For Future Doctors : The Change is coming …………. Part 2
February 3, 2012 by Pagalavan Letchumanan
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
|
|
|
Like this:
Like Loading...
Related
Pagalavan's Avatar 
I would like to ask is it true under the 1Care system the government will make every person to contribute up to 10% of their income to this 1Care fund?
At the moment, the figure has not been revealed. What I heard was that the higher you earn the higher you pay with the max of 10% of income. Gov servant, pensioners and senior citizens will be exempted. But again I also heard that these group of people will only be able to go to government run clinics and hospitals. Those earning less than certain amount will also be excluded!
Yes. But I heard government servants and pensioners are exempted from this rulling. Obviously it’s politically motivated.
Imagine our national debts to equal GDP by 2019, with 41.6% of the national budget is allocated for the emoluments of our bloated civil service, with the economic growth may not even achieve 3%, so many impending disasters, can our government weather the storm? Somehow, they had to push the financial burden to someone else as the tank is going empty.
At the end of the day, healtcare is not free.
The system set up seems viable – it sounds very similar to the system set up here in Australia.
Doctors dont dispense drugs – pharmacies do, and there is COMPETITION by these pharmacies to offer the most reasonable prices. Most drugs are generic anyway.
Beats the crony PharmaNiaga system.
In the long term, the success of this system will depend on the efficiency and IT support services available in hospitals. The online checking of restrictions and references for max repeats etc must be fast and efficient. Simple things like fuzzy searches (eg. searching for Vinalafaxine will return a list that includes Venelafaxine), and simple clear cut prescription guidelines go a long way.
Unfortunately 1Care will also be run by a crony system
Yeah, you wonder how they are going to profiteer from all this.
Always remember. Do u buy protons? Ur tax goes towards the national automatic policy. But do u buy protons? Why not? And if you do, did you choose it or were you forced to?
Those GP’s who own 5-6 clinics, minting money from the competitive advantage of ‘group purchase of drugs’ from India are absolutely screwed. They will start to sell their clinics. Single GP’s can buy these entities cheaply and make a decent living. It kinda evens out the playing field. The big time money makers will be squeezed out.
2 doctors can easily handle a practice in some rural areas, catering to about 2000-3000 and providing consults, preventive care and emerg. services.
GP’s providing emergency service… now that’s a thought. A one-man jack of all trades. It’s usually tough to handle resus patients even with properly trained teams in Emergency.
In Australia, seeing 2000-3000 a month is bad practice
DR Pagal ..it is me again..actually I am a GP in rural area..This 1Care (do not care actually) ideas not giving Doctors to dispense medicine concerning me..It is a burden to patient costly and logistically ,i mean to get medicine at Pharmacy..This scheme make more money for Pharmacy..Actually Doctors know more about medicine rather than pharmacist..The pharmacies near me selling antibiotics,antiviral without any problem..There is no enforcement here..so Dr pagal could you give me some relief news?…Hope you reply
I am not sure what you want me to say. Nothing is clear at the moment. If you do have any pharmacist who sells drugs over the counter, someone have to make a complain to the authority. If not , no action will be taken.
Thanks Dr Pagal..I mean is MMA fight for this ..I heard this news not spread enough to public..but still they running this Tak Nak 1 care campaign thru facebook,twitter ,youtube..I know this still far from implementation but if they are planning it will happen soon isnt it?..but I know we are not ready yet for this..
The implementation is due in 2014. MMA has been against this right from the begining but being a professional body, they can’T object everything the government is planning. The reason why we are using the online media is to create awareness to the public as the mainstream media is always bias in reporting anything against the governemnt.
Thanks Dr Pagal..Now i am satissfied..
Would you like to clarify how a doctor can know more about medicine (drugs), more than a pharmacist would? Isn’t a doctor supposed to prescribe medication, while a pharmacist dispense – like how its being done in developed countries?
If doctors lose their dispensing rights, then beat the system! Get a pharmacist buddy, open a pharmacy next door to your clinic – everybody wins!
I occasionally have a conversation with few pharmacists about drugs..personally I knew more than them..especially OFF LABEL USE and side effects..I do not go against pharmacist but what I mean here is DR HAVE RIGHTS TO HAVE MEDICINE IN HIS CLINIC AND DISPENSE ON HIS OWN RIGHT …THIS WHAT MALAYSIA HAVE DONE FOR THE PAST DECADES RGHT?
Then, Wan, if doctors know more about drugs than pharmacists, why have pharmacists in the first place, since the study of drugs being the core of the latter’s profession? Doctors being the first and foremost expert in drugs would render pharmacists obsolete in Malaysia – probably the first country to do so.
In Malaysia, doctors have dispensing rights because the medical system was at its infant stages when those rights were given. That was a time when there were almost no local doctors, not to even mention pharmacists. Those rights have not been reviewed yet. You may be screaming to protect your rice bowl, but you are also preventing progress, and a system of check and balances.
You may be right..But I guest you one of the the 1care promoter now..Now I can charge consultation RM 60 ringgit not include medicine then my patient may be your relative ..think about it Spark…
Soon people will stop working rather than pay all these extra taxes (or opt to work part time and earn just under the taxable income bracket). They will eat out less (no junk food), excercise a lot more, reduce their stress levels, spend time with and homeschool their children.
No more rushing around madly.
Back to a more relaxed lifestyle.
I forsee that a lot of lady private practicioners will be doing this.
Then of course the govt doctors will be overworked making up the shortfall in doctors.
Soon only govt doctors will exist.
After a while students will stop opting to do medicine.
I guest that day will come my friend…
Cant see it happening
actually.. what MSN is suggesting sounds perfect. work within the taxable bracket. thats the only sane way to live. enjoy la sikitt…. kan ada kedai rakyat 1 malaysia… beli sardine dari sans la… save ur money…buy ur iPad at the end of the year laaa…
aiyah so simple k.
Wow sounds like the current system that is being used in Australia…in Australia everyone has to pay a 1.5% income levy to fund Medicare and PBS which then acts as health insurance and also protects the citizens from rising medication costs. So before you Malaysians start complaining and proclaiming that Malaysia is such a terrible country and that you want to move somewhere, bear in mind that the grass isn’t always greener on the other side
Each country has their own pros and cons. No country is perfect. You also can’t compare a developed country from a developing country.