NST-MSQH: 1MALAYSIA CLINICS: Have qualified indicators to improve service

1MALAYSIA CLINICS: Have qualified indicators to improve service

2010/01/26
DR M.A. KADAR MARIKAR, Chief executive officer, Malaysian Society for Quality in Health 

PREVENTION and promotion of health is the cornerstone of primary healthcare and the best and most affordable way to save lives and improve overall health.
The setting up of the 1Malaysia clinics should be lauded because access to affordable healthcare is an important dimension of quality healthcare.

The issue of 1Malaysia clinics being managed by senior paramedics (assistant medical officers and registered nurses) should be an acceptable measure in times of shortage of doctors, and the Health Ministry has given the assurance that proper standard operating procedures are in place to govern the roles, responsibilities and limitations of paramedics to make sure that safe and quality healthcare services are provided to the deserving.

Continuous education for paramedics is of equal importance in maintaining their skills and knowledge.

The 1Malaysia clinics should be regarded as a "triage centre" to lessen the burden faced by the Health Ministry's community clinics (Klinik Kesihatan) and the emergency departments of government hospitals. It is well known that the majority of cases seen in the emergency departments are minor cases. With the setting up of 1Malaysia clinics, the authorities should be able to manage such cases there.

The 1Malaysia clinics should also be able to play an important role in the wellness paradigm being expounded by the Health Ministry by providing more needed preventive and promotive healthcare services.

The majority of cases seen in emergency departments are minor cases that can be treated in 1Malaysia clinics.

As one of the main advocates of safe and quality healthcare in the country, we hope that quality indicators will be set up to monitor the provision of services by 1Malaysia clinics.

Quality indicators such as the number of patients who return to a 1Malaysia clinic with the same complaint or illness after 48 hours of receiving treatment and the number of appropriate referrals to doctors may be used to assess and improve the safety and quality of services.

They may provide important feedback on whether 1Malaysia clinics should be manned by paramedics or upgraded to clinics managed by doctors.

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My Comments (DQ):

While it is good to urge for quality indicators to check on the performance of clinics, this should not be another exercise at maximising earnings for related industry players. 

The MSQH is a separate independent body which was initially set up together with MMA and APHM through the auspices and encouragement of the MOH, through an MOU signed in 1998. 

However, the MMA is undergoing a serious re-examination of its involvement due to somewhat 'opaque' processes and most importantly the procedural and ultimate goals and possible vested interests involved. 

Funding and spending processes must also be made more transparent, because this must not evolve into a personal-to-holder behemoth which is unanswerable to no one, least of all the medical profession and/or the authorities.