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2009: The Day the MOH Stood Still!

2012: The Day After Tomorrow?

                                    The above 2 years seem to have a fascinating meaning to me. Year 2009 is the year that MOH seem to be falling apart into pieces. No, I am not talking about the AHINI epidemic but something really critical seem to be happening within MOH and it is in a crisis. According to the Mayan calendar, year 2012 will be the end of the world. Well, even though I may not believe it but for MOH this may become a reality soon! 

                                    After I completed my training in Singapore mid of last year, I came back to JB to be involved in full time academic activity and some clinical services. Even though I may not be doing full clinical services in MOH hospitals, my one foot is always in MOH. I do see patients that have been referred to me and I also run a clinic at Hospital Sultanah Aminah. What I can’t help to notice in MOH hospitals since I left almost 4 years ago, is the complete deterioration of the services provided to the patients. From the bottom of my heart, I will say that the quality of care has deteriorated tremendously. Not only the nursing care has taken a dive but also the quality of the junior doctors. This is despite the increase in numbers. Let’s see why I say so.

                                    In the process of trying to increase the number of nurses in the country, as usual, our policy makers have decided to allow many private nursing colleges to boom. Quality of students? Well, who cares, as long as we see the numbers! This mentality has gone to each and every sector in our country which is turning this country into a laughing stock of the world. We have English teachers who can’t speak English! Some may argue that everyone can be trained. Even monkeys can be trained to write/type but do they know what they are typing/writing? A system without merit is equivalent of having no system at all. We must have people with certain intelligence to do certain jobs! 

                                    In the MOH hospital that I am practicing at the moment, there seem to be almost 3-4 nursing colleges using the hospital, including the MOH nursing college. Some of their tutors seem to be foreigners. So, what do the “trained” nurses do? Well, the “trained” nurses in the wards now have become glorified clerks and “chartologist”. They sit in a corner and write reports to pass over. Every observation and nursing procedures in the ward are given to the student nurses to do, who obviously do not know what they are doing or looking at. The “trained” nurses seem to be more interested in writing reports, which most of the time will be the same from the previous day. Do they know what is happening to the patient? I hope so, but most of the time you will be disappointed. They sign the drug charts that they have given I/V antibiotics but patient does not have a branulla since admission!! Do you call this being smart or glorified stupidity? A stat dose of medication ordered at 2pm given at 9pm!! Well, I can go on and on till tomorrow if you want more examples but I hope you get my point.

                                    Let’s come to the doctor’s issue. Once upon a time, our education system was one of the best in the world. Our SPM, STPM and university degrees were recognized internationally. Out STPM certificate still do, but likely not for long. Where are we now? The “Little Napoleons” that was created by our NEP and BTN have successfully infiltrated the education system over the past 40 years and converted our education system to the opposite direction. We have graduates of “business admin” who are absorbed into becoming a teacher to teach “English” and “History”! I have personally come across a person who failed SPM but was absorbed into teacher’s training college and currently teaching in a secondary school!! Ironic isn’t it? A person who failed SPM is teaching students who are sitting for SPM!! “ Malaysia Boleh”. People have lost faith in our education system and thus the shift away from the national schools and the mushrooming of the tuition centers throughout the country. Recently, I had a vegetable lorry driver who was accepted into police training!!! God save the country! Now, what has this got to do with MOH?

                       Whether you like it or not, the “Little Napoleons” are slowly but surely infiltrating into the health sector of the country. Do you know that the whole state of Perak has no Nephrologist at the moment? They resigned en-bloc due to dissatisfaction with the hospital’s “Little Napoleon” who made “racist” remarks about the unit for trying to dialyse the poor without any preference! At least, this is what I heard. The same situation may occur soon in Negeri Sembilan and Alor Setar, just keep watching. Do you know that there is only one Cardiothoracic Surgeon for the entire state of Penang in Penang GH, struggling to cope? Do you know that some of the hospitals and even university hospitals have Head of Departments that are so junior, less than 10 years of service? Do you know that fresh master’s graduates are teaching master’s student? Do you know that all the drugs have been changed to generics? Who cares whether it works or not. Some hospitals do not even have enough infusion pumps!

                        Many years ago, SCHOMOS brought up the issue of the importance of senior doctors in the MOH and the need for them to be retained for the training of the future specialist. However, the MOH was slow in their response and the effect is being seen now. We practically do not have good, experienced senior consultants in MOH to guide and nurture out future budding specialists. Due to lack of supervision, serious mistakes are being made at the lower level. Junior doctors are not being monitored closely. We have housemen who do not take patient’s blood before rounds, claiming he will do it after rounds at 12pm!!. It basically means that the blood result will be back after 5pm and no one will bother to review the result!! So why bother sending anyway. I have written about the qualities of houseofficers and who to blame in Berita MMA, March 2009 and thus I will not go into this topic again.

                        The health sector was the only sector where politic was not much involved before. Unfortunately, things seem to be changing and the “rakyat” is going to suffer in silence. The public health service is going down the drain. 2009 may be the year that this is beginning to happen but the doomsday may finally come in 2012 when most remaining senior consultants begin to retire! It is a malignant disease that is spreading rapidly throughout MOH. Having the numbers are not important. Time will come where people will say “I won’t even send my  ……..  to MOH hospitals”. SCHOMOS should stop looking at doctor’s remuneration and start looking at the “Little Napoleons” who is going to destroy MOH. Till then please enjoy the deterioration…………………