Privatising the Malaysian Health Care System?

This is a must read in Lim Kit Siang's Blog, as it will affect all of us in the health care line in the future. Here are some excerpts...

"1. Health care funding must come from the public’s purse and not taxes. Meaning why in God’s name are we paying taxes for then? Our education system is in the gutter.

2. All government hospitals are to be corporatised for greater efficiency.

This sounds fair enough. Only problem is will the hospitals, just like MAS, Telekom and TNB supposed to continue employing deadwood or can we VSS them and will the government pay them off.

4. Financial incentives shall be the main driver of the system

Are health workers in Malaysia ultimately driven by money? Someone has got this equation wrong here. If you are a doctor having worked in Kapit or Manjung and get kicked about when you are trying very hard to pass your Membership examinations on your own and even when you pass, you are told to hang around a district hospital because you don’t have the cables, and after passing are continuously bypassed to be replaced by a local specialist much junior to you and further told your postgraduate qualifications are useless, do you seriously think these doctors leave because they want more money.

2. This fund will receive income from a separate tax and perhaps some from general taxation.

We are in fact back to square one aren’t we? Our national health budget is only 3 to 4%. Why can’t we raise it to 6% and let professionals manage the show instead of all these Pengarahs, Deputy DGs, DGs, etc who have no clue about IT, marketing, finance, auditing and human resource. Malaysian Healthcare requires professional management as in every other organization. You don’t need to privatize it to be efficient.

4. All GPs will be allocated a certain number of patients and become “fund managers”. They will get the same income per patient whether the patient comes to their clinic ten times in a year or not at all. This is to prevent over investigation and treatment by specialists. If they stay within their budget, the GP will get a hefty bonus. If the GP exceeds this referral budget, he may face a financial penalty! This is to make GPs efficient gate-keepers.

In the Malaysian setting, this has to be dangerous. The MOH’s unholy and rabid haste in implementing the PHFSA will now come to roost. If you expect a GP to “hold on” and “manage” the patient and refer when absolutely necessary, then the GP must be knowledgeably equipped. In the NHS a GP needs to have the MRCGP, followed by numerous other courses which include areas of your interest and the respective qualifications in obstetrics/gynaecology, paediatrics, surgery, urology, cardiology, geriatrics, dermatology, respiratory medicine or diabetes. No one GP can know everything. But short sighted officials at the MOH jumped the gun by excluding doctors from this decision making.

In Malaysia we are currently throwing nurses and MAs caught working in GP clinics in jail and by God, are encouraging sinsehs, bomohs, ayurveds and homeopaths to set up practice in our government hospitals."

A very interesting read indeed.