centre, contact person, number and name of the suppliers.
Currently, no local authorised representative for the product had been identified based on the registered medical device establishment listing in Malaysia.
Dr Hasan said that presently, only two products were listed in their database, none of which were PIP.
“However, an assessment on safety and performance will be carried out once the Medical Device Act 2011 is enforced,” he said.
The scandal in Europe erupted after the now-defunct manufacturer in southern France shut down after it was found using substandard, industrial-grade silicone gel.
The French-made Poly Implant Prothese (PIP) implants which is currently embroiled in a scandal in Europe are not used for cosmetic surgery in Malaysia, but at the same time, there were no statistics for breast implants in the country.
Health director-general Datuk Seri Dr Hasan Abdul Rahman said the ministry do not have statistics on Malaysian women who have had breast implants.
“It's hard to keep track of those who have had breast implants since most of them go abroad, like Thailand, to get it done as it is cheaper. Some may also go to unauthorised beauticians,” he said yesterday.
A safety notice had been posted in the division's website urging women to continue to routinely monitor their implants and to consult their surgeons if they had any concerns.
“Specialists or centres which made use of PIP implants are advised to contact the ministry's Medical Devices Control Division. The ministry will also inform the public on this issue from time to time,” he said.
In the notice, the division urged implant users to provide relevant information including the name of the healthcare centre, contact person, number and name of the suppliers.
Currently, no local authorised representative for the product had been identified based on the registered medical device establishment listing in Malaysia.
Dr Hasan said that presently, only two products were listed in their database, none of which were PIP.
“However, an assessment on safety and performance will be carried out once the Medical Device Act 2011 is enforced,” he said.
The scandal in Europe erupted after the now-defunct manufacturer in southern France shut down after it was found using substandard, industrial-grade silicone gel.
Guidelines for cosmetic surgery
Star: PETALING JAYA: Those who opt to go to unqualified medical practitioners for surgical and non-surgical cosmetic procedures at unregistered clinics are putting a lot at risk.
Plastic surgeons are concerned that many Malaysians still go to unqualified practitioners to have such a delicate procedure carried out.
Consultant plastic surgeon Dr Cheong Yu Wei said invasive procedures must be carried out by registered medical doctors in a proper environment to avoid unnecessary complications later.
“If the procedures are done in a registered hospital, they will be on record. If anything goes wrong, they can be held accountable and responsible for their actions,” he said in an interview.
Dr Cheong urged the Government to set guidelines to regulate the industry and help the public in selecting authorised clinics and hospitals for such procedures. Also, it is important to outline who were qualified to perform certain procedures.
“There are many who promise the sky but are you sure what they say is true? Customers do not know how or where to verify,” he said.
He advised the people to visit the Malaysian Association of Plastic, Aesthetic & Craniomaxillofacial Surgeons and the National Specialist Register websites to check if the names of the doctors were listed to ensure that the person conducting the procedures was qualified.
“Patients should be more vocal over their concerns and raise questions if they are apprehensive or doubtful of what they are about to undergo. Some may think it is rude or impolite to do so but it is your right to know these things.
“They should question the doctor's background, his qualifications and even his certificates. Also, ask for the brand and name of products to be used in any of the procedures and do your homework. Well-known brands will have their own websites filled with information including the contents of the products,” he said.
Consultant plastic surgeon Dr Lee Kim Siea was concerned about illegal injectors and injection material used for facial fillers.
“Fillers from well-known brands usually have a better safety profile. Paying a bit more for well-known brands is worth every sen. The doctor who administers it is equally important as you can still get complications if the injector is not qualified to do it,” he said.
He cautioned the public on the usage of silicone gel used as filler material as it cause severe deformities years down the line.
Plastic surgeons are concerned that many Malaysians still go to unqualified practitioners to have such a delicate procedure carried out.
Consultant plastic surgeon Dr Cheong Yu Wei said invasive procedures must be carried out by registered medical doctors in a proper environment to avoid unnecessary complications later.
“If the procedures are done in a registered hospital, they will be on record. If anything goes wrong, they can be held accountable and responsible for their actions,” he said in an interview.
Dr Cheong urged the Government to set guidelines to regulate the industry and help the public in selecting authorised clinics and hospitals for such procedures. Also, it is important to outline who were qualified to perform certain procedures.
“There are many who promise the sky but are you sure what they say is true? Customers do not know how or where to verify,” he said.
He advised the people to visit the Malaysian Association of Plastic, Aesthetic & Craniomaxillofacial Surgeons and the National Specialist Register websites to check if the names of the doctors were listed to ensure that the person conducting the procedures was qualified.
“Patients should be more vocal over their concerns and raise questions if they are apprehensive or doubtful of what they are about to undergo. Some may think it is rude or impolite to do so but it is your right to know these things.
“They should question the doctor's background, his qualifications and even his certificates. Also, ask for the brand and name of products to be used in any of the procedures and do your homework. Well-known brands will have their own websites filled with information including the contents of the products,” he said.
Consultant plastic surgeon Dr Lee Kim Siea was concerned about illegal injectors and injection material used for facial fillers.
“Fillers from well-known brands usually have a better safety profile. Paying a bit more for well-known brands is worth every sen. The doctor who administers it is equally important as you can still get complications if the injector is not qualified to do it,” he said.
He cautioned the public on the usage of silicone gel used as filler material as it cause severe deformities years down the line.
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