Doctors or pharmacists?

NST: KUALA LUMPUR: Complement each other, not fight. This is the advice given by Health Minister Datuk Liow Tiong Lai to doctors and pharmacists who have been arguing over the right to dispense medicines.
“We are talking about two professional bodies. They should complement each other and not be competing with each other.”
He said it could not be denied that both were specialised in their respective fields of work.
Right now, Liow said, the system was such that doctors handled all the functions.
On the issue of separation of duties in the dispensing of medicine, he said: “I had a meeting with the Malaysian Medical Council last week and I will be meeting representatives from the Malaysian Medical Association tomorrow. I will meet representatives from the pharmaceutical industry next week.”
Liow said he would decide on the matter after the meetings.
For almost 20 years, pharmacists have been fighting for the return of their right to dispense medications but have been unsuccessful for various reasons.
The ministry had planned to conduct a pilot project on the separation of functions between clinics and pharmacies in selected major towns before implementing it nationwide.
However, even before the pilot project could kick off, there have been protests by doctors.

Patients want their pills from clinics

NST: KUALA LUMPUR: The number of patients who visit private clinics may drop if doctors are not allowed to dispense medication, said the Dermatological Society of Malaysia.
Its president, Dr Allan K.C. Yee, said Malaysians usually see a doctor to get medicines.
“Malaysians generally do not believe in paying consultation fee for nothing, if they know they are not going to get medicines from the doctor,” he said.
This is one of the reasons why the 70-plus member society is against the idea of separation of functions of doctors and pharmacists which would also apply to dermatologists, who are medical doctors by profession, said Yee.
He added that dermatologists are more qualified than pharmacists in advising patients in applying topical medicines which is frequently the common treatment for skin problems.
“Dermatologists are better qualified to show the patients how to apply the medicine to the affected skin, how much of the medicine to use and how to store them,” he said.
The patients might also be shy to ask the pharmacists how to use the medicine in a pharmacy, especially if the problem is around the private parts, he said.
Yee admitted that dermatologists’ profits will drop if the separation takes place but said the consultation rate will not change.
He also said the condition of the topical drugs is compromised when drugs are sold in bulk packaging and then repacked by pharmacists.
“Customers are the ones who lose out because they would not be able to keep the medicine for long as it would be either spoilt or become ineffective,” he said.

Aedes breeding in 80pc of project sites

NST: SHAH ALAM: Eighty per cent of construction sites and abandoned projects inspected in Selangor were found to be breeding grounds for Aedes mosquitoes.
State Health director Dr Rosnah Hadis said this was one of the main factors contributing to the high number of dengue cases in the state.
Aedes larvae were found in polystyrene containers left by workers, wheelbarrows and even in puddles of water on the floors of unfinished buildings.
Dr Rosnah said many construction sites, especially in Shah Alam, had been issued compound notices and stop-work orders for ignoring the Health Department’s notices.
“Eight out of 10 places inspected were found to be breeding grounds for Aedes mosquitoes. My strategy now is to target these sites,” she told the New Straits Times at an exhibition and talk on dengue prevention organised by the state Health Department with the co-operation of Shah Alam Municipal Council (MBSA) yesterday.
Dr Rosnah said previously, fogging was carried out only at construction and abandoned sites which were near reported cases of dengue.
As of April 12, a total of 4,389 cases of dengue have been reported in Selangor, with areas under MBSA’s jurisdiction recording the highest number, at 332 cases.
From April 6 to 12, 326 new cases were reported in the state.
State Health, Estate Workers, Poverty and Caring Government Committee chairman Dr A. Xavier Jayakumar, who was present at the event, said all involved parties should sit together to map new strategies to combat dengue.
Commenting on an NST article yesterday on the lack of funding for dengue research, Dr Xavier said funds should be channelled to the relevant parties for new studies to be undertaken.
“Funding should be increased. Currently, the Institute for Medical Research is carrying out research on dengue and Aedes mosquitoes.”
He added that with more funds, manpower could be expanded and there would be more people working on fighting dengue.

Proposal to avoid serious health issues among NS trainees

Star: AYER HITAM (Johor): More stringent medical checks at national service camps nationwide are among the proposed measures to address health problems among trainees.
National Service Council chairman Tan Sri Lee Lam Thye said every camp was equipped with qualified medical assistants to conduct such checks.
“I have brought up the matter with the programme’s director-general Datuk Abdul Hadi Awang Kechil and he will look into ways to avoid serious health problems among trainees.
“Besides that, I want all the trainees to be honest in declaring the state of their health before entering the camps,” he told a press conference after launching the Sembrong NS Camp open day here yesterday.
He was commenting on reports of a female trainee in Kemaman, Terengganu, who recently gave birth after complaining of stomach pains.
Lee said Abdul Hadi would discuss these issues with the Health Ministry.
He said that at present, compulsory medical checks for every trainee prior to entering camp was not possible as the Health Ministry did not have enough manpower.
“The Health Ministry could not agree with the proposal for a compulsory check-up when the matter was discussed in 2004.
“However, we will revisit the matter if the need arises in the future,” he said.
On another matter, Lee said the NS committee would go to schools to explain and promote the programme to future trainees, but it would be done on a request basis.
“The future trainees, mainly Form Four and Form Five students will be better prepared mentally after attending these sessions.
“We welcome SMK and Chinese independent schools to request for such talks but we cannot accommodate all schools as we do not have enough manpower,” he said.
At the open day yesterday, Angkasawan Mejar Dr Faiz Khalid, who earlier this year was appointed as the NS programme icon, held a dialogue with the trainees.

Medical grads snub ministry programme

NST: KUALA LUMPUR: Most of the medical graduates from unrecognised universities appear to have snubbed the special programme offered by the Health Ministry.
Just a dozen of the 220 graduates may opt for the programme said P. Chitrakala Vasu, chief executive officer of Maju Institute of Educational Development which is registering students for the programme at its Asian Institute of Medicine, Science and Technology University. She said the figure is based on the number of the graduates who took the registration forms at Tuesday’s dialogue with MIED chairman Datuk Seri S. Samy Vellu.
Chitrakala said the programme comprised one-year pre-clinical studies at a medical institution and two years of practical clinical work at appointed hospitals. The affected graduates, 70 per cent of whom are Indians, attended last Tuesday’s dialogue session. However, a spokesperson for the graduates, claimed that none of the graduates were interested in the three-year programme.
The programme costs RM150,000 and there is no guarantee of a pass.
“These graduates will have to spend an additional five years, which includes the compulsory two years housemanship, before they can practise,” said the spokesperson. She added that many of them had decided to sit for the equivalent qualifying exam overseas.
The affected medical graduates obtained their degrees from the Philippines, China, Japan, Pakistan, Romania, India, Armenia, Indonesia and the British Virgin Islands.
The spokesperson said the graduates’ degrees were recognised by the World Health Organisation.
She said many chose to pursue degrees that are unrecognised in Malaysia as the graduates failed to get a place in local universities.
The cost of pursuing a medical degree in a recognised foreign university can be as low as RM150,000 or as high as RM1 million, according to Pathmavathy Suresh, the managing director of Nugrahan Sdn Bhd, a representative of recognised foreign universities The cost of getting a medical degree at an unrecognised university is between RM70,000 and RM150,000, she said.

Health Ministry to study hospital charges

Star: PETALING JAYA: The Malaysian Medical Association (MMA) and Fomca support the Health Ministry’s plan to review private hospital charges for room, equipment and medicine.
MMA said the charges should be uniform while Fomca proposed the ministry use existing mechanism within its purview to address the issue.
However, the Association of Private Hospitals Malaysia (APHM) merely expressed its willingness to listen to Health Minister Datuk Liow Tiong Lai’s recommendations but doubted that it would be easy to regulate the charges.
MMA president Datuk Dr Khoo Kah Lin said currently, such charges were not totally uniform as private hospitals set their own billing standard.
“We support the call to look into such charges so that we will see a more streamlined, affordable and equitable and uniform rates at the private hospitals,” he said yesterday.
“If the government regulates doctors’ fees, but does not regulate hospital charges, it is not going to be able to make medical treatment in the private sector affordable to consumers. Doctors’ fees form a very small fraction of the hospital bills,” he said.
Dr Khoo was commenting on the Health Minister’s remark that a committee would be set up to conduct a study on the issue of private hospital fees.
Liow said the ministry had a mechanism to control charges under the Private Hospital Act.
However, Dr Khoo said there must be a reasonable control of private hospital charges in view of the rising prices of medical equipment and drugs.
“While the minister’s call for a review of costs in private hospitals is a good idea, I would like to caution the people that there are various pricing depending on what type of surgery, equipment, facilities and medicine used.
“We can’t push to say that everybody must reduce prices because private hospitals providing five-star quality services and those with three-star quality services are not the same,” he added.
APHM vice-president Datuk Teddric Jon Mohr said the association would listen to the minister’s recommendations and share its concerns and ideas to come up with a solution.
“We are willing to sit down with the minister but private hospitals have to spend millions of ringgit on hidden costs. There are a lot of issues private hospitals have to deal with to maintain their standard.”
Pressed further if it was possible to make uniform charges of room, equipment and medicine at private hospitals, he said:
“It will be very difficult. For instance, I don’t think we could say that every private hospital can charge RM200 for in-house patients because different hospitals have different things.”
Fomca vice-president K. Koris said the association welcomed the minister’s concern but questioned the need to set up a committee to conduct a study on the matter.
He proposed that Liow use the mechanism within his ministry such as the National Patient Safety Council to look into the issue.

Health ministry to check on private hospital charges deemed excessive

Star: PETALING JAYA: The Health Ministry will review private hospitals’ charges for room, equipment and medicine, which many have said are excessive.
Minister Datuk Liow Tiong Lai said he would instruct the director-general to set up a committee to conduct a thorough study on the issue of private hospitals’ fees.
He said the ministry had a mechanism to control the charges under the Private Hospital Act and that currently only doctors’ fees were regulated.
He also said he would meet the Malaysian Medical Association, Association of Private Hospitals of Malaysia and consumers associations to get their feedback.
“When I say that the ministry will review the fees, it does not mean that we want to limit the hospital fees,” Liow said.
“Don’t get me wrong, but there are some hospitals that are reasonable with their charges because of their five-star-quality services, but some are exorbitant.”
Liow also said the Government only regulated certain charges and that it would not be easy to regulate all the charges as some patients preferred to stay in luxurious rooms.
He urged the public to complain to the ministry if they were not satisfied with their hospital bills.
“I will set up an avenue for the public to lodge complaints and I will make sure that there is a proper mechanism to address the problem,” he said.
MCA Public Services and Complaints Department chief Datuk Michael Chong said he often received requests from patients for his help to appeal to hospitals to reduce charges.
He said some of the cases involved RM20,000 to RM50,000, especially surgery cases.
“I advise patients to demand itemised billing from hospitals, so they can dispute the charges if they feel that they are unreasonable,” he said.
However, he said patients who requested for extra services such as deluxe rooms should not complain about the extra charges.
National Consumer Complaints Centre director Darshan Singh said the review was a timely move as medical bills have been escalating.
“The prices are inflating and this is also probably because of involvement of insurance companies,” he said.
Muslim Consumers Association project director Noor Nirwandy Mat Noordin lauded the ministry’s plan and said private hospitals should have some social obligations.
“Some of their profit must go back to society through discounts,” he said.

Grads prefer to stay on overseas

Star: PUTRAJAYA: More and more medical students sent abroad to study on government scholarships, many costing more than a million ringgit each, are breaking their 10-year bond by refusing to return and serve in public hospitals.
“This is a sore point with us. In 2006, 21 medical students in Britain did not return. Last year, the number was 63. For those studying in Ireland, three students did not come back in 2006 while last year, 27 did not return,” said Human Capital Development division director Datin Madinah Mohamad.
She said these students cost the Government up to RM1.1mil each in funding for the five-year course.
“The number has been steadily increasing each year since 2003. The excuse these undergraduates often give is that they want to do their two-year housemanship over there and continue with sub-specialisation courses.
“But when they do so, they may then get employed and become eligible for registration in Britain. With the pay they are getting there, it’s highly unlikely they will come back and serve here,” she said in an interview here yesterday.
Since 2003, 145 students from Britain and 85 from Ireland have not come back. However, only three from Russia, two from Jordan and one from Japan failed to return.
Another reason many students chose to stay back could have been due to PSD’s perceived lenient treatment of such students in the past and a paltry penalty of RM160,000 each before 2003, she said.
“It encouraged undergraduates, who have seen many of their seniors being let off, to follow suit,” she said.
Although the department had officers in Britain and Ireland to track down errant medical students, some in the last year of studies ignored notices and others did not bother to show up when called for interviews.
She said tougher measures were needed to make them come back and serve or pay their bond.
The department was now seriously considering suggestions to make errant students repay twice or thrice the sum of their scholarships as punishment.
“We need to study this recommendation,” she said, adding the department had also handed 30 such cases since 1989 to the Attorney-General’s Chambers for legal action and had even declared one former student bankrupt.
But legal action was slow and guarantors would be taken to court only as the last resort, she said.
Since PSD’s Overseas Scholarship Programme started in 2000, RM2.15bil in scholarships had been given to 10,485 students up to the end of last year.

Number of obese growing bigger, says Liow

Star: PETALING JAYA: About 50% of 13 million Malaysian adults could be overweight or obese, a worrying trend that seems to be on the rise.
Health Minister Datuk Liow Tiong Lai said while the National Health and Morbidity Survey in 2006 revealed that 43.1% of Malaysian adults were overweight or obese, which was double the figure from a decade ago, the numbers could have already increased since then.
Liow blamed the disturbing situation on the lack of proper health knowledge, adding that Malaysians needed to be better informed and motivated to stay healthy, in terms of diet, physical activity, stress management and disease prevention.
He said Malaysians had also grown accustomed to an affluent lifestyle, and were more comfortable sitting at home and watching television or being in front of the computer, instead of enjoying the outdoors.
“For example, how many people know that losing even a modest five to 10% of their weight can result in better health?” he said in his speech yesterday when launching Nutrition Month Malaysia 2008.
Saying he himself was overweight, Liow said Malaysians took “eating right” lightly as they did not know what to eat, when to do so and how much they should consume.
“There is plenty to eat but unfortunately, many of us are not making wise decisions on what and how much to eat. Instead, we act on impulse,” he added.
“With our busy lifestyles, we would rather eat out than at home, opt for fast food rather than cook at home.
“And too often, we spare little thought about health and the nutritional value of what we put into our tummies.”
Malaysian Association for the Study of Obesity president Prof Dr Mohd Ismail Noor later said that about 90% of overweight and obese adults in the country were “very likely” to develop diabetes.
“What is worrying are younger people who have diabetes and are also overweight.
“You do not have to wait until you are 40 to have this disease. They are now as young as 25,” he said.
He also said if one of a person’s parents was overweight or obese, the chances of his being in a similar situation was 40%.
The chances increased to 80% if both parents were either overweight or obese, he added.
Genetic predisposition, he said, contributed to between 10% and 15% of those who faced the weight problems.

Dental grad offers kids renewed hope

NST: MELBOURNE: When Malaysian dentist Asilah Yusof graduates from the University of Adelaide today, she will give hope to thousands of young Malay children affected by craniofacial abnormalities.
The PhD candidate will use her newly acquired postgraduate degree to help treat children with cleft lip and palate deformities, the most common form of facial abnormalities found among children in Malaysia.
Her thesis findings will provide dental surgeons with a new set of measurements to help diagnose, treat and also improve the post-operative care of children with craniofacial abnormalities.
“Malays tend to have a shorter anterior cranial base, which may set up a wider palate and maxillary arch,” Asilah told the university’s monthly magazine Adelaiden.
“My PhD involved developing reference data of Malay children based on three-dimensional computed topography, comparing facial variables between males and females and also comparing the results with Caucasian populations.”
Asilah’s postgraduate studies were sponsored by her employer, Universiti Sains Malaysia, where she is teaching dental students and furthering her research into craniofacial morphology.
She completed her Graduate Diploma in Clinical Dentistry at the University of Adelaide in 2000 after finishing an undergraduate degree at the University of Otago in New Zealand.
Born and raised in Kota Baru, Kelantan, Asilah is the daughter of two health workers.
She was inspired to study dentistry as a child after visits to the hospital clinic.
“I worked with Malaysia’s Ministry of Health as a dentist after graduating in 1996 and spent a year working in a remote rural area, which opened my eyes to the facial deformities that affect many of our young children,” Asilah said.
Asilah joined Universiti Sains Malaysia in 1999 as a trainee lecturer and was encouraged to return to Adelaide to study for her PhD in 2001.
“The dental school in Adelaide has an outstanding reputation because of the excellent supervision provided by Professor Grant Townsend and Dr David Netherway,” she said.
Asilah intends to use her PhD to continue her research into software development for craniofacial analysis and post-operative implant placements at the Universiti Sains Malaysia hospital.
She will graduate at an offshore ceremony at the Grand Hyatt Hotel in Hongkong today with 70 other students.
This year, the university is holding offshore graduation ceremonies in Singapore and Hong Kong.