PARTI Sosialis Malaysia (PSM) is extremely disappointed to hear from Health Minister Datuk Seri Dr Dzulkefly Ahmad that the government is thinking of opening private wings in government hospitals under the new “Rakan MOH” programme.
The previous avatar of this retrogressive plan – then termed the Full Paying Patient (FPP) scheme – was first announced by the then Barisan Nasional (BN) government in 2007.
PSM then rallied a coalition of NGO and activists to object to this plan by organising a series of protests including at the four government hospitals in 2011 that had been selected to expand this scheme.
These PSM-civil society protests resulted in the deferment of the further implementation of the scheme for a couple of years, but after that, the government implemented the FPP scheme without fanfare in 11 general hospitals across the country.
PSM rallied people against the FPP scheme because we genuinely felt that it would be bad for the ordinary citizen.
The problem with our government hospitals is that we do not have enough senior, experienced specialists to treat the more complicated cases and to train the younger specialists.
Approximately 75% of the specialists with more than 10 years of experience post specialisation are in the private hospitals that have mushroomed across the country, leaving only 25% of this group of senior specialists in the government hospitals where, up till now, more than 75% of the in-patients are being treated, and the new generation of specialists are being trained.
The chronic lack of experienced specialists translates into very long waiting times for patients with complicated conditions, delays in diagnosis and treatment, misdiagnoses, inadequacy of training programmes for younger doctors trying to specialise, and more stress for the junior doctors who have to handle the heavy patient load without adequate backup. This is why we protested the FPP scheme back in 2011.
Its surreptitious implementation in 11 hospitals in the years that followed has demonstrated very clearly that our apprehensions about the FFP scheme were largely correct.
The FPP scheme allows senior doctors to see private patients “after office hours” in government hospital premises, and charge them private rates.
Many senior government specialists partook in the FPP judiciously and limited their private patient time to less than 10 hours per week.
But there were a significant number who expended excessive time to seeing their private patients. These over-enthusiastic specialists were able to earn more than twice their government salary through this scheme.
But this had a deleterious effect on the morale of the other specialists who had to bear the responsibilities of looking after ordinary “non-paying” patients. It also affected training of young specialists.
If you dig a little deeper, the FPP scheme actually creates a serious conflict of interest for the specialists who participate in it. Patients will only come to the FPP clinics if the waiting list in the free public clinic is too long and the service there a little “suspect”.
One of the responsibilities of senior government specialists, who are mostly heads of their respective departments, is to improve their unit’s performance in terms of waiting time, competence of the junior specialists in their department, etc.
But a better run, efficient public clinic would mean less patients for the FPP clinic.
We know, with certainty, that the Health Ministry has asked the hospitals implementing the FPP scheme to carry out internal audits regarding the impact of the scheme on patient care, junior doctor training and morale of government doctors.
We have heard that many of these internal audits are quite critical of the scheme, having identified numerous shortcomings. Has the current Health Minister taken a look at these internal audits?
Perhaps he should, and if they aren’t as bad as the PSM has been told, release them for public viewing before implementing the avatar of the FPP scheme – the Private Wings scheme.
PSM would like to remind our friends in the Madani Government that they came in with the promise of reforming the government to benefit the common man.
We totally understand that they are concerned about the RM 1.2 tril sovereign debt that the government is facing, and their desire to reduce the budget deficit from its current 5% of GDP to 3% or lower. We get that.
But what we strongly disagree with any measure that in effect transfers resources away from the ordinary man is the street.
Our health care system is struggling with a shortage of senior specialists. Any measure that reduces the availability of specialists for the rakyat is totally unacceptable. We consider it extremely irresponsible.
Our public health care system is a concrete expression of our people’s desire to create a caring inclusive society premised on the solidarity of all the people living in this country.
In a very real way, it defines the “soul” of the nation. Any measure that degrades our public health care system is a bright red line for not only the PSM but also for many civil society groups. Please do not cross it. – Sept 26, 2024
Dr Michael Jeyakumar Devaraj is PSM chairperson and former Sungai Siput MP.
The views expressed are solely of the author and do not necessarily reflect those of Focus Malaysia.
Main image: The Star
