The Socialist Party of Malaysia (PSM) is extremely disappointed to hear from Health Minister Dzulkefli Ahmad that the “Madani” (civil and compassionate) government is thinking of opening private wings in government hospitals around the country under a new programme termed “Rakan MOH” (Friends of the Ministry of Health).
The previous avatar of this retrogressive plan – then termed the “full-paying patients” scheme – was first announced by the then Barisan Nasional government in 2007.
PSM then rallied a coalition of NGOs and activists to object to this plan by organising a series of protests, including at the four government hospitals (in 2011) that had been selected to expand this scheme.
These PSM-civil society protests resulted in the deferment of the further implementation of the scheme for a couple of years. But after that, the government implemented the full-paying patients scheme without fanfare in 11 general hospitals across the country.
PSM rallied people against the scheme because we genuinely felt that it would be bad for the ordinary person.
The problem with our government hospitals is that we do not have enough senior, experienced specialists to treat more complicated cases and to train younger specialists.
About 75% of the specialists with over 10 years of experience post-specialisation are in private hospitals, which have mushroomed across the country.
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This leaves only 25% of this group of senior specialists in government hospitals, where, up till now, over 75% of the in-patients are being treated and where a new generation of specialists are being trained.
The chronic lack of experienced specialists translates into very long waiting times for patients with complicated conditions, delays in diagnosis and treatment, and misdiagnoses.
It also translates to inadequacy of training programmes for younger doctors trying to specialise and more stress for junior doctors who have to handle the heavy patient loads without adequate back-up.
This is why we protested against the full-paying patients scheme back in 2011.
Its surreptitious implementation in 11 hospitals in the years that followed has demonstrated very clearly that our apprehensions about the scheme were largely correct.
The scheme allows senior doctors to see private patients “after office hours” in government hospital premises and charge them private rates.
Many senior government specialists took part in the scheme judiciously and limited their private patient time to less than 10 hours per week.
But there were a significant number who expended excessive time to seeing their private patients. These over-enthusiastic specialists were able to earn more than twice their government salary through this scheme.
But this had a deleterious effect on the morale of other specialists who had to bear the responsibilities of looking after ordinary “non-paying” patients. It also affected the training of young specialists.
If you dig a little deeper, the full-paying patients scheme actually creates a serious conflict of interest for the specialists who participate in it.
Patients will only come to the full-paying patients’ clinics if the waiting list in the free public clinic is too long and the service there a little ‘suspect’.
One of the responsibilities of senior government specialists, who are mostly heads of their respective departments, is to improve their unit’s performance – in terms of waiting times and the competence of junior specialists in their department.
But a better run, efficient public clinic would mean fewer patients for the full-paying patients clinic.
We know, with certainty, that the MoH has asked the hospitals implementing the full-paying patients scheme to carry out internal audits regarding the impact of the scheme on patient care, junior doctor training and morale of government doctors.
We have heard that many of these internal audits are quite critical of the scheme, having identified numerous shortcomings.
Has the current health minister taken a look at these internal audits? Perhaps he should, and if they aren’t as bad as PSM has been told, release them for public viewing before implementing the avatar of the full-paying patients scheme – the “private wings” scheme.
PSM would like to remind our friends in the Madani government that they came in with the promise of reforming the government to benefit the common people. We totally understand they are concerned about the RM1.2tn sovereign debt that the government is facing, and their desire to reduce the budget deficit from its current 5% of gross domestic product (GDP) to 3% or lower. We get that.
But what we strongly disagree with is any measure that in effect transfers resources away from the ordinary people on the street. Our healthcare system is struggling with a shortage of senior specialists. Any measure that reduces the availability of specialists for the people is totally unacceptable. We consider it extremely irresponsible.
Why irresponsible? Because you, Madani, are the government. You have much more power than we had when we were together in opposition criticising the BN government.
You must use your position and power to address the difficult questions like, how is it that in a country whose GDP in real terms has increased 25-fold in real terms (ie after discounting for inflation) over the past 50 years, government revenue has dropped from about 30% of GDP 50 years ago to its current 14%.
This is the crux of the problem, isn’t it? An increasingly smaller portion of the income this country is generating is accruing to government.
That is why the government does not have enough funds to spend on healthcare, start an old age pension scheme, accelerate the transition to green energy, rehabilitate our rivers and forests, and upgrade our management of municipal waste. All of these are not profitable ventures, and thus will be not be undertaken by the private sector.
In a properly functioning economy, a reasonable proportion of the wealth collectively generated by society must be channelled to the government to fund all the programmes and services that the private sector is not interested in.
Unfortunately, in Malaysia, as well as in many other countries, the proportion of societal wealth that is being allocated to make life better for all the people is diminishing over time.
Why is this so? Can it be reversed? These are the crucially important issues that the government must look into?
Are you guys in the Madani government even addressing these issues? That would be a responsible exercise of the powers that the people have entrusted to you.
If, instead of looking to address the misallocation of the income of the country, the Madani government persists in poorly thought-out policies that affect the wellbeing of the people, do not expect PSM to look the other way.
Our public healthcare system is a concrete expression of our people’s desire to create a caring, inclusive society premised on the solidarity of all the people living in this country. Our public healthcare system, in a very real way, defines the ‘soul’ of the nation.
Any measure that degrades our public healthcare system is a bright red line for not only PSM but also for many civil society groups. Please do not cross it.
- Tegakkan maruah serta kualiti kehidupan rakyat
- Galakkan pembangunan saksama, lestari serta tangani krisis alam sekitar
- Raikan kerencaman dan keterangkuman
- Selamatkan demokrasi dan angkatkan keluhuran undang-undang
- Lawan rasuah dan kronisme
Reduce road crashes
Sadly, 7,000 people in Malaysia die on the road each year due to road crashes over the last 10 years (the lower deaths in 2020 was due to movement restrictions).
One former minister lamented that every life lost costs the country RM1m for that life lost, plus another RM1m to treat other victims who don’t die and another RM1m for loss of productivity and time wasted. This does not include the mental stress and emotional upheaval among the victims and their families.
If the minister’s estimate is correct, every year the country loses about RM21bn due to road crashes and accidents. This savings can be directed to MOH budget.
More hospital beds will be freed up if road crashes victim reduces.