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Archive for February 3rd, 2012

The first part of this topic was written by me on 15/12/2011 https://pagalavan.com/2011/12/15/for-future-doctors-the-change-is-coming/. Since then I witnessed that 1Care issue is being discussed in various blogs, online news and even public forums are being conducted to discuss this issue. MOH seem to be keeping very quiet. Today, Malaysiakini wrote several articles concerning this issue.

However, I notice this announcement in Malaysian Pharmaceutical Society(MPS) website quite interesting http://www.mps.org.my/newsmaster.cfm?&menuid=37&action=view&retrieveid=3562.  Remember what I wrote on 6/10/2011 https://pagalavan.com/2011/10/06/i-told-you-so/ that there will come a time when doctors will not be allowed to dispense medicines ? Well, it is coming!

If you look at the MPS website announcement below, it is clearly stated that the government will outsource medication dispensing services under the 1 Care scheme to community pharmacist. A standard list of drugs will be provided and paid by the National Health Scheme under 1Care. So, I am not sure where the GPs dispensing rights will stand. Probably, they may ask GPs to hire pharmacist if they want to dispense medicine but then the statement “Pharmacy premises not to be shared by non pharmacy related services” is clearly stated.

Whatever said, the change is coming for better or worst! Just be prepared. It is not the rakyat alone who is going to be affected but also the doctors. And don’t think that the government doctors will not be affected!  “The current Govt Hospitals and Health Clinics will be given autonomy and will operate like private entities” is again clearly stated. This means that government hospitals and KKs will eventually be corporatised and will decide on their own how many doctors they will employ/pay! Probably, this is the reason why government is increasing the salary as a prelude to corporatosation. All doctors will eventually work on contract basis under corporate companies.

TRANSFORMING COMMUNITY PHARMACY PRACTICE TOWARDS 1CARE
Date: 15th January 2012 (Sunday)
Venue: Wisma MPS, Puchong, Selangor
A brief report– by Mr Gan Ber Zin (Chairman, MPS-Community Pharmacy Task Force)
1) Overview of 1Care for 1Malaysia and Health Transformation
Dr Hj Nordin Bin Saleh,  Deputy Director, Health Policy & Planning Unit, Planning and Development Division, MOH
·          1CARE is not based on any 1 country model but take into consideration the various models as practiced by different countries
·          The 1Care transformation proposals are now in the final stages
·          The current Govt Hospitals and Health Clinics will be given autonomy and will operate like private entities
·          All patients can see a GP or a Dr (the first point of contact) in any Health Facility (previously govt KK). If the Dr in the primary clinic deem necessary for patients to be seen by specialist then the patient can be referred to a specialist
·          The Drs are to prescribe medicines within a standard list (prescription will be generated online and in generic names). Any medicines prescribed that are not in this standard list will not be covered by the NHFS and patients will have to pay “out of pocket”
2) Role of Community Pharmacists in 1Care
Pn Abida Haq Bt Syed M Haq, Deputy Director, Clinical & Technical Pharmacy, Pharmaceutical Services Division, MOH
·         All Pharmacies can register under the 1Care
·         Benchmarking of Pharmacy is suggested and only benchmarked pharmacy will be retained in the panel. Also Pharmacy will probably need to be accreditated
·         Pharmacy will be reimbursed for medicines dispensed. A standard drug pricing system may be introduced once the standard drug list has been finalised
·         Dispensing outside the list will not be reimbursed and patients need to pay out of pocket for them
·         Dispensing by generic as far as possible and Pharmacies has the choice of the generic brands
·         Pharmacists to be paid a dispensing fee
·         Other type of fees structure for other services, eg smoking ceasation programe or other health awareness programmes to be worked out with representatives from MPS to be in the committee
3) Pharmacy Practice Benchmarking for Quality Practice
Cik Mariam Bintarty Bt Rushdi   Deputy Director, Pharmacy Development, Pharmaceutical Services Division, MOH
·          A new guideline on community pharmacy benchmarking is ready and copies can be obtained from MPS
·          Under the new guidelines, share equity and decision making to be represented by pharmacists
·          Guidelines on location of Pharmacies
·          Pharmacy premises not to be shared by non pharmacy related services
·          No advertisement of products and no sponsored signboards
4) Concept of National Health Financing Scheme
Dr Nour Hanah Bt Othman. Deputy Director , Policy and Pharmacy Management, Pharmaceutical Services Division, MOH
·         Under the 1Care, the Govt, Employers & Individuals will contribute towards a National Health Financing Scheme (NHFS)
·         Cost of the medicines dispensed under the 1Care will be paid by the NHFS. Items dispensed outside the list will be out of packet payment by patients
5) New Pharmacy Act and Impact on Pharmacy Practice
En Azman B. Yahya, Deputy Director, Pharmacy Board, MOH
·         Scheduled to be tabled at next parliament seating
·         Annual Practicing Certificate (APC) for pharmacist will be issued in the pharmacist name and not to the premise of practice as currently done
·         Pharmacists require to accumulate minimum 30 CPD points before they are eligible to be issued the APC.
·         MPS is the authorised body to monitor the CPD points
·         Govt will outsource the dispensing of prescription to pharmacies
·          PRP can undergo their 2nd year of training in pharmacies. The pay of these PRP should not be lower than what the government is paying them

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Finally, one of the main stream newspaper has brought this issue to the public : http://thestar.com.my/news/story.asp?file=/2012/2/3/nation/10668315&sec=nation, http://thestar.com.my/news/story.asp?file=/2012/2/3/nation/10667498&sec=nation. But I am very sure nothing will happen. One of the reason why the government issued a moratorium of nursing colleges in 2010 is because they are well aware that they have put their foot into their mouth. They had approved too many nursing colleges without looking at the actual requirement. A knee jerk reaction in the name of shortage of nurses!! you can’t pull back the license that you had given.

The same will very soon happen to the doctors. I am still hearing a lot of people telling me that doctors will never become jobless. To be frank, there is nothing special about being a doctor. No government promises everyone a job! The government never asked you to become a doctor and thus you cannot blame the government. That’s the reason the government also issued a moratorium for medical schools last year but it is just too late! 36 medical schools for a population of 27 million with almost 40+ medical programmes ( some schools has up to 4 concurrent programmes). We should be in Guinness World Book of Records for having the highest number of medical schools per capita population and the country with the fastest growing medical schools in the world( 28 medical schools in 12 years)!! Malaysia boleh mah………….

The situation of medical graduates is more complicated than any other profession. If you do not get a post for housemanship, you will never be able to work as a doctor. Of course, not forgetting the amount of money that you spend to become a doctor and the fact that if you don’t get a job here, you can’t just apply to any other country as your degree is not recognised anywhere else, something peculiar to the field of medicine.

Jobs in nursing hard to come by for graduates

PETALING JAYA: It is difficult not only for diploma graduates but also degree-holders to get a job in nursing.

Some have ended up becoming insurance agents, tuition teachers and sales assistants while others are involved in part-time businesses as they wait for a nursing vacancy to open.

Hartini Haron, 25, from Sabah, said she graduated one-and-a-half years ago with a nursing degree from a public university but had yet to get a job in the field even though she had sent in “countless” applications.

“I am disappointed with the whole situation. We studied for four years and now, we can’t even get a job,” she said.

A few of her friends got a nursing job almost a year after completing their studies, said Hartini, who does whatever part-time work that she can get.

Hartini said new graduates with no working experience as a nurse found it tough competing with graduate nurses who had working experience.

Nurses from the Health Ministry who continued their studies for a degree were easily absorbed into the system, she added.

Another public university nursing graduate, Khairun Nisa Mohammad, 25, from Ampang said she received an offer from a private hospital after nine months of unemployment.

“The Government must provide job opportunities. If not, why did they provide nursing courses?” she asked, adding that only one of her course mates got a job as a lecturer with the Health Ministry.

Before getting her current job, Khairun Nisa said she worked as an assistant merchandiser.

“Some of my Chinese friends have become nurses in Singapore,” she said.

She said only two of her 30-odd classmates got jobs as nursing lecturers with the Health Ministry while the rest had not been able to get a nursing job and worked as sales assistants, insurance agents and tuition teachers.

Sofia Yusof, 25, who completed her nursing degree in July 2010, said she accepted a nursing job in March last year at a private hospital in Johor but was being paid according to the salary scale for diploma holders She added that she could not get a nursing job via the Public Services Commission.

“I have to support my parents who are old and pay for my study and car loans,” she said.

Another graduate who wanted to be known only as Nooraniza, 25, from Johor, said she had sent her applications to the commission, but there was no vacancy at the moment.

Desperate for a job, she accepted a nursing job at a private hospital which was only willing to pay a “diploma scheme” salary.

“I took up the job because I didn’t want to burden my father,” said Nooraniza, whose father is a crane driver.

S. Gnanapragasam, 62, said his 22-year-old daughter and several of his friends’ children were having difficulty getting nursing jobs after completing their diploma courses.

He added: “They spent several years studying and in the end, they are struggling to find jobs. My daughter finally found a job but she is not doing what she was trained to do.”

Nursing job woes cut deep

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.

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