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Archive for the ‘Politics’ Category

Towards Malaysian Baru ?

It has been almost 3 months since I last updated my blog. I had to travel a lot during these 3 months and a lot of personal issues to settle. But one thing I never forget or miss, is to vote! I have voted in every election since 1995 except in 1999 where I could not go back as I was on-call(at that time my voting station was in Seremban before I changed to Johor for 2008 election). This year’s election was the mother of all elections and the verdict was something I had never expected. I never expected BN to fall in my life time! The most I expected was to give BN a close simple majority to win. I also never expected Johor to fall and close to winning 2/3 majority by Pakatan. While I stood awake till 4am in the morning of 10/05/2018, i could not resist the tears that flowed through my eyes when I saw the people of Malaysia waking up and voting out a government that has been in power for 61 years.

I had always supported a 2 party system. It is a system that is in place in most western countries or matured democracies. The people have the power to decide which coalition party will rule the country. In any such countries, you will see that the people will change the government every 5-10 years. This will keep the ruling party on their toes and never to underestimate the power of the people. Once they fall, their dirt will be washed in public as what you can see happening right now in Malaysia. So, in the future no party can hide anything for long. It will benefit the people in long run.

So, what are we to expect from this new government. To be frank, I don’t expect much in 5 years. There are a lot of things that need to be corrected over a short period of time. First and foremost, I feel the new government should put a system in place that will prevent any form of power abuse. AG, MACC, EC chairman etc should be elected by Parliament and made answerable to the Parliament. MACC should be given power to prosecute. These people should face the Parliament to answer questions from both side. Prime Minister’s term should be limited and Finance Minister should never be the Prime Minister.

WE should not forget that the mess that this country is in now, and abused to the maximum by the previous PM was created by our current 7th Prime MInister! I had written enough about this in my earlier articles way back in 2010. I had mentioned how DR M’s social engineering and Malay nationalist ideas destroyed the future of this country. However, he did develop this country into an economic power house which benefited many people. Unfortunately, as smart as he is, he never expected or foresee that his very own people will misuse the system that he created. I just hope that in his last few years of life, he had realised his mistakes and do what is necessary. I had always said to many people that GOD will make sure that DR M will live long enough to see the damage that he has done to this country. GOD is great!

Many people asked me whether anything will change to the medical field. Firstly, I don’t think the long waiting period of medical graduates for employment will change anytime soon. With the current financial situation of the country, it is unlikely that the new government can create more post or even build more hospitals. With increasing number of graduates from this year( where all medical schools will be producing graduates), the waiting period will only get longer. However, one thing that the new Education Minister can do is to tighten the entry qualification into the medical program. By doing this and making the accreditation process tougher, many medical schools (especially the smaller “shop-lot” ones) will undergo slow death due to lack of enrolment. Over the last 2 -3 years, many medical schools already struggling to meet the required number of students.Imagine increasing the entry criteria to 5A’s in SPM with higher CGPA in Pre-U courses. Hopefully, this measure will slowly reverse the current situation over the next 5-10 years. Remember, the mess that we are in now was created almost 14 years ago!

If even the Ministers’ have to take pay-cuts, I don’t expect any pay rise to civil servants in near future. Probably once the country’s economic status is better, we can expect some pay rise. What I would like to see is a complete restructuring of the Malaysian Healthcare System. The current system of having public and private healthcare system running parallel to each other is not sustainable in long run. The government would not be able to sustain the increasing healthcare cost and maintaining an almost free healthcare system. On the other hand, the private health insurance companies would not be able to sustain the private health sector. Our private health sector is almost 90% funded by the private health insurance. I use to tell my friends that if the private health insurance collapses, I will become jobless!

I would really like to see a proper integration of public and private healthcare sector via a National Health Financing Scheme. This should include the GPs, private hospitals, KKs and public hospitals. WE have enough doctors but maldistribution is the issue. BY having such a system, maldistribution between private and public sector can be reduced. Eventually, this will also reduce the maldistribution between urban and rural areas.

With all the euphoria that we are having now, it is just too early to say how this new government will perform. Statistic shows that Pakatan only received 48% of the votes with BN & PAS taking 52% of the votes. Pakatan won in many areas due to split votes. PAS benefited from split votes in Kelantan and Terengganu. Personally, I feel that the Pakatan government is not really in a very stable situation. Tides can change by next election if they do not outperform the previous government by leaps and bounds.

Whatever said, politics in Malaysia will NEVER be the same anymore………

 

SELAMAT HARI RAYA 2018 TO EVERYONE………

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The world of medicine is changing rapidly. For those who are aware what is happening around the world, we know how the perception of public towards medical profession has changed. Unfortunately, there are many out there who are living in cocoons, do not even know that sooner or later they can be charged for manslaughter!. The recent case in UK involving Dr Bawa Garba has sent shock waves around the world. A senior trainee paediatricians were given suspended jail sentence of 2 years for gross negligence amounting to manslaughter. GMC ( the guardian of medical profession) appealed to High Court to struck off her registration despite Medical tribunal giving only 12 months suspension. Two weeks ago, the court allowed GMC to struck off DR Bawa Garba from medical registry. A detail reading of her case will remind us that what has happened to her, happens on a daily basis everywhere in this world! Unfortunately , the world is changing.

Many still believe that medical indemnity will cover their butt if and when they make any mistake. Unfortunately, any negligence leading to death can now be charged under manslaughter and no more a civil negligence case. IN Malaysia, similar case is currently ongoing involving our very own DPM’s son in law’s death. The doctor who gave sedation is now being charged for manslaughter which can carry a prison sentence of up to 10 years. If he is convicted, it will set a precedence for any other such cases in the future. Similarly, another doctor was charged in December 2017 for circumcision gone wrong. He is being charged under Section 338 of Penal code for causing grievous hurt which can give you 2 years of imprisonment.

IN the US, just 2 months ago, an anaesthetist was charged for murder, “killing” a patient undergoing plastic surgery procedure by giving overdose of an anaesthetic agent. In fact, the first time a doctor was charged for second degree murder in US was in 2015.

Doctors around the world are rallying behind DR Bawa Garba. The fact is , the case just portrays how the healthcare system has failed. She was overworked, just came back from maternity leave and covering 2 person’s job without a supervising consultant. Sounds familiar? Unfortunately, the court do not take into consideration of all those shortfalls. It just concentrates on the negligence part and sentenced her accordingly. Any gross negligence leading to death is now considered a manslaughter! Is anyone still living in dreamland thinking that doctors are “gods” in the eyes of public? You are treated similar to anyone else when you cause a death due to negligence. Nothing special.

DR David Sellu’s case in 2013 is another good example. A well renowned colorectal surgeon of 66 years old was sentenced to 2 and a half years imprisonment for causing death of a bowel perforation case. A patient who developed bowel perforation following a knee surgery, deteriorated while waiting for surgery and subsequently succumb to sepsis. This happened in a private hospital with limited facility for emergency anaesthetist and OT. Thankfully, after 15 months spending in jail, the court of appeal reversed the decision when new evidences emerged regarding the lack of facility and why he could not do the surgery immediately. Unfortunately, damage is done and he had spent 15 months in jail together with other criminals convicted of rape, murder etc! After saving lives for 40 years, at the age of 66 he was treated as a criminal and even labelled as Dr Death! He was also subsequently subjected to GMC’s suspension. This is a good article to read as well : https://health.spectator.co.uk/david-sellu-a-surgeon-wrongly-jailed/

These cases have created a new term : ” Medical Manslaughter“! The list of such cases in UK till 2014 are listed in this article and attached below.

 

Looking at those cases above, we will wonder that these are nothing unusual in day-to-day medical practice. It happens on daily basis. Sometimes complications can never be predicted. Errors do occur and it is not entirely due to the doctor’s fault but the system as a whole. There are many factors that can cause such negligence to happen or how the complications are treated. Unfortunately, the court only considers the healthcare professional’s mistake. This applies to paramedics as well. Nurses have also been charged for manslaughter. This WEBSITE has some information of other health professionals who have been charged similarly.

 

The above video made last year is worth watching. Doctors are humans and do make mistakes. However, the society is not willing to accept these mistakes anymore. I had written much about civil litigation that is increasing day by day. Criminal charges are now increasing day by day as well. As long as you are proven to make gross negligence leading to death, you can be convicted for manslaughter. This can be as simple as giving a medication !  For example, if you give IV Pethidine for pain and the patient stopped breathing and dies, you can be charged for “murder”! And subsequently, the medical council will struck you off the register!

As I had always said, the world of medicine is changing. Modern medicine is infected by virus of mistrust as written over HERE. Commercialisation of medicine is one of the reason behind these issues. A profession which started during ancient times as a science to help people has been systematically and gradually converted into a multi billion dollar business. A business to suck people’s money in many developing countries. Generally, countries which have a universal healthcare system will have lesser number of negligence and complains, as patients do not pay much. Unfortunately, NHS in UK is dying day by day due to lack of funds and overcrowding.

If criminal charges against doctors left unchecked, we may be seeing many doctors behind bars despite saving many lives! I wonder whether AI will come to the rescue? Can AI be charged in court for making a mistake? These are the reasons why many doctors are feeling the overwhelming stress at work(burnt out) all over the world. After years of training and money spent, a simple mistake will land you in court. What use to be civil has now become criminal offence. I can only see more and more doctors retiring early and leaving medical practice. Many do not even encourage their offsprings to do medicine.

What I foresee is that the society will dig their own grave. More and more people would not do medicine. Many doctors would not take high risk cases. Consent forms will become as thick as “Harrison’s Book of Medicine”. Finally, mistakes will be hidden and notes will be fabricated!  The art of medicine is already dying due to CBM (Cover backside medicine) but eventually medicine itself will undergo a silent death………..

Gong Xi Fa Chai everyone………

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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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