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SEPTEMBER , 2023 | THE HEALTH
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As for private healthcare , she said the current consultation fee limits for private general practitioners ( GPs ) set by Schedule 7 of the Private Healthcare Facilities and Services Act ( PHFSA ) of 1998 need urgent deregulation .
Currently , GPs can only charge between RM10 and RM35 for a consultation , while MOs or Medical Officers ( who are on the same level as private GPs in terms of qualifications ) in private hospitals can charge between RM30 and RM125 under Schedule 13 .
“ The MMA had set these rates in 1992 as a guide , and the MoH adopted it and legislated it in 2006 . According to the law , these rates should be updated from time to time , but this has not happened , for reasons known only to the Ministry of Health ,” she said .
The private GPs are also facing issues with Third Party Administrators ( TPAs ) or Managed Care Organisations ( MCOs ). A number of the TPAs charge private GPs substantial registration fees of up to RM5,000 just to be appointed as a panel clinic .
Some TPAs have also been obtaining revenue through fee-splitting , which is illegal in medical practice . Additionally , TPAs are not regulated by any authority .
SUPPORTING NATIONAL MEDICAL ASSOCIATIONS
Meanwhile , CMA President Dr Muruga Raj said the CMA was developing a mobile app to connect all the national medical associations ( NMAs ) and individuals to improve knowledge sharing and networking among Commonwealth members and enhance medical student exchange programmes .
“ With this app , we will be able to join as members , share our events , our scientific webinars , our healthcare workshops and our ideas with all our members in the 56 countries .”
Student exchange , he explained , is done via Medical Universities and the individual students .
“ We are working on getting at least one national medical university from each country to accept Commonwealth medical students to give them better insights into the global healthcare status .
“ We also recently signed up with St . Lucia Spartan Medical Universities to conduct short courses for our members , and all these can be done via our new app that will be launched in about two weeks .
“ CMA also will verify health care courses and give CPD points to those who attended the course . These points are
Dr Muruga Raj ( right ) was elected last year to head the CMA .
needed to renew our Annual Practicing Certificate ( APC ).”
CMA , established in 1952 , is a non-governmental organisation with the primary goal of supporting and enhancing the capacities of NMAs of countries within the Commonwealth to improve the health , well-being and human rights of their countries and communities .
Dr Muruga , who is immediate Past President of the MMA , took over as CMA President on Nov 5 , 2022 , succeeding Dr Osahon Enabulle , the current World Medical Association President .
According to Dr Muruga , universal health coverage ( UHC ) is the most important and urgent health care issue that needs to be addressed in Commonwealth countries .
“ We have issues about UHC in some of the poorer Asian and African countries .
“ We are currently working together with other NMAs on UHC , as well as digitalisation of healthcare , impact on health due to climate change , healthcare workers safety , and vaccination programmes for some countries .”
ELEVATING HEALTHCARE THROUGH NEEDFUL REFORMS
On healthcare reforms in the country , Dr Azizan stated that the Health White Paper has already set the direction for the healthcare system and the reforms that are needed .
“ Engagement with experts to see the reforms through should continue , along with the setting of timelines and careful budgeting in allocations to carry out the reforms
Dr Azizan Abdul Aziz
within the planned timeframe .
“ Some of the reforms which may not necessarily require financial commitments such as improving the work environment through the change in work culture , ensuring transparency in selection criteria for promotions and career progression are reforms that can already be carried out .”
Planning of healthcare human resources should be the government ’ s main priority as it significantly impacts the quality of care in the present and in the future , she emphasised .
“ The healthcare needs of the population are increasing , and in seven years , the healthcare demand is expected to increase further as Malaysia will reach ageing nation status . By this time , 15 per cent of the population will be 60 years and above .
“ There are currently shortages in healthcare workers across the board ; hence , urgent planning is needed to address these gaps . The number of specialists to manage and treat common health issues of an ageing population will also need to be increased .
“ It is imperative that we support the career pathway of junior doctors as they will be the senior doctors and specialists in the future .”
She also noted that public-private partnerships will reduce MoH ’ s burden in managing the health of the nation .
“ The country ’ s primary care , which includes the 13,000 private GP clinics nationwide , should be strengthened .
“ The government should provide support to ensure the private sector , especially private GPs , can provide the best in their services rather than focusing efforts on micromanaging their physical facilities , adding burden and increasing the cost of practice .”
ADVOCATING FOR DOCTORS ’ RIGHTS AND NEEDS
Since its inception , the MMA has stood for the rights and needs of doctors and will continue in these efforts , said Dr Azizan .
“ It is one of the reasons why I joined the MMA as a houseman in 1986 , so I encourage doctors who have yet to become members to join us as you can play an active role in improving the healthcare system .
“ One of the initiatives to address workplace issues such as bullying or harassment is Helpdoc , which was launched by the MMA in 2017 .
“ Helpdoc was set up for doctors to seek help on such issues at the
National health insurance scheme should be independent |
THE INTRODUCTION of a national health insurance scheme has always been a contentious and pressing issue in Malaysia .
It is one of the longest-discussed insurance schemes in the country that has never been implemented . For over 35 years , various health ministers have never had the political will to implement such a scheme .
There had been numerous conferences , seminars , meetings , symposiums and discussions with stakeholders , but for some reason , the government could never come to a decision . Will it finally be implemented under this government ?
Commented Malaysian Medical Association ( MMA ) President Dr Azizan Abdul Aziz : “ It is one of the ideas discussed since the 1980s . However , the public ’ s trust deficit in
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the government , lack of transparency and political will were among the reasons it failed to be implemented much earlier .
“ We are happy that it is being discussed by experts now as one of the potential long-term solutions towards better , sustainable healthcare financing . There are a few models of implementation being discussed . However , it must be explored further to determine which is most suitable , achievable and practical in the Malaysian context .
She said introducing a national health insurance scheme cannot happen overnight as all the various models must be examined thoroughly . It may also need to be implemented in stages to test the scheme ’ s robustness .
“ The objective , however , should
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be to ensure equitable access to the full range of essential health services in line with the principles of Universal Health Coverage ( UHC ).”
Dr Azizan said MMA welcomes national health insurance . Still , it must be introduced under a separate Act and managed by a not-for-profit agency accountable to Parliament .
It should be independent of any ministry , with each stakeholder in the ecosystem engaged and the cost of managing the scheme clearly defined . Transitioning to healthcare digitalisation will also be crucial in managing a health insurance scheme .
“ Digitalisation can save millions in government expenditure by reducing redundancy and duplication in the current healthcare system and increasing efficiency ,” she said .
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