Getting treated closer to home

Star: PUTRAJAYA: The Health Ministry is mulling over a proposal to allow repeat patients of government hospitals to seek follow-up treatment at government or private clinics near their homes at minimal cost.
Newly-appointed Health Minister Datuk Liow Tiong Lai and ministry officials came up with the proposal recently to lighten the burden of the people.
“We are thinking of ways to help these patients seek treatment at nearby clinics, including private ones, and having a certain understanding on how they could work closely with government hospitals,” he said.
He said the medical records could be sent to a clinic near the patient’s home through a specific channel of communication or the Internet, accessible only to those involved.
Liow said officials would have to come up with innovative ways and study the matter extensively, including the cost to be borne by the Government, before implementation.
“However, our main target is to provide better services.
“Currently, repeat patients have to travel to specific hospitals for follow-ups or treatment.
“The proposal is also part of the ministry’s effort to reduce the waiting period at government clinics as they are facing a shortage of doctors and other medical staff,” he said.
Liow said he was concerned that the current ratio of doctors to patients at government hospitals was just one doctor to 1,121 people, while in developed countries it was 1: 600.
“Only 60% of the posts are filled and this problem has been dragging on for quite some time.
“The Cabinet has addressed this problem many times by giving incentives to doctors, but it appears that the move was not enough to retain them,” he added.
Liow said government hospitals would not be able to compete with the private sector in terms of providing better income and incentives.
Therefore, he added, the only solution was for the two sectors to work together to overcome the many problems.

Pay attention to ADD

Star: KUALA LUMPUR: Teachers need to learn how to spot Attention Deficit Disorders (ADD) among pupils and get quick help. Otherwise, the children will be doomed to learning difficulties throughout their school years.
About one in five children are afflicted with ADD and, if left unattended, lose motivation, become noisy, naughty and lazy.
These were the findings of a nine-month pilot study on Year One and Two pupils in five Klang Valley primary schools jointly carried out by University Malaya Medical Centre’s (UMMC) Child Psychiatry Unit head Dr Aili Hanim Hashim and senior lecturer Dr Subash Kumar Pillai.
Dr Subash said that a few teachers and counsellors, trained to identify ADD pupils in Year One and Two, spotted 50 of them and sent them to the Child Psychiatry Unit.
“They were treated by psychiatrists to cope with learning difficulties and being unable to follow the teacher,” he said.
Some pupils were asked to bring along their parents as they were depressed or suffered emotional problems because the parents constantly quarrelled or were divorced, he said.
“After treatment, the pupils returned to classes and about half of them showed improvement,” he said at a UMMC Seminar on Mental Health Problems Among Children in Schools aimed at raising awareness about the need to promote and protect children’s mental health.
“Good mental health is essential for a child’s learning, social development and self-esteem.
“It is shown that mental health developed in early childhood becomes the basis of one’s mental health throughout adult life,” Dr Subash said.

Newcastle medical campus for Iskandar

NST: KUALA LUMPUR: Newcastle University will open a medical education branch campus in the Iskandar Development Region (Iskandar), a move which is expected to halve the cost of producing a UK-educated doctor.
South Johor Investment Corporation Bhd senior vice-president (education development) Khairil Anwar Ahmad said construction of the branch campus was expected to start later this year.
The university would have an intake of about 150 students per year, he said.
“We are setting up the campus based on the demands of the university and expect to complete it by 2011.
“It will be one of four international universities that will be opened in Iskandar,” he said.
Khairil said arrangements were now being made to allow students to do their practical work at hospitals in the area.
“The students may also be able to do this at healthcare facilities in Iskandar later,” he said.
Khairil said Newcastle University was the first foreign university partner in Iskandar.
“The arrangement is that we provide the facility, then lease it to the university,” he said.
Malaysia has suffered from a shortage of doctors and a low doctor-to-patient ratio for some time.
In 2002, the country began a programme to bring in foreign doctors to alleviate a shortage of medical practitioners. However, since then the Health Ministry has stopped taking foreign doctors in, with some who were already here being sent back due to poor performance.
Currently, it costs RM1 million to train a doctor in England.
Newcastle University international medical education project manager David Forman said the degrees would be exactly the same as the ones that were offered in the UK.
“It’s not just a franchise or training programme. The programme will be the same. There will be no dilution of standards.”

E-Kesihatan will not be dumped

NST: KUALA LUMPUR: The e-kesihatan system will not be scrapped but will be further studied by the government.
Transport Minister Datuk Ong Tee Keat said the government was aware of public complaints against the system.
“This is among some of the initiatives that are being looked at again,” he said after officiating the sixth Universiti Tunku Abdul Rahman convocation at Wisma MCA yesterday.
The transport ministry has been attempting to implement the e-kesihatan system since 2005.
The system was supposed to allow the annual health checks of commercial vehicle drivers in the country to be electronically submitted to the Road Transport Department (RTD).
However, it received widespread criticism from doctors, taxi and bus operators who claimed that the scheme was a money-making operation.
A former RTD director was alleged to be a director of the company responsible for implementing the system.
However, this was refuted by the RTD.

Act meant to weed out unqualified practitioners

NST: KUALA LUMPUR: “Doctors, just write to me at tionglai@gmail.com.”
This was Health Minister Datuk Liow Tiong Lai’s response to complaints about the Private Healthcare Facilities and Services Act 1998.
Doctors had complained that the act was being unfairly enforced.
Liow said he was certain the act was not meant to penalise doctors in the private sector, but to help ensure good healthcare services.
“We really have to do something about the irresponsible ones. But this act is not meant to give people problems.”
The act compels private practitioners to register with the ministry or face a fine of RM300,000. He said the act was meant to weed out bogus doctors and unqualified practitioners.
Doctors have been writing to the press recently to express their dismay over the Dr Basmullah Yusom case.
Dr Basmullah was jailed when he could not pay a fine of RM120,000 for failing to register his practice with the Health Ministry in January.
Liow, who took office last week, gave his private email address as he has yet to be assigned an official one.

Govt hospitals to send weekly reports

NST: KUALA LUMPUR: Government hospitals will be required to send a weekly report to the Health Ministry on patient care services.
They will have to pay special attention to the outpatient department and the intensive care unit.
Health Minister Datuk Liow Tiong Lai said the ministry was especially concerned with the time taken for patients to see doctors as well as the number of doctors available to see patients.
Liow said the waiting time for outpatients at hospitals should be cut from the current average of 45 minutes to 30 minutes.
“I met some patients (at KLH) who have been waiting for two hours to see the doctor,” he said.
He said this during his first official tour of the Kuala Lumpur Hospital.
Liow was briefed by hospital director Datuk Dr Zaininah Mohd Zain on the running of the hospital.
Liow was accompanied by Deputy Minister Datuk Dr Abdul Latiff Ahmad and Health Director-General Tan Sri Dr Ismail Merican.

No decision to stop doctors from dispensing medicine

NST: KUALA LUMPUR: The Health Ministry has not decided to disallow doctors from dispensing medicines.
Health Minister Datuk Liow Tiong Lai said yesterday he would like to meet the Malaysian Medical Council, doctors and pharmacists to discuss the matter.
Liow said he was aware of the Malaysian Pharmaceutical Society’s proposal for pharmacists to dispense medication to patients.
“At the moment, we are still looking at the proposal.
We have not made any decision yet,” he said after his first official visit to the Kuala Lumpur Hospital yesterday.
Liow was commenting on a New Straits Times report yesterday headlined “Doctors to be disallowed from dispensing medicines” that quoted health director-general Tan Sri Dr Ismail Merican as saying that the move was in the pipeline.
He had also said that a pilot project on the proposal would be launched soon.
He said the move could not be implemented earlier because of logistics problems, especially the shortage of pharmacies and pharmacists.
Liow said the most important thing was for the people to have a good healthcare system.
“That is the responsibility of the government. We do not want to burden the rakyat with extra costs,” he said.
The Malaysian Medical Association is against the proposed move to disallow doctors from dispensing medicines.
President Datuk Dr Khoo Kah Lin said the public should decide if they wanted to get medication from either pharmacists or doctors.
He said a doctor’s primary role was to diagnose and treat which included giving appropriate medication to patients.
“Therefore, doctors cannot give up their right to dispense medicine,” he said.
Dr Khoo said doctors were already separating the consultation fee from the cost of medication, to avoid being accused of profit-making in dispensing medicines.
The MMA’s recommended fee for consultation is RM30 for minor ailments. However, doctors generally provide consultation and medication for less than RM30.
Dr Khoo said pharmacists should not be allowed to prescribe medications without a doctor’s prescription.

In another development, a senior medical consultant, who declined to be identified, said some pharmacists were already dispensing medicines and treating patients, especially after checking their glucose level and blood pressure.
“This is already affecting our business,” he said
He said pharmacists should refer patients to doctors for diagnosis and treatment.
“Their work is only to dispense medicines prescribed by doctors. Pharmacists cannot become doctors. They cannot prescribe medicines based on basic tests,” he said.
A doctor in Klang, who only identified himself as Dr Rahim, asked if pharmacies would be open around the clock to cover prescriptions issued by doctors at 24-hour clinics.
“So who is going to dispense medicines in this context, the doctor or the pharmacies?” he asked.
The Malaysian Dietary Supplement Association, however, said the proposed move to disallow doctors from dispensing medicines was long overdue.
Its president, Jagdev Singh, said pharmacists were best suited to dispense medicines because they were more knowledgeable about “drug to drug interaction, drug to health interaction and adverse reactions”.

MMA opposes move to make pharmacist sole dispensing agents

NST: The Malaysian Medical Association (MMA) will oppose a move by the Health Ministry to make pharmacists the sole dispensing agents in the country.
Its president, Datuk Dr Khoo Kah Lin, said based on the ministry’s statistics in 2006, the pharmacist-population ratio in the public sector is 1:29,966, the private sector 1:7,828 and the total ratio is 1:6,207.
He said MMA felt that the public should be left to decide from where they wanted to obtain medication, either from a doctor or pharmacist.
“In helping them to make such a choice, the public need to have all the facts regarding the present position, their advantages and disadvantages and the costs to them as individuals and a community, if the system is to be changed,” he said in a statement here today.
Yesterday, Director-General of Health Tan Sri Dr Ismail Merican said soon, doctors would only be allowed to issue Rx-prescribe medications but patients needed to obtain their medication from pharmacies.
Currently, doctors especially at private clinics diagnose diseases, prescribe medicines and dispense them to patients.
Dr Khoo said some local manufacturers did not use the same base substance as the original patented drug.
“Thus, although the amount of active substance is the same, the potency and duration of action may differ…so may the shelf life of the drug.
“This is the main reason most doctors still prefer to use patented medicine, not because we want to gain profit or get incentives,” he said.
Dr Khoo said if the proposal shot off prematurely, patients would face the inconvenience of having to travel to another location to buy the medicine prescribed by the doctor.
He said if there was to be change, it should be made gradually beginning with the larger towns, and pilot studies should be considered so that problems that arise could be ironed out.
“In the meantime, both professions (doctor and pharmacist), together with the ministry could look at this problem objectively and solve it amicably, keeping in mind the interest of patients,” he said.

No decision on docs dispensing medicine

Star: KUALA LUMPUR: The Health Ministry has denied a report which said doctors would be prevented from dispensing medicine.
Health Minister Datuk Liow Tiong Lai said the article, which was published on the front page of a local English daily on Saturday, was not true.
“We have not made any decision at all. We are conducting a study, but it is only at a preliminary stage,” he said.
The report said a pilot project on the separation of functions between doctors’ clinics and pharmacies would be launched by the Health Ministry.
It also said that the pilot project would be launched at selected major towns, with the ministry closely monitoring the strengths and weaknesses of the system before implementing it nationwide.
Liow said while the Ministry was considering the request by pharmacists, the study had yet to be completed and a pilot project might not even be launched if the findings were not encouraging.
“If we find that people will be affected (negatively), we might not even carry out the pilot project,” he said.
He added that he wanted to meet up with doctors and pharmacists to understand more about the issue.
“But most importantly, at the end of the day, the people must enjoy good medical services,” he said.
Liow was speaking to reporters after visiting the Kuala Lumpur General Hospital on Saturday.

TB a problem once again

NST: SERI ISKANDAR: Tuberculosis (TB), a killer disease in the country in the 1950s and 1960s, is once again posing a threat.
There has been an increase in the number of TB cases in the last 10 years.
Malaysian Association of Prevention of Tuberculosis president Datuk Seri Yeop Junior Yeop Adlan said this was despite the government’s success in implementing the national TB control programme which brought the number of cases down to below 100 for every 100,000 people.
“However, in the last 10 years, the number of cases has been increasing, with 59.8 cases recorded for every 100,000 people in 1994 and 62.6 cases in 2006,” he said at the opening of the state-level World TB Day here yesterday.
Also present were Perak deputy health director (public health) Datin Dr Ranjit Kaur and Perak Tengah district health department medical officer Dr S. Elangovan.
The theme of this year’s event, “I am stopping TB”, is in line with the World Health Organisation’s vision of eliminating TB by the year 2050.
Yeop Junior, who is also MAPTB Perak branch chairman, said that an average of 16,000 cases had been recorded yearly.
Among the factors believed to have contributed to the increase are medical staff who fail to diagnose TB in patients seeking treatment for continuous cough, a symptom of the disease.
They have since been instructed to conduct a thorough examination if a patient complains of a week-long cough.