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3 years ago, i wrote an article about a pharmacy which was treating patients like a doctor‘s clinic. In fact that was the 2nd time I wrote about the same pharmacy. For the first, I sent an official complain to Jabatan Kesihatan/KKM and for the 2nd I sent the letter to JKN. However, I never received any further feedback from any one of them. Typical of any government agencies which never provide any feedback. Wonder whether it is under Official Secret Act!

While over the last few years, I do see patients being prescribed medications by pharmacist which they should not be prescribing in the first place, I just kept quiet as I felt it is worthless complaining. I have seen Prednisolone being given by pharmacist without prescription and even NSAIDS being given continuously without even knowing the patient’s renal status. Worst still, I have even patients buying Methotrexate from pharmacy without even my prescription.

Last week, yet again I saw the VERY SAME pharmacy/pharmacist prescribing the following 2 medications to a patient with poly arthritis of 1 year duration!

IMG_20160624_1122025

 

According to the patient, she was not even examined by the pharmacist. He just listened to her complains and gave her the medications above. One is a steroid(Betamethasone) and another is Sulphasalazine! Patient developed allergic reaction to Sulphasalazine and THANKFULLY, she stopped the medications. Sulphasalazine contains sulphur and allergic advise should always be given as it can cause Steven Johnson Syndrome and Toxic Epidermal Necrolysis. I will always advise patients about allergic reaction whenever I prescribe Sulphasalazine. Furthermore, this is a generic Sulphasalazine! Finally, one fine GP referred this patient to me.

So, what action has the JKN taken to this pharmacy? How in the world they can continue to prescribe these type of medications to the general public? I forwarded yet again this picture to a colleague of mine in JKN for further action. While I don’t expect anything much but at least I have done my job to protect the public.

ON another note, why did this patient even landed up with a pharmacist? Sometimes, we are to be blamed for all these issues. Patient had seeked multiple consultations from various GPs and Klinik Kesihatans but was only given NSAIDS. Patient has clear-cut Rheumatoid Arthritis. Her RT wrist is almost fused now.

Then we have TCM practitioners who are happily treating patients with “so-called” herbal medications which obviously contains steroids. The moment the patient walks into my clinic, I will give them a spot diagnosis and most of them will be shocked! An obvious Cushing’s syndrome. Serum Cortisol levels will be < 16 in almost all these cases. I do this just to prove to the patient that they have been taking exogenous steroids. Interestingly, recently I came across a patient who was given intravenous infusion by a TCM practitioner over the last 2 months. It was given periodically with tapering dose durations. The patient has Rheumatoid Arthritis. The patient definitely looked Cushingoid. Was he giving steroid infusions? “ Hari ini masuk ubat, besok boleh lari lor“, exactly what the patient told me! Obviously it is steroids! I wonder whether the person giving it knows that these are all steroids and nothing miracle! Or are they giving western medicine in the name of herbal medicine?

I call a spade, a spade all the time. Many do not like me because of this but I have my principles. Patient safety comes first in all instances. Sometimes, we doctors are to be blamed for all these distrust going on out there. While I have said that patients are becoming more and more naturalistic, claiming we are giving chemical to destroy their kidneys etc, doctors are also venturing into unethical medicines. Unethical practices are NOT uncommon nowadays. I have seen enough steroids being given by doctors themselves. Just saw a 76 year old man with OA knees given betamethasone daily for the last 3-4 years. The daughter is asking me why is his skin becoming thin with easy bruising! How am I suppose to answer that when I know exactly what’s the answer.  I saw a patient with generalised body-ache being given Prednisolone 5mg tds! Am I outdated or something? Many doctors out there still do NOT label their medications despite the law mandating it. Eventually business and profit takes over you, either consciously or unconsciously!

It’s called “Prostitution of Medicine“, a word described by the late Prof TJ Danaraj, the founding Dean of University Malaya medical faculty. Commercialisation of medical education and medical practise will eventually lead to this. Medicine is used to make money. It’s not a noble profession anymore.

The world on the other hand is going mad, especially in Malaysia where race and religion is used for business. WE have doctors promoting anti-vaccination (circulating in Facebook) and home birth. In fact, my wife just saw a HO who refuse to vaccinate her child! She is still doing her Housemanship. Interestingly, her husband who is not a doctor is not against it !We have doctors promoting supplementary products claiming can cure every illness in the body. We have an apex University promoting miracle water, suppose to cure 150 illness. We have syariah compliant dental clinics , whatever it means! What’s next ? Halal and Non-Halal clinics/hospitals? Trust me, we will be seeing more and more of these type of issues creeping into this country.

The practise of medicine is never the same anymore. I enjoyed practising medicine during the first 10 years of my service when patients listens to you and unethical practices were almost unheard of. Now, it saddens me when I see patients refusing medical treatment, refusing vaccines, unethical doctors, lost of clinical medicine and the rise of investigative medicine(make money for corporate guys). The rise of vaccine preventable infections like Diphteria and Measles are part of the consequences of our society’s ignorance. Wondered why our medical forefathers created medical councils run by medical practitioners to control the ethical practise of doctors? They had predicted few centuries ago that medical practise can be misused for profit and the world of medicine will eventually undergo slow death.

Many youngsters will realise all this when they start their practise. With more and more doctors being produced with huge debts behind them, medical business will only get worst! While my books will hit the stores within the next 2-3 months, I am now preparing for my 3rd book which hopefully will be released next year.

Selamat Hari Raya 2016 to everyone……………

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Finally, the government aka JPA has announced the new scheme for scholarship. As expected, the numbers has gone down and overseas scholarship is being reduced. When the bursary program was announced in 2012/2013, it was an election goody. Somehow I knew it may not last long. Those who benefited are the lucky ones. Personally I feel we should stop giving scholarship based on SPM results. SPM is never a pre-university course. WE should standardised our Pre-University courses and use that as the University entry and scholarship requirement. Unfortunately, in the name of education hub, there are simply too many pre-university courses being conducted in Malaysia. This has resulted in agencies, including MMC to use SPM results as the main university entry requirement.

I had always felt that the best students should be retained within the country. However, it should be in public universities. Unfortunately, selection of students into public universities are always biased based on certain constitutional rights. Education should never be commercialised. WE can see the outcome of this commercialisation with the quality of graduates being produced nowadays. This in turn will also affect the public universities’ quality as it is never based on merit. We have just too many higher institution of learning with too few academics. We have more medical schools than what UK has for double the population.

Well, for this year, only 250 students will be selected for bursary. None from next year. Only top 20 students will be given overseas scholarship which I think is fair enough. They must return to serve the civil service. 200 special scholarship for engineering courses are still maintained. The local undergraduate scholarship will be given as loans. Graduates are required to repay 25 per cent of the loan amount if they work with government-linked companies; graduates are required to repay 50 per cent of the loan amount if they work in local private companies; and graduates are required to repay the entire loan amount if they choose to work abroad. For those who join the public service sector, they should serve within a certain period of time according to their field of work, for example within six to seven years for engineering and over 10 years for the medical field. 

Personally I feel it is a fair criteria but does the same rule apply for scholarship offered by other bodies such as MARA, State governments, Majlis Agama etc?

*** update 9/04/2016: as expected, the government announced that all 2015 top SPM students will receive bursary to study locally****

Fewer overseas scholarships

BY CHELSEA L.Y. NG

PUTRAJAYA: The bulk of SPM top scorers who apply for Public Service Department (PSD) scholarships can forget about studying in top universities around the world.

They will have to make do in local universities.

The privilege of choice overseas study will be reserved only for the best 20, according to the Public Service Department (PSD) which is the country’s largest provider of scholarships and bursaries for post-secondary education.

In a media briefing here yesterday, a PSD senior spokesman said only 20 of the “creme de la creme” would be allowed to study in top ranking universities abroad and return to join the civil service.

“It is part of the long term plan to inject the civil service with quality graduates who will in turn be quality civil servants.

“They will be groomed to be our civil service’s next generation of leaders,’’ the spokesman said.

He said an additional 200 top students would have places under the Special Engineering Programme but would only be allowed to study in Japan, Korea, Germany and France.

On the new funding regulations, the spokesman said that studies in local public and private universities will be given priority.

“We cannot be having all our finest and brightest study outside the country as it does not reflect the aim of having outstanding students in our local institutions,” he said.

The spokesman also announced that there will be no more Bursary Graduate Programme from next year onwards.

For this year only 250 SPM leavers with 9A+ from 2015 will be offered funds through the bursary programme to study locally.

As for some 744 students, who qualified for the bursary programme in 2013 and 2014 and were hoping to study abroad, they will now have to do their degrees in local public and private universities.

The spokesman advised the 744 students not to be disheartened.

“You can’t get what you want all the time, just like everyone wants to be a CEO but that is impossible,’’ he said.

“The focus is on funding more people to get into the varsities here. The quality of our varsities have improved,” he added.

Stressing that the Government was trying its best to offer as many scholarships as possible from the RM1.65bil pool announced in Parliament recently, the spokesman said there was also the additional allocation of RM160mil approved under the recalibrated Budget 2016 to fund this year’s batch of students.

This amount, which came following the Budget 2016 revision announced in January, is meant to support 49,060 students, with 41,324 (84%) of them studying here, and the remaining 7,736 overseas.

He said among the criteria that will guide the PSD in its selection process were merit and the socioeconomic background of the applicant, besides grades and co-curricular achievements.

The spokesman said the department will also focus on those categorised in the B40 and M40 groupings, with attention on technical & vocational education and training (TVET).

(B40 refers to the bottom 40% of households in the country who typically live on a monthly household income of under RM3,860, while M40 refers to those from households with monthly incomes of up to RM8,319)

A thousand students from B40 families will be offered the Dermasiswa B40 to pursue diplomas in polytechnics and public universities, including Universiti Tenaga Nasional and Multimedia University, he said.

Seven thousand university students, who are currently pursuing their studies in local public and private institutions of higher learning, will continue to benefit from PSD funding.

The spokesman added that a special briefing for 2013/2014/2015 Bursary candidates will be held soon, although no specific date was mentioned. More information can be found at esilav2.jpa.gov.my or by calling 03-88853603/3777/3398.

PSD introduces new sponsorship model

Tuesday April 5, 2016
10:32 PM GMT+8

PUTRAJAYA, April 5 — The Public Service Department (PSD) has implemented a new student sponsorship model this year, including the introduction of a sponsorship programme for 1,000 students from the B40 families.

(B40 relates to bottom 40 per cent household income) Besides the B40 Dermasiswa programme and five other sponsorship schemes, the new model also requires students to sit for the Cambridge Online Test (COT), to evaluate the applicant’s personality and tendencies.

A senior PSD officer said overall, the new PSD sponsorship model was drafted based on four key thrusts, namely merit and inclusivity; focus on the B40 group, M40 and the Technical and Vocational Education Training(TVET); development of Malaysia as an education hub; and, return on investment (ROI).

“The new model focuses on the sponsorship of students to local higher learning institutions to retain the brightest students in the country, thus supporting efforts to make Malaysia a regional education hub,” he said.

Five other sponsorship programmes are the National Scholarship Programme; the Special Engineering Programme to Japan, Korea, France and Germany; the Local Undergraduate Programme; the Post-Bursary Programme; and the Bursary Programme.

He said to ensure commensurate returns, starting this year, sponsorship would be implemented in the form of variable rate loans except for the Dermasiswa B40 programme.

The sponsorship agreement will be subjected to four conditions, namely loans can be converted into full scholarships and are exempted from repayment if graduates serve in the public service.

Graduates are required to repay 25 per cent of the loan amount if they work with government-linked companies; graduates are required to repay 50 per cent of the loan amount if they work in local private companies; and graduates are required to repay the entire loan amount if they choose to work abroad.

“For those who join the public service sector, they should serve within a certain period of time according to their field of work, for example within six to seven years for engineering and over 10 years for the medical field,” he said.

The PSD officer said for the Dermasiswa B40 programme, sponsorship would be given to 1,000 students to pursue diploma studies in polytechnics, public universities, Universiti Tenaga Nasional (UNITEN) and the Multimedia University (MMU) in the TVET field.

“It is estimated they will receive a minimum sponsorship of RM25,000 for a duration of three years,” he added.

He said the selection of students for the B40 Dermasiswa Programme was made, among others, through the National Poverty Data Bank or eKasih list, students from households with monthly income of RM3,690 and below and consideration on household income based on states and localities.

“This is part of the government efforts towards realising the highly-skilled talent development to meet the needs for skilled workers in the future.” On the National Scholarship Programme, he said 20 best Sijil Pelajaran Malaysia (SPM) 2015 holders would be sponsored to study at top universities worldwide.

He said the sponsorship would cover the preparatory courses in the country, that were limited to certain fields, designated by the government.

For the Special Engineering Programme to Japan, Korea, France and Germany, the PSD officer said it would be given to 200 SPM 2015 holders, who were interested to take up a diploma or bachelor’s degree programme in engineering in the three countries.

The sponsorship would also include preparatory courses taken in the country, he added.

He said under the Local Undergraduate Programme, sponsorship would be given to 7,000 students to pursue their studies in public universities, UNITEN, MMU and Universiti Teknologi Petronas (UTP).

PSD will continue the Post-Bursary Sponsorship Programme for 744 Bursary Programme 2013/2014 (SPM 2012/2013) students, in order for them to pursue their first degree at local universities set by the government.

Under the Bursary Programme, he said sponsorship would be given to those who obtained 9As+ and above in SPM 2015, with the selection of recipients based on merit and inclusivity.

According to the PSD officer, the sponsorship is focused on the fields of clinical and health, engineering and technology, and science and social science.

“The Bursary Programme that was previously handled by the Education Ministry will be implemented by PSD on a one-off basis and for 2016 alone. This programme will not be continued, beginning 2017,” he said.

Meanwhile, he said a special briefing session with the Bursary Programme 2013, 2014 and 2015 students would be held in the near future.

Students involved can refer to the PSD’s portal at http://esilav2.jpa.gov.my or contact 03-88853603/ 3777/ 3398 for more information regarding the briefing.

Overall, he said the JPA was continuing its sponsorship programme with an allocation of RM1.65 billion for 49,060 students comprising 41,324 students locally and 7,736 students abroad.

An additional allocation of RM160 million has been approved under Budget 2016 to finance the sponsorship of new students in 2016. — Bernama 

– See more at: http://www.themalaymailonline.com/malaysia/article/psd-introduces-new-sponsorship-model#sthash.QyEIwPS1.dpuf

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Just about a month after watching the Millenium Falcon flying for the first time in 30 years, I was mesmerised by a local movie that was released last week. I have been watching their promotion on TV and listening to them on radio over the last 2-3 months but I must admit that I never expected the film to be so well done and nostalgic. “Ola Bola” is a movie that must be watched by all Malaysians. It shows what this country was, 30 years ago.

The movie shows how great our football team was in 1970s and early 1980s. I was in primary school then and names like
“Spiderman” Arumugam, Mokhtar Dahari, Santokh Singh, Hassan Sani, Shukor Salleh, Soh Chin Aun, James Wong etc were household names. Our rivals were South Korea and Japan. We were the best team in SEA and one of the best in Asia. What happened? South Korea and Japan have reached World Cup and we are still struggling to even win SEA tournaments. The answer : “politics”.

When I went to watch the movie yesterday, the theatre was full house. It was a mixed racial crowd. Interesting to see for the first time a Malaysian movie being watched by all races sitting together. It is a multiracial movie which shows the lifestyle during the 1970s. Multiple languages are spoken but mainly English and Malay. Subtitles are in 3 languages. I must admit it is a movie of high quality. Every detail was well planned and captured. We can see old radios, old black & white TV, old houses, old cars and even old motorbikes. Even dressing and hair styles follow the 1980s era. I really don’t know where they got all the items from. It’s really nostalgic!

Despite having new actors and actresses, the movie was well made. Some moments may really give you goosebumps and may even give you some tears. It reflected how Malaysia was during those days. All races getting together and celebrating the achievement of the country. A multiracial football team that was the best we have ever had. I grew up during those era and I must say it is sad to see what we have become. Racial politics, first engineered by Dr M since 1981 is the reason why we are in current situation. Sports, education, Universities, public service were all politicised to the extend that everything should be controlled by a single race. That was DR M’s philosophy which he has publicly said and written in his book. Every sports association and education centres are now run by politicians!

The football scenes of the movie was well choreographed. I really don’t know how they actually did it. It was like watching a real football match. Some dialogues can be a bit draggy but that is expected from new actors who was chosen based on whether they can play football! I would not reveal much of the story to avoid spoilers but suffice to say that the movie is not just a football movie but it tells us a story of what type of country we were, at one time. Will we ever reach that status again with all the racial and religious politics being played around over the last 25 years?

The ending was really impressive! Don’t forget to sit through the end credits where they will show you all the old pictures of our football greats. For the first time, audiences actually clapped/cheered at the end of the movie!! I only see that in Rajini Kanth’s movie!

Well done to Chiu (the director, a Batu Pahat boy) and the production crew. Every Malaysian should  see this movie, including our politicians!

 

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Over the past few months, there has been interesting developments and debates going on in UK, especially in England. Back in March 2015, newly re-elected UK Prime Minister David Cameroon announced that he will introduce a “truly 7 days a week” NHS system by 2020. This resulted in huge outcry by the medical community in UK, resulting in Facebook post etc. In July , we saw this interesting Facebook post by Dr Janis Burns who challenged the government to proof that the mortality was higher in the weekends and also to proof that NHS service is not running over the weekends. She also mentioned about her life story!

Politicians are politicians wherever they are. Their interest is only to get public support to win elections. However, we can’t say that whatever he said are all lies. Every system has it’s flaws similar to Malaysian healthcare system. I can’t say much about the UK system as I am not working there at the moment but I can say that the situation in Malaysia is almost the same. IN Malaysia, during weekends, only the on-call doctors work, including MOs and Consultants. Usually, only 1 Consultant is “on-call” over weekend (each for Saturday & Sunday) with 1 or 2 MOs. This is definitely not the same as the working days where everyone is around. Obviously, the standard of care will not be similar.  Of course, priority is given to emergency cases over the weekend. I presume the situation is the same in UK based on the Facebook post by Dr Janis. The Health Secretary has clearly told BMA to get “real”!

The issue in UK has become more intense over the last 2 months. In August The Guardian reported that thousands of UK doctors have applied for ” Certificate of Good standing” from GMC which basically means they are applying to work overseas. The numbers applying increased tremendously after the new contract announcement. The new contract which is being planned to be implemented in England (Scotland and Wales has not agreed to it yet) has redefined working hours which included Saturdays, removed overtime allowances between 7-10pm but increased hourly allowance for newly defined “overtime” and increased their basic pay. However, the doctors in UK claim (see below) it will result close to 30-40% pay cut as they will earn less on overtime allowances. The GP trainees are also affected as their pay supplements will be terminated.

It is very interesting to note that eventually it boiled down to money and survival. Remember, what I said few months ago in my post ” Passion vs Debt” and  “Passion vs Debt vs Reality” , passion is one thing but living a life is another! That’s exactly what this doctors in UK are feeling. While they have the passion to serve, living a life with debts to pay and can’t even afford to buy a property in London and major towns brings them to reality of survival. I keep saying this to youngsters who do not know the reality of life before venturing into any course. At the end, it is just a profession to earn a living. Bankruptcy rates among Malaysians are at a worrying trend due to huge debts!

On 28th September 2015, doctors marched to Downing street in protest of the new contract. Whether this will change anything remained to be seen as the government is planning to implement the new changes as soon as possible, latest by April 2017 if I am not mistaken.Whatever said, you chose the profession and you need to live with what is given. If the politicians can prove that the weekend standard of care is lower than weekdays, then doctors will not be able to defend themselves. This is why I keep telling the junior doctors, you chose this profession willingly, thus do not complain about long working hours etc. It is the same elsewhere. I had said enough before. Our government can also ask doctors to take a pay cut once they have enough doctors as getting  a job will become a privilege. You go where the vacancy is and can’t demand anything. Worst still, our degrees are mostly not recognised elsewhere! You can’t run anywhere!

Where do you think these UK doctors will go? Most will land up in Australia or New Zealand as their training in UK is recognised in these countries. This in turn will reduce the number of available post for others. Malaysians whose intention is to migrate to Australia will need to think about the effect of this UK policy on us. Those who are planning to move to Australia by sitting for AMC exams will be worst affected. As I had always said, never do medicine if your intention is to migrate. It is the most difficult profession to migrate.

Please read all the links given.

 

‘I can’t sacrifice my family for the NHS’: the junior doctors forced out of jobs they love
Young doctors are seething with anger over new contracts threatening lower pay, longer hours and increased stress. But do they really have it that bad? Here junior medics on the verge of quitting describe salaries that barely cover the bills – and a workload that means they could end up earning as little as £10 an hour
Junior doctor David Watkin: ‘We feel very under-appreciated by the government and the Department of Health.’

Amelia Gentleman
@ameliagentleman
Monday 28 September 2015 17.12 BST Last modified on Tuesday 29 September 2015 09.06 BST
At what point does a dedicated doctor, with a lifelong commitment to the NHS, decide it is time to quit? For Dr Singh, 34, a junior doctor in general medicine, the moment will come when he is no longer able to pay his mortgage and childcare bills, a situation he expects to find himself facing sometime next year.

Dr Singh has worked in hospitals, with regular A&E shifts, for 10 years since qualifying, loves his job and describes himself as “the kind of doctor you’d want to see to your gran”. But, having done an online calculation assessing how the Department of Health’s new junior doctor contract will affect his household income, he believes he and his paediatrician wife face a 25% cut to their joint take-home pay, making life in London unaffordable. He plans to move into the pharmaceutical industry.
New junior doctors’ contract changes everything I signed up for

Several of Dr Singh’s friends have already left the medical profession to work as bankers and consultants in the City; others are considering emigrating to work as doctors in Australia or New Zealand. Most of them are dispirited by the proposed contract, but are more fed up with the daily stress of their work, annoyed that the long hours and considerable financial and personal sacrifices they make during their training are not appreciated, and they worry about the impact that dwindling morale could have on the NHS and its patients.

“I am not looking for parity of pay with my friends in the City. But if you can’t afford to pay your mortgage or your child’s nursery bills and you can’t look after your child yourself in the evening or [at] the weekend because the government is proposing you should work those hours on a normal basis, you can’t continue with that kind of life,” he says, asking for his full name not to be published to avoid annoying his employers. “I am a very valuable resource to the NHS. I do work incredibly hard, I really enjoy looking after my patients and I get immense satisfaction from it. I have an absolute commitment to the NHS but I can’t sacrifice my entire family for that. I have to put a roof over my son’s head.”

Junior doctors will be balloted to decide whether to strike over a radical new contract imposed on them by the Department of Health, which redefines their normal working week to include Saturday and removes overtime rates for work between 7pm and 10pm every day except Sunday. The government says the changes will come with a rise in basic salary, higher hourly rates for antisocial hours and will be “cost neutral” – but doctors believe this change could reduce salaries in some areas of medicine by up to 30%. The British Medical Association (BMA) argues that it is “unacceptable that working 9pm on a Saturday is viewed the same as working 9am on a Tuesday”.

It is unusual to hear doctors getting angry and this swell of rage is disconcerting. A social media campaign means their voices have begun to be widely heard over the past week. If the effects of the government’s austerity drive on care workers, for example, have gone largely unnoticed, the seething protest from this powerful group looks set to be harder to ignore.

Most junior doctors are smart enough to know that they will have to work hard to persuade the public that they are a genuinely needy section of society. A perception of doctors as well-paid professionals has stuck and even a semi-attentive observer knows that the harsh 100-hour-week working pattern that used to characterise medical training has been abolished.

What most people outside the medical profession are probably unaware of is that you aren’t just a junior doctor for a fleeting period after qualifying; this makes up a substantial chunk of your career – sometimes a decade, and often stretching late into your 30s. Basic salaries start at around £23,000 and are enhanced by various complicated supplements, including the antisocial hours pay that is set to be cut. Because medical training takes longer than other degrees, most junior doctors have large amounts of student debt and are expected to continue paying for the exams as part of their ongoing training, in addition to putting in large amounts of unpaid study time and paying out monthly professional payments to the General Medical Council (GMC) and the BMA.

Few people chose to go into medicine for the money, but this contract has triggered a surge of resentment about how much harder doctors work for less money than their equally ambitious and well-educated peers in other fields.
Radiologist Anushka Patchava says she will have to quit the profession if the proposals are implemented.
Anushka Patchava, 29, a radiologist who qualified in 2011 and has at least two more years as a junior doctor before she graduates to being a consultant, plans to switch careers and is midway through a rigorous interviewing process with two management consultancy firms. She is fed up with the hours and the current pay and is despondent at the prospect of getting a substantial cut to her salary. She earns £31,000, which includes a 40% supplement to her basic salary, to compensate for the antisocial hours she works. Once the new contract is imposed, she thinks she will see this reduced to £27,000 or £28,000 and she expects the hours she works will become even more antisocial. She campaigned for David Cameron in May’s general election, but has subsequently rescinded her membership of the Conservative party in protest at the contract.

If she gets the management consultancy job, Patchava will quadruple her salary on day one. “It’s horrific, isn’t it?” she says. She doesn’t consider herself to be materialistic and, in normal circumstances, would not want to leave a job she loves, but the level of needless daily stress has become wearisome and she is constantly aware of lack of morale among her colleagues.

“Going into work is a struggle – you have to psych yourself up. You’re so short staffed that you can’t offer patients everything you want to offer them. There aren’t enough doctors to fill the posts that there are available now, even before the contract is brought in,” she says. “We are not supported and morale is low. You work really long hours, taking decisions that impact on people’s lives and, at the same time, you’re worrying whether your pay check is going to be enough to cover your bills.”

The daughter of two NHS surgeons, Patchava has an deep-rooted sense of loyalty to the NHS, but her parents understand the pressure she is under and why she wants to leave. There are no perks; she has to buy expensive food and coffee from the hospital cafe and pays £12 every night shift to park in the hospital car park. She calculates that, once the long hours are factored in, she earns about £10 an hour, so these costs are not negligible. As junior doctors, her parents used to get free food and free accommodation. Four of her closest friends from Cambridge, where she studied medicine, have already left to work in the City. “One of them got a gold medal in medicine, for being top of the year, but they dropped out for exactly these reasons.”

These are not alarmist stories being spread by campaigners. Even the Conservative MP and doctor Sarah Wollaston, who chairs the Health Select Committee, knows about the brain drain – her daughter has left the NHS for Australia. Now she, her husband and eight of their friends work in a hospital where they have yet to meet an Australian junior doctor in the casualty department. “It is staffed almost entirely by British-trained junior doctors,” Wollaston wrote this week.

Patchava worries about what will happen when she wants to have children and has to organise childcare for the irregular hours. Another aspect of the new contract is that parents who take time off to look after their children will no longer see their pay rise automatically while they are on leave. People who take time out of the medical training system to do research will be similarly penalised. Other changes include the removal of a supplement paid to those going into general practice, to match those working in hospitals, which doctors believe could see trainee GPs losing a third of their pay.

“I don’t have a luxury lifestyle, but I don’t think I could support children with that money and those hours,” Patchava says. “The NHS runs on the philosophy of altruism. Everyone comes in an hour early and stays late to make sure the work is done. We love the NHS, but this has been such a kick in the teeth. I’ll have no hesitation about taking a job elsewhere.”

This sense of mismatch between the commitment put in and reward taken out is widespread. “I’m 30 years old, live in a friend’s flat with three other people, don’t own a car and have still got thousands of pounds of debt,” writes one junior doctor in an angry email. “My friends outside of medicine have bought houses, have children and the majority have their weekends and evenings for themselves. On top of my ‘48 hours a week’, I teach and lecture in my free time, attend courses (which we have to fund), study and do everything I can to be a better doctor. I love my job – I couldn’t imagine living with myself if I left. However, the prevalence of locums and holes in the rota, overstretched stressed GPs and A&E staff make the atmosphere toxic. We miss weddings, funerals, birthdays. Relationships are lost, friends estranged, all because we love our job.”

Foiz Ahmed, a junior doctor in emergency plastic surgery (who is grappling with £30,000 debt) argues that the new contracts will strike a pernicious blow to the NHS and patient safety. “This isn’t just about salaries, although of course a 10-30% pay cut is unmanageable for most of us. Let’s ignore the fact that I used to earn more an hour while working for a mobile-phone company as a student … With the continued denigration of public perception of doctors, there is a sustained attempt to make the NHS fail. A demoralised workforce performs less efficiently, and a less-efficient system can be broken up and sold to private firms.”

The Department of Heath insists these fears are misplaced. “We are not cutting the pay bill for junior doctors and want to see their basic pay go up just as average earnings are maintained. We really value the work and commitment of junior doctors, but their current contract is outdated and unfair.”

Junior doctors are not convinced. The GMC had 3,468 requests for a certificate of current professional status, the paperwork needed to register to work as a doctor outside the UK, in the 10 days since the new contract was announced; usually it processes 20 to 25 requests a day. Partly this was the result of a concerted online campaign to get junior doctors to apply as a way of showing their anger. But some doctors, such as David Watkin, 30, a paediatrician based in Birmingham, truly intend to leave if the contract is imposed. Watkin recently returned from a year working in New Zealand, has stayed in touch with his employers out there and is confident that there will be a job for him.

The day-to-day stress Watkin experiences in Birmingham, which is mainly the result of standing in for unfilled doctors’ shifts, was absent in New Zealand. “But stress is not really the issue,” he says. In New Zealand, he says he felt more looked after, with meals paid for and professional fees covered by the hospital.
Would I be a fool to return to the NHS on the new junior doctor contract?
“Here we feel very under-appreciated by the government and the Department of Health. We have sacrificed a lot – years of training and extra hours studying outside of our work. We have moved around the country every six months to go where our training jobs send us, with no say in where we go, so it’s difficult to settle anywhere and hard to buy a house. We, as a body, are feeling under attack; it feels like any concerns we raise are being misrepresented with hospitals portraying us as just wanting more money.”

At 30, he still has about £9,000 in debt (down from about £30,000). He has done seven years as a junior doctor already and has another four to go before he becomes a consultant. “I worry that this is going to lead to an exodus of doctors, and I worry about the pressure that this will put on those who stay – and on patients. I had a work-experience student with me this week; it feels harder to come out with a positive line about why they should do it.”
Holly Ni Raghallaigh: ‘I worked very hard and put myself in a lot of debt to get here.’ Photograph: Teri Pengilley for the Guardian
Holly Ni Raghallaigh, 29, a trainee urologist, is planning to go to Scotland (which, like Wales, will not impose the new contract). She has been pushed to the brink of bankruptcy by the cost of her training, and doesn’t feel able to take a pay cut. With five more years as a junior doctor, she doesn’t think she could afford to continue if her pay is reduced.

 

“I worked very hard and put myself in a lot of debt to get here,” she says. At one point she had to pay for a urology course ahead of an exam and was so overdrawn that she missed two consecutive monthly payments to the GMC, was temporarily removed from the medical register and subjected to a large fine. She estimates she has spent £5,000 on mandatory surgery courses and exams during surgical training; she is paying back her remaining £10,000 of student loan at a rate of £450 a month. Once her rent in London and her monthly subscriptions to the Royal College of Surgeons (£50), GMC (£40) and BMA (£18) are paid, she has nothing left. It isn’t possible to save towards a deposit on a flat.

“Every single time I found myself in my overdraft or having to borrow petrol money or forego a flight home to Ireland to book a course, or every weekend I spent working as a locum to fund my education – I would do it all over again,” she says. “I adore my job and, honestly, working in the NHS is all I have ever wanted to do. And, for the record, I am grateful to the taxpayer who has put me here.” She says she hopes the tales of difficulties she found “embarrassing and demoralising” make people understand the financial pressures junior doctors face. “I don’t want it to sound like a sob story. I could have managed my finances better, but I had no money.”

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While the country is being entertained by our political masters on a daily basis on who will be voted as the stupidest of them all, the medical fraternity was yet again shocked by a picture that was circulated via social media. I received the “picture” early yesterday morning which I felt need further evidence on it’s authenticity before saying anything.Then I was informed that it happened in Johor and in one of the main hospital in Johor Bahru. I was shocked and dumb founded!

IN June 2015, I wrote HERE about professionalism and ethics of doctors. The public view us or use to view us as the most educated group of people. They expect us to behave professionally. In that article, I mentioned that doctors should remain professional at all times, mind our words and should never reveal any personal information of any patients or take any pictures of any patients without their consent. These pictures taken should never be displayed in public domains. It should only be used for teaching purposes in close group discussions.

Unfortunately, a once respected profession is going down the drain. I had predicted many things in this blog over the last 5 years and even in my MMA articles almost 10 years ago. Many, which use to be just “rumours” had become reality. Many accused me of spreading rumours and scarring the future generations but had to swallow their own words along the way. A clerk in a hospital recently said that ” if a SPM result such as this can become a doctor, I should have become one!!“. That’s how bad the SPM results was, of an houseman. Remember my article over HERE ?

There is no doubt that the quality of doctors had deteriorated. I have to admit the fact. No point hiding it anymore. Call a spade a spade!. This picture which shocked me was something that I had never expected for a doctor to do. I can’t even imagine such a thing can happen. Something that I failed to predict! All kind of words are coming out of my mouth but I am trying to be as professional as possible.

When I started to receive news that the picture was authentic and who the doctor was, I was speechless. There goes the reputation of doctors. While in my previous article I spoke on the battle between doctors and proponents of home birth, here we had just shot ourselves. It only takes one person to spoil everything. Would the public trust doctors anymore? We must understand that no matter how the public mistreat us or shout at us ( as I had written many times before), since we became doctors to “help” people, we should just keep quiet and do our work! Just make a police report if you think it is overboard. Recently, a nurse who brought her husband to a district hospital at 1am for palpitation told me that, the doctor said “ Please decide fast where you want to be admitted, I want to sleep!“.

The Star has reported that the matter is being investigated. Interestingly, it says that the doctor in also known to take selfies in operating theatres, OMG! I think it is time for MOH to do something about this. Whatever said, action must be taken against this doctor. MMC should also take action as it is considered a professional misconduct. This should never happen!

 

 

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Well, the world is changing! I had written several times in this blog that patients nowadays are not the same as it used to be. This is something that the current budding doctors are totally unaware when they claim that they want to “help” people by being a doctor. Only those in practise will understand what is happening out there.

Today, Malay Mail published several articles regarding ” Dr Belittle“(see below). It was about a Facebook posting which supposedly breached patient confidentiality and made various unwarranted remarks against the proponents of home/natural birth. Actually, I have been watching this ongoing debate among these group of doctors and the supporters of home birth for quite some time now. While both have their own believes , I do agree that certain unwarranted remarks or unacceptable language should not come from professionals like us. We should debate it in a civilised manner with facts rather than emotion. Saying that, I do see a lot of emotional rants in this blog by the younger generations when they don’t agree with my statements. But, do you see me doing the same?

We should understand that patients have every right to accept or deny our treatment. One of the ethics of medicine is “patient’s autonomy”. It is not mandatory for any patients to follow your treatment plan despite all the explanation given. You can scare and scold a patient but they have every right to deny any treatment offered to them. I use to get irritated by these group of patients when I was a junior doctor but after some time I began to accept the fact that our job is just to advise. You advise a patient for mastectomy for Ca Breast but she goes for traditional treatment. 6 months down the line , she comes back to you with metastasis all over the place! Do you scold her? It is her body and her life, you can’t do anything about it! Unfortunately, over the past 18 years, I have one thing which seem to be getting louder by the day. It is the refusal to seek doctor’s advise or treatment. The patient rather trust a traditional medicine practitioner than a doctor, simply because they feel that these practitioners are prescribing and using “natural” treatment rather than chemicals. They refuse to believe that these “natural” treatment are usually adulterated  with modern medicine chemicals such as steroids, NSAIDS and antibiotics. But you can advise till the cow come home and they will not listen to you. They will only listen when complications occur and they come back to you for treatment. I had seen enough Addisonian crisis, Liver toxicity and peptic ulcer disease from patients taking TCM. I had even sent some for analysis and showed them the proof.

What do I do when I see such a patient, nowadays? Basically, I don’t give a damn anymore. I tell them right to their face that since they do not want to take any treatment plan from me, please do not come to see me again for any problems. I rather treat and “help” patients who are willing to follow my treatment plan than wasting my time on patients who are never compliant. And for those who do come back to me, I will give them a piece of my mind before treating them.

Unfortunately, that is the reality out there. That’s why whenever a budding doctor tells me that he wants to help people, I tell them that not many patients nowadays really appreciate your help anymore. The real appreciation nowadays are in rural areas and interiors. Unfortunately, not many doctors would want to work in these areas. Just yesterday, I heard another Gynaecologist being sued in court. Together with him, another 2 doctors will have to be involved as they co-managed the complications that this patient had.

Coming back to the articles in Malay Mail today, I find the articles rather depressing. Firstly to the fact that many “unprofessional’ remarks were made by doctors which is not the right thing to do. NO matter what you discuss openly in any public forum/social media, patient’s details and particular should never be released. I see a lot of such pictures and details being written in Facebook  which is unethical. Anything that you publish that can directly or indirectly point to any patient’s particulars, where it took place etc can be sued by the patient. Also, please remember that a written consent must be taken from the patient for any pictures or videos taken. On the other hand, the article seem to be supporting home/natural birth proponents, blindly. While home birth is nothing new, it should be done by people who are trained medically. Even in some developed countries like N.Zealand, UK etc, midwives do deliver babies at home. However, these are done to low risk cases only. If they pick up anything unusual or feel that the patient might be high risk, the patients are referred to hospital for delivery. Unfortunately, the proponents of such method in Malaysia are mainly non-medically trained people. Majority do not take any responsibility when complications occur. Furthermore, they provide information that are not true and never disclose the complications that had occurred to their clients. No action can be taken against them as well. Remember, even some of the supporters of such methods had died during delivery.

Unfortunately, as a doctor, our job is to treat any emergency no matter who they are. They can be drug addicts, prisoners, murderers, robbers, snatch thief’s, HIV patients or even patients who refused to listen to you before. Your job is to treat them for whatever emergency they come with. If it is non-emergency, in a private sector, you can refuse to see the patient on a basis that you are emotionally not ready to treat such a patient. BUT, in government sector, you can’t, as you are an employee of the government, paid by the government to do the job.

So, if any of these patients who decided to deliver at home come to you with a complication, it is your job as a doctor to treat them. You can complain all you want, but that is your job. You decided to become a doctor to help people. So, just keep quiet and do it no matter how much anger you have in your heart. You have to accept the fact that it will never be the first or the last such case that you will see. That’s when you will ask yourself why I became a doctor when patients don’t listen to me anyway? And when the mother dies, a full report need to be sent to MOH as maternal mortality is a national index. Subsequently, you will be called for the Maternal Mortality meeting to find out why the mortality happened. I feel in such case, MOH should take action against the proponents of home births. BUT do they have the authority/law to do that?

As for the patients, it is their right. If they want to harm themselves, it is up to them. It is their life not ours. I realised this after few years of working as a doctor. BUT they should realise that they should NOT cause any problems to others as well. Don’t run to the hospital when complications occur. Take the people who advised you to do home delivery to task. Sue them or ask them to pay for the complications. Unfortunately, our society are more than ready to sue a doctor but not a traditional medicine practitioner or anyone else who has been advising them all this while. Do you see anyone suing these people? You don’t! That’s the sad life as a doctor. Not only you get sued for everything nowadays but also get called up by MMC for emotional rants, as you had breached professional ethics!

Doctor’s life is never the same anymore………………… so, It’s time for me to take another holiday on the seas….. ……

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Doctors reminded of professional etiquette
By Vanessa Ee-Lyn Gomes
Published: June 3, 2015

PETALING JAYA, June 3 — A government doctor may have possibly breached patient confidentiality by discussing a young mother’s home delivery case over social media, says deputy health director-general (medical) Datuk Dr S. Jeyaindran.

He said the Health Ministry had regularly reminded doctors about Facebook use besides professional etiquette regarding medical discussions over the Internet.

Dr Jeyaindran said a patient’s information was always confidential.

“There is a very fine line because doctors sometimes use social media to discuss a patient’s condition or conduct consultations, but the patient’s name should never be revealed.”

He said there were implications and repercussions from public postings on social media which doctors may be unaware of.

“Unfortunately, a lot of doctors still do not realise that postings on social media may lead to breach of patient confidentiality and ethics,” he said when commenting on a young doctor’s Facebook post which ridiculed a patient suffering a third degree tear following a home birth.

Other medical professionals left mocking comments on the post.

Dr Jeyaindran, who is also a member of the Malaysian Medical Council, said it was inappropriate for medical professionals to post such comments.

“The use of social media to openly discuss patient issues is not appropriate and is definitely not advocated,” he said.

He said the council could investigate the matter if there were complaints from the patient, her family or the public.

“The doctor has to be present before the disciplinary committee to see what form of patient confidentiality has been breached,” he said.

“It does not matter who lodges the complaint because the doctor’s professional conduct will be examined.

“We will also study what information was shared in the post.”

On home birthing, Dr Jeyaindran said the ministry did not advocate it because of the risks that could lead to complications.

It is understood an investigation will be carried out on the direction of the director-general of health to ascertain if there was a breach of professional conduct and patient confidentiality.

– See more at: http://m.themalaymailonline.com/malaysia/article/doctors-reminded-of-professional-etiquette#sthash.y47COpoB.dpuf

MMA: Patient info not for open discussion
By Ida Nadirah
Published: June 3, 2015 07:32 AM GMT+8

PETALING JAYA, June 3 — Social media has given rise to issues regarding patient confidentiality, said Malaysian Medical Association (MMA) president Dr Ashok Zachariah Philip.

With widespread use of social media platforms such as Facebook, medical practitioners are not excluded from using them to channel their experiences, joys and frustrations.

However, Dr Ashok said doctors were discouraged from using social media as a forum to discuss patient information.

He said doctors in general do not reveal patient details, but would sometimes share information with other doctors for discussion or consultation.

“The problem with Facebook and such, even if something is discussed in a closed group, people can still share the information,” he warned.
He said patient information and histories should not be shared in open forums, and should only be done in traditional channels, such as bulletin boards.

Dr Ashok said the sharing of a patient’s photographs could only be done with the patient’s consent. Failure to have consent would be unethical, even if the patient was unidentifiable.

“If found guilty of breach of confidentiality, the doctor may face action by the association as well as the Health Ministry,” he said.

In reference to the recent criticism on a Facebook post where a mother suffered third degree tears during a home birth, Dr Ashok said it was not right for the doctors to use such crude language.

“We, as doctors, are human as well, and we may be angry over the result of a patient ignoring the doctor’s advice.

“However, we still have to treat the patient in the best way possible, and in no way suggest causing more harm,” he said.

He said it was improper for the doctors to comment publicly about the mother, whose medical history was unknown to them.

He said it was not uncommon for mothers to deliver at home.

– See more at: http://m.themalaymailonline.com/malaysia/article/mma-patient-info-not-for-open-discussion#sthash.X9KmQppk.dpuf

Use lidi and yam roots to stitch tear, doctor advises
BY IDA NADIRAH

Wednesday June 3, 2015

PETALING JAYA, June 3 — A young woman who sought treatment for a third degree tear after home birth has become the butt of crude and distasteful jokes from doctors who latched on to sarcastic comments posted on Facebook by the doctor who was treating her before delivery.

In the general tirade againt home birth by 26 others including young doctors, one even went as far as saying that the patient should use yam roots and a lidi (coconut leaf skewer) to stitch the wound.

If that was not rude enough, he went on to suggest in a similarly unprofessional vein that the first-time mother use glue and aloe vera to heal herself.

A Kuala Krai medical officer who agreed to the doctor’s post, mockingly said: “Yes, please repair naturally. No analgesia (painkiller) please.

Another doctor belittled the woman and patients who supported natural birth, saying “I guess positive vibes, giving birth while standing, lots of hugs, etc can’t prevent third degree tear? Hmmm, maybe because it was not natural enough.”

A third degree tear involves a tear through the perineal muscles and the muscle layer around the anal canal following a natural birth.

The person who started the sordid affair, a house officer at the Hospital Sultanah Nur Zahirah in Kuala Terengganu, had posted this on her Facebook page on Saturday night: “Homebirth. refused everything. Came to hospital for 3rd degree tear. Yes doctor, please repair my tear. Keep calm and continue oncall

To add insult to injury, the doctor also included part of the patient’s pregnancy record book in which the woman had said she would not require any medical attention during delivery at home.

The shocking use of unacceptable language and breach of patient-doctor confidentiality has come in for reprimand from the Malaysian Medical Association and the Malaysian Medical Council which took the doctor who belittled the mother and her fellow medical practitioners to task for bringing the profession into disrepute.

A group of mothers who advocate home birth have also expressed outrage over the manner in which the doctors had treated the woman who went for a procedure that had gained acceptance worldwide.

The photograph of the woman has been circulated widely and found its way into other public Facebook postings despite an attempt to erase the patient’s signature.

The first Facebook posting has been taken down but the author and other doctors continue to discuss the matter openly on Facebook.

– See more at: http://www.themalaymailonline.com/malaysia/article/use-lidi-and-yam-roots-to-stitch-tear-doctor-advises#sthash.67D0nPC8.dpuf

Home birthing is here to stay, doctors told
BY IDA NADIRAH

Wednesday June 3, 2015

PETALING JAYA, June 3 — Doctors have been told to wake up to the fact that home birthing is here to stay.

Hypno-birthing educator Nadine Ghows said the phenomena of doctors criticising mothers who advocate home birth had been going on for some time on social media.

She said the language used by the doctors tended to be patronising and condescending, oreflecting a lack of training on basic etiquette.

“Some doctors still see patients as someone to control … this is partly due to the ‘white coat’ syndrome,” she said.

She said the attitude of some doctors towards patients was unhealthy and they lacked an understanding of their role in the patient-doctor relationship.

She was commenting on the case of a house officer who had posted confidential information on a patient on Facebook which in turn elicited rude and crude remarks from a host of others including doctors.

Nadine, in decrying the actions of the doctors, said basic training on etiquette had to be offered to young doctors especially on the strict rule that they could not share any information on a patient with the public.

She said a medical lecturer from Universiti Kebangsaan Malaysia (UKM) had started a basic etiquette course for young doctors last year.

“Maybe we will not see the results soon now. I hope this course will play a role in ensuring that humanity and respect are brought back to medical care,” she said.

Researcher and engineer Nur Firdaus A. Rahim, 31, said every patient had the right to their opinion on matters involving medical procedures and their requests had to be respected by doctors.

“They should not belittle or insult parents who holds their own opinions on such matters,” she added.

“I am affected by their actions. I had initially planned to give birth at a government hospital but will now chose a private hospital that is more natural-birth friendly.”

Flight attendant Zamzilah Fairuz Kamarul Zaman, 30, said she did not mind doctors sharing their experience “but sharing patients’ records goes beyond the limit.’’

– See more at: http://www.themalaymailonline.com/malaysia/article/home-birthing-is-here-to-stay-doctors-told#sthash.v69ph7lE.dpuf

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Last week, our PM revealed the 11th Malaysia Plan (RMK 11). As usual, a lot of sugar-coating and wonderful plans were mentioned. With the current reputation that our PM is enjoying, it has to be taken with a pinch of salt. The market did not respond well this time around. On Monday, our Bursa crashed. That simply shows that no one believed what was mentioned in RMK 11.

I will not talk about the entire plan as many of it are repetitive issues. I will concentrate on the medical field as attached below. Let’s look at the 1: 400 ratio. This is nothing new. Right from the beginning, the government’s intention is to achieve the ratio by 2020. That’s the reason why numerous medical schools were given license to start. As usual, our government is only interested in quantity rather than quality. We want to achieve everything on paper but in reality, half of it ” tak boleh pakai !!”. First they said that it is WHO recommended ratio, but last year, WHO has made it very clear that they never came up with such a ratio. Interestingly, just last month, MOH said that we are short of post and there are too many graduates coming into the market, but suddenly everything changes. I believe our PM do not know what he is talking about, as usual. Secondly, with the number of graduates being produced now, we will achieve the ratio 1: 400 by 2017. Don’t need to wait till 2020. All our 36 medical schools will be producing graduates by 2017. We have already reached a ratio of 1: 600 in 2013. The statistics for 2014 is yet to be announced.

Whatever said, these ratio does not mean anything as it includes both government and private doctors as well as doctors in administrative jobs. No matter how many beds that you have in the government sector, it will always be overcrowded as 80% of patients are dependent on government hospitals. This brings me to another question of bed ratio; 2.3: 1000 patients that was mentioned in RMK11. This ratio includes both private and government, but only 20% of patients will use the private sector. Unless the government comes up with a National Health Financing Scheme (which was not mentioned in RMK 11), the bed ratio do not mean anything. Everything will look glorified on paper but meaningless in reality.

Now, let’s look at the “so-called” new hospitals that are going to be built. Are they really new hospitals?

1) Hospital Bentong : There is already a 152 bedded hospital in Bentong. So, is this new hospital replacing the existent one?

2) Hospital Baling : Again, a 160 bedded hospital is available in Baling. So, nothing new either.

3) Hospital Kamaman: A 116 bedded hospital is available

4) Hospital Maran : A 60 bedded Hospital Jengka is in Maran, about 40km from Maran town. A 500 bedded Hospital Temerloh is also about 40km. I am not sure where exactly these new hospital is going to be but likely it will be quite nearby to the existing hospitals.

5) Hospital Pendang :This will be a new hospital

6) Hospital Pasir Gudang : Hospital Sultan Ismail, a 500 bedded hospital is just 15km from Pasir Gudang. There are also 3 private hospitals in Pasir Gudang District: KPJ Pasir Gudang, Regency Specialist Hospital and Penawar Hospital. So, do we really need another hospital there? Will it ever materialise. It is an industrial area where most workers are foreigners.

Building an upgraded hospital is good. However, looking at our track record, likely these hospitals will never see the light of the day. Remember, Hospital Shah Alam is yet to complete since RMK 9. Remember, Hospital Sultan Ismail was delayed for almost 3 years? Furthermore, most of these hospitals are only going to replace the existing hospitals with better facilities. It is not going to increase the number of new post very much. There will still be too few of a new posts for increasing number of new graduates.

What about cluster hospitals ? In early 1990s, a concept known as Nucleus Hospital (under RMK6) was introduced. Hospital Manjung, Hospital Sg Siput, Hospital Kulai, Hospital Segamat, Hospital Batu Pahat etc are few of the hospitals that are Nucleus hospitals. A total of 12 was introduced based on a system in Britain. It suppose to be community based hospital which acts as a nucleus for further expansion and upgrading. Unfortunately, many remained as district hospitals with some basic speciality. I got no idea what this cluster hospital is all about. I presume it is sharing of manpower and facilities among hospitals within a district/area. If that is the case, specialist may be running between few hospitals. I remember our Health Minister did mention about this few months ago. It may end up chasing away more specialist from the government sector.

Upgrading of health clinics is a necessity. Unfortunately, many of the current clinics are already facing shortage of funds and expired equipments. I hope the current ones could be upgraded first before selecting a “few” for upgrading work.

Finally, another 165 “1Malaysia clinics” will be introduced. This is a disaster for GPs. Some of this 1Malaysia clinics in N.Sembilan and Selangor is currently being filled by MOs. While it is a good publicity stunt, it will affect many GP’s income.

While everything looks good on paper, many may not happen. With the current economic situation, where will the government get the money? That is the question many economist are asking. Some of these projects will be shelved as usual, or postponed to 12th Malaysia Plan. Many may fail, as happened again and again, countless number of times……… History repeats itself!

 

 

 

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