Thursday, January 28, 2010

malaysiakini-DG Health: 1Malaysia clinics boon to urban poor

1Malaysia clinics boon to urban poor

Aidila Razak & S Pathmawathy
Jan 28, 10

'1Malaysia' clinics have been set up with the urban poor in mind to provide a form of financed healthcare and to reduce the burden on overcrowded government clinics," said the Health Ministry's director general Ismail Merican.

"Healthcare is becoming increasingly expensive and if the government does not act, there will come a time will come when the public can no longer afford it," he said.

ismail merican
"There are a special group of people with special needs - the urban poor. So far we have been concentrating on the rural poor. We have rural clinics run by assistant medical officers and nurses.

"They have been running for decades. And because of the strength of the rural healthcare system, Malaysia is often said to have among the best healthcare systems in the world.

"The recently established '1Malaysia' clinics fill this need and they are equivalent to normal government clinics, which are manned by medical assistants."

Ismail (above) said the living conditions of the urban poor were quite disturbing and the 50 clinics introduced all over the country were to cater simply to their basic needs.

"A lot of them who are sick are not going to bother to go to a clinic because they do not the transport or the means. Often, if they had medical treatment early, more serious problems could have been prevented."

He added that the '1Malaysia' clinics are situated within walking distance in these poorer areas.
Patients had only to pay RM1 for treatment. Once a week, a doctor is appointed to check on the clinics, audit the prescriptions and monitor the work of the medical assistants.

"I must tell you that the community is very happy about this. I met a pak cik who was walking with a cane and he said he would never go seek medical treatment ordinarily, 'but since your clinic is here, I come'," said Ismail.

Changing catheters

He made it clear the MAs are not taking over the role of doctors, but there were many tasks they could on their own.

"For instance, if a patient's catheter needs to be changed, do you want the old man to queue for two hours to see a doctor? This task could be easily done by a MA or the nurse. Children fall down the stairs and you want to wait for hours just to get a dressing?

"The MA cannot start treatment. There is no medicine to be prescribed there other than for simple illnesses like coughs, colds, and stomach aches," stressed Ismail.

"Say somebody comes and the blood pressure is high the MA is not going start treatment.
"The first thing he will ask is whether the patient knows he has hypertension. If the answer is yes, the MA will want to know if he is taking his medication. If he says no, the MA will order him to continue with the medication or tell him to go see a doctor and start treatment."

He added that RM10million had been allotted to monitor the effectiveness of the clinics for about three months.

He mused that that a healthcare financing mechanism might be one solution to cope with the growing cost of healthcare but felt the time was not right for its implementation.

"The public is very demanding and they are insistent on high-quality care but they do not want to pay too much for it.

"But if we don't have a healthcare financing system, there is a big possibility that the public will not have the healthcare infrastructure they want. The cost of drugs and technology are going up all the time. At some point we might have to introduce that."


Comments from mk readers:

by drvk 

The scenario described by the DG as to how the MA is going to handle cases will remain as a description only. In reality there are a lot of things that can go wrong and they often do in the practice of medicine. Even an ex clinician should know that. I wonder how much of the 10 million will be allocated for malpractice suits? And for your information,catheters ARE being changed by MA and staff nurses in ALL Government clinics and hospitals already!.

The real issue is all along we did not cater for the health of the rural poor and now giving them peanuts is actually no big deal. In this modern time and age, we should have already one sizable clinic in every kampung and mobile ones for more remote areas. Instead we have hospitals worth millions that grow fungus or are structurally unsound. The truth is much public money has been spent with little progress. Satu lagi projek Barisan Nasional. So don't be conned by this Ismail Merican with his little crumb hand-outs.


dranony said...

Has the DG addressed the fact that, under the Medical Act 1971, any place of treatment that is called a "clinic" MUST be manned by a Registered Medical Practitioner (that means a doctor with a valid Annual Practicing Certificate). Anyone who operates a "clinic" while NOT being a Registered Medical Practitioner, is in violation of the Medical Act 1971.
And the offender is liable to a fine of RM2,000, and imprisonment up to Two Years (for subsequent offences)!
By setting up these "clinics" and promoting them, would the DG be, in fact, aiding and abetting such violation of law?

dranony said...

A clarification:
Doctors are NOT against the good jobs performed by Medical Assistants.
However, the law states clearly that the scope of their duties require that they are under the supervision of Medical Officers.
Furthermore the law does NOT differentiate between private medical clinics and government clinics, in limitations of the scope of MAs.
But since the DG has insisted that private clinics must NOT be operated by MAs, surely the same prohibitions should also be imposed upon government clinics too.