MPS-MMA Seminar 2010: Doctors and Pharmacists: Partners in Health Care

MPS-MMA Seminar 2010:

Doctors and Pharmacists: Partners in Health Care

Summary Points of Health MInister's Speech during the MPS-MMA Seminar 

by Dato' Sri Liow Tiong Lai:

1. Doctors and pharmacists are integral players in the healthcare team and have complementary and synergistic roles to play in ensuring that patients get optimal medical care – doctors, by virtue of their in-depth knowledge of diseases and treatment modalities; and pharmacists, by virtue of their in-depth knowledge of medicines. They must therefore be able to support each other in their important roles.

2. In the public sector, doctors and pharmacists, each with their distinct roles in prescription and dispensing, have long been collaborating and working closely with each other in patient care, often going on ward rounds together. YBMK hopes that this culture will also spread to the private hospital and community settings.

3. As of Dec 2009, we have a total of 7,298 registered pharmacists in the country (i.e. 3,716 in the public and 3,582 in the private sector), giving a pharmacist to population ratio of 1:3,878.

4. With regard to the medical profession, we have 20,929 registered doctors in the public sector and 10,344 in the private sector, giving a total of 31,273 doctors, i.e. a doctor to population ratio of 1:905.

5. In other words, as at the end of 2009, we have 1 pharmacist to every 4.3 doctors in the country.

6. In terms of private community facilities, we have 6,672 registered General Practitioner Clinics against 1,830 Community Pharmacies in the country. In other words, we have, on average, 1 Community Pharmacy for every 3.6 General Practitioner Clinics in the country.

7. The Pharmacy Division, in collaboration with the Malaysian Pharmaceutical Society, has already embarked on a geo-mapping project to see if the Community Pharmacy to General Practitioner Clinic mix in the country is sufficient for the community pharmacies to adequately serve the needs of the rakyat vis-a-vis the GP clinics, particularly in the rural areas.

8. I have also instructed the Ministry to study if the ratio of 1 doctor to 600 population and 1 pharmacist to 2,000 population, as recommended by the WHO for developing countries, or a pharmacist to doctor mix of 1: 3.3 as implied by these ratios, are adequate for the needs of this country, bearing in mind the increasing trend towards specialisation and sub-specialisation of services.

9. With these in mind, it is timely for the two professions to sit down together to discuss these issues and all other matters of mutual interest, such as the placement and distribution of this manpower, and the separation of prescription and dispensing roles, in order to serve the rakyat and the nation better in the spirit of 1Care for 1Malaysia. We look forward to their proposals.

The Sun: Flat rate contribution for healthcare scheme By Hemananthani Sivanandam

Flat rate contribution for healthcare scheme
By Hemananthani Sivanandam, The Sun, 12 July 2010, Monday, Front page news

Minister of Health, Datuk Seri Liow Tiong Lai (third left) sharing a light moment with a group of seminar participant after presenting his opening address on Malaysian Pharmaceutial Society and Malaysian Medical Association Seminar at the Medical Academies of Malaysia near Jalan Tun Razak here, today. Looking on, President Malaysia Medical Association, Dr. David Quek (second left) and President Malaysia Pharmaceutical Society, Datuk Nancy Ho (center). - Bernama

KUALA LUMPUR (July 11, 2010): The proposed National Health Financing Scheme will work on a flat rate and not be scaled to the income of the contributors, Health Minister Datuk Seri Liow Tiong Lai said today.

He said everyone needs only to contribute a set minimal amount monthly, as there will be only one standard scheme to provide primary health care for all Malaysians.

“It’s not like insurance where there are many kind of schemes. It is only one. It does not follow your salary scale where the higher you earn, the higher you pay. It’s a flat rate,” said Liow after officiating at the ‘Doctors and Pharmacist As Partners in Healthcare’ seminar today.

Liow said as such, those who want extra services will have to fork out extra or opt to buy medical insurance for themselves.

He however gave an assurance that the poor and the needy will be taken care of, even if they do not contribute to the scheme.

"Those who can’t afford to pay will be fully paid for by the government,” said Liow, adding that a cut-off point will be established for contributions, whereby those earning below a certain income level will be exempted from paying.

Asked if the scheme will affect clinics with the pre-determined flat rates paid per patient, Liow said the patients will have to pay part of the cost if the cost of their treatment exceeds the flat rate.

“They (clinics) will be paid a flat rate.... say RM40, so if the cost of the treatment and medicine is more than RM40, then the extra will have to be paid by the patient," he added.

In an immediate reaction, Malaysian Medical Association (MMA) president Dr David Quek told theSun the association is "cautiously optimistic" about the proposed scheme.

"We believe in the system but the proposed scheme may not be sustainable as the out-of-pocket cost is rising," said Quek.

He said should the proposed scheme be implemented, the premium or contribution must be low for the public to "buy into the system."

"Our policy has always been to encourage the government to provide equitable healthcare for all but we need to educate the public on this matter," said Quek, adding that MMA believes the poor and the elderly are the groups that should be given serious consideration.

Under the proposed health financing scheme every adult who earns an income has to contribute a certain amount to a fund which will be administered by the proposed National Health Financing Authority, a statutory body under the health ministry.

The scheme was first proposed during the Fourth Malaysia Plan (1981-1985) but never took off.

In June 2008, Liow however announced that the ministry would "relook" at the proposed scheme, which reportedly may take at least 10 years to be implemented as there are many areas to be looked into.

Saying the scheme is still at the proposal stage, Liow invited the public to give their feedback.

“We have engaged with the stakeholders and now we want to talk to the public. It is a big scheme. It’s a total transformation of the healthcare system."

"It cannot be done instantly and it cannot be carried out without proper, thorough planning,” said Liow adding that the public can post their feedback at his blog (www.liowtionglai.com/blog/) or at the ministry’s website. -- theSun

Bernama: Liow: Doctors’ compulsory service may be reduced

Liow: Doctors’ compulsory service may be reduced

KUALA LUMPUR, Feb 7 – Health Minister Datuk Seri Liow Tiong Lai said the government is studying the possibility of shortening the doctors’ compulsory service in public hospitals. He said the ministry was hoping to come up with the decision by this year.

“The ministry is looking at four years of service (two years of housemanship and two years of compulsory service) compared to five years (three years of housemanship and two years of compulsory service) now,” he told reporters after launching B-Nes Sdn Bhd, a company specialising in birdnest products, near here, today.

He was commenting on a statement made by Deputy Minister in the Prime Minister’s Department Senator Datuk T. Murugiah on Jan 27 that the government was looking at increasing doctors’ compulsory service in public hospitals to between five and 10 years to overcome the shortage of doctors.

He said the idea to extend the compulsory public service for doctors to five or 10 years from the current three in order to overcome the annual shortage of doctors in government hospitals, was not practical.

“We are looking at cutting it (the compulsory service) and making it more attractive for doctors to practice voluntarily in the sector. Forcing them to do so is not good,” he said.

The public sector is reported to face a shortage of between 14,000 and 15,000 from the 25,000 doctors needed, and the situation was made worse with some 300 to 400 doctors leaving the service yearly, despite about 3,000 new medical graduates entering the field at the same time.

Liow also said the ministry had issued a circular last month to standardise the working hours of house officers and medical officers in government hospitals.

“Housemanship is an important training period during which the young doctor is expected to acquire all the necessary basic knowledge and skills required to be a safe and competent doctor, including the ability to adapt to the tough and busy life of a doctor.

“However, I do not want their working hours and conditions to be detrimental to their health and learning process, nor to compromise the safety and interests of their patients,” he added. – Bernama