Liow, what’s happening to basic
healthcare services at clinics, hospitals?
By Chua Jui Meng
AS A
FORMER Health Minister, I abhor complaints of the people being denied
healthcare services in government clinics.
Health
Minister Liow Tiong Lai must seriously look into the complaint of a pensioner
who was denied his normal blood test check-up in a clinic in Negri Sembilan.
The
retired civil servant’s complaint was highlighted by cpi (Centre for Policy Initiatives) and if valid, it is worrisome
for Malaysians (see cpi posting
reproduced below).
The
pensioner claimed he was told by the doctor
that he could not carry out the usual blood tests for him because the service had
been discontinued at clinics as well as government hospitals in Negri Sembilan.
The directive to stop blood tests in
government clinics and hospitals is supposedly from the (federal) government.
Liow! Where are you? You must
clarify and explain what is going on in your ministry?
Why is this happening? Is the
government trying to save money because of all its plundering and emptying of
the national coffer or is it an attempt to enrich the private sector healthcare
providers who will then make quick bucks on blood tests?
I pray it is not because of
financial constraints that this is happening.
If the government can just squander
away RM250 million on “Cow Minister” Shahrizat’s family, I don’t see why there
should be any problem providing sufficient basic healthcare to the people.
Liow must quickly clarify or explain
such shoddy healthcare services dished out by the government clinic in Negri
Sembilan.
In any civilised or developed
country, the healthcare of its citizens is top priority.
The government is duty-bound to
provide basic medical treatment and healthcare services to the poor and
low-income families.
It is the people who drive a nation.
They cannot afford to be unhealthy or medically unfit.
The long queues of patients at
government clinics and hospitals, especially in Sabah and Sarawak, are telling.
It only tells us that the health
ministry’s efficiency and services have declined drastically in the last
decade.
According to an Oct 1, 2012, report
by THEEDGE (http://www.theedgemalaysia.com/index.php?option=com_content&task=view&id=221760&Itemid=77), the Federation of Private Medical Practitioners’
Association Malaysia said the government must give more thought to the 1Malaysia
Clinics to fully serve the urban poor.
Its president Dr Steven Chow said
the RM20 million Budget 2013 allocation for 70 additional 1Malaysia Clinics was
insufficient.
Prime Minister Najib Abdul Razak had
announced RM19.3 billion for operating expenditure and development expenditure
in the health industry.
That is no small amount but if it is
not enough, then it should be topped up.
There is also the question of
whether the allocations had been prudently managed.
When a government starts faltering
on medical and healthcare services to the people, it is a sign that the
national coffer is in dire straits.
What remains, if any, is the most
important question for Malaysians to ask the Umno-led Barisan Nasional federal
government.
I echo cpi’s concern in asking whether this is the tip of the iceberg of a
medical crisis.
Here’s the cpi posting:
Tip of the iceberg of a medical
crisis?
Written by Anonymous Wednesday, 19
December 2012 11:55
Commentary
CPI's introduction
We received a letter of complaint on
public healthcare services in Negeri Sembilan.
A ruling has been issued stating
that blood tests for many medical conditions can no longer be carried out by
the government hospitals and clinics in the state.
We are reproducing the complainant's
letter in its original Bahasa Malaysia as well as providing a translation of
the text in English (see below).
We have discussed with various
doctors the likely impacts of this ruling on discontinuing blood tests.
Prospective patients, healthcare workers and the general populace should be
made aware of these.
The consequences include:
- Cancer detection. Patients who have undergone surgery or chemotherapy for cancer now cannot check for the recurrence of the following cancers (the relevant blood test are here cited): colon cancer (CEA), prostate cancer (PSA blood), ovarian cancer (CA125) and testicular cancer (AFP).
- HIV detection. It cannot now be confirmed whether patients have HIV or not. For patients already being treated for HIV, the progress of their treatment cannot be monitored (CD4/CD8 counts).
- Diabetes monitoring. The gold standard for monitoring a patient's blood sugar level (HbA1c) in government diabetic clinics in the state will no longer be available.
- Drug abuse. Tests that are required to identify new candidates for drug rehabilitation programmes, like the methadone programme, cannot now be done (HIV; Hepatitis B and C). Monitoring cannot be done to ensure that patients are not taking illicit drugs such as cocaine, morphine and amphetamines (urine drug tests for these).
- Epilepsy tests. Epileptic patients who are not responding well to medical treatment for seizures need certain tests to determine the correct concentration of a prescribed drug for treating seizures effectively. These tests are now not available (carbamazepine, phenytoin, valproic acid). Without these tests, doctors cannot check whether the patient is being correctly medicated for seizures, or whether the patient will require a different drug.
See the complaint letter for more
information.
This matter has broader
implications. These are:
Poor patients now have to resort to
private healthcare
Given that these tests now cannot be
done in public hospitals and clinics, patients might have to go to private
hospitals or private blood testing companies. This is a financial burden for
lower and middle income patients, particularly in a belt-tightening economy.
The performance of doctors would be
affected
In a setting where blood test
information and/or medicine supplies are lacking, the judgement and services of
the government doctors will likely be impaired. This would be to the detriment
of the patients. There could occur a kind of triage situation where only
the most urgent cases will receive treatment while other patients who still
need treatment may be denied it.
Rationing could mean queues and
bottlenecks at hospitals
The rationing of blood tests or even
medicine supplies might mean that there could be bottlenecks or queues at the
affected hospitals and clinics. Aside from inconveniencing sick patients, this
could further strain the operations of hospitals and clinics. Hospitals
elsewhere might have to cope with the possible spillover of patients from the
affected hospitals.
A sign of other crises
If a basic and critical part of
healthcare such as blood tests cannot be carried out because of financial
difficulty, other areas of healthcare are also likely to have been affected,
such as the provision of medicines and health programmes (e.g., diabetes and
smoking cessation), which is indeed the case. The possibility cannot be
discounted that this Negeri Sembilan episode may be the tip of the iceberg of
bigger financial misgovernance. It forces open questions about the actual
health of our country's finances.
The authorities should respond
swiftly given the gravity of this complaint. Other stakeholders might want to
investigate the efficacy and integrity of our public health system. The
adequate provisioning of basic needs for the people cannot be compromised in
any properly managed country.
*****************
From: XXX
To: The authorities concerned
December 14, 2012
Urgent Crisis: Important Blood Tests
No Longer Available at All Negeri Sembilan Hospitals and Health Clinics Due to
Lack of Funds
Salutations.
I am a retired Malaysian civil
servant and diabetic patient with a thyroid problem.
I need to do blood tests to check
that my thyroid level is healthy.
Two days ago I sought treatment at a
government health clinic in Negeri Sembilan.
The doctor said he cannot carry out
the usual blood tests for me.
I was surprised to be told that
blood tests have been discontinued at the clinics as well as government
hospitals in Negeri Sembilan.
I was informed that this directive
is an order from the government.
Quite recently, the shortage of
medicines in government hospitals and clinics was debated in Parliament and the
matter remains unresolved. Now (we’re told) even blood tests cannot be carried
out.
It defies logic that a crisis such
as this can occur in a peaceful and prosperous country like ours. If we were a
war zone like Gaza in Palestine then it could make better sense that blood
tests and medicines could not be provided. How is it possible that our
situation in Negeri Sembilan has become akin to that in a conflict zone?
A total of 50 blood tests have been
listed as discontinued, and they include important ones such as:
- Tests for HIV
- Tests for cancers
- Tests for dengue fever
- Control tests for diabetes
- Tests for hepatitis B and C
- Follow-up tests for thyroid
treatment
- Tests for thalassaemia
- Tests for infertility
I received information that blood
testing is unavailable because the government has no more financial allocations
for laboratory materials.
In fact, it is said that laboratory
materials worth RM500,000 procured earlier were obtained on credit (that is, by
incurring debt) from medical suppliers .
Many patients including myself have
given blood samples but it is likely that these samples will be discarded as
the blood tests will no longer be carried out.
This is a waste of the rakyat's time
and the rakyat’s money.
I am angry and disappointed with the
lackadaisical attitude shown in dealing with this serious matter.
It is not logical when the federal
government can afford to spend millions of ringgit on KR1M/BR1M handouts and on
bonus payments to the civil servants.
What use is all that if the
government does not have a single sen to guarantee the provision of a basic
service in public healthcare?
The Negeri Sembilan government
announced last week that it obtained a 'smart city' grant of USD400,000 (~RM1.2
million) from the IBM computer company for the state.
Is the ‘smart city’ status a greater
priority than the health of the suffering masses?
I hope that my complaint will open
the eyes and hearts of our leaders and that immediate action can be taken for
the basic wellbeing of the people.
Thank you.
STILL SERVING THE COUNTRY
A retired civil servant
Daripada:
XXX.
XXX.
_____________________________________
Kepada:
Pihak-pihak yang berkenaan.
14 Disember 2012
Krisis Gempar: Ujian-ujian Darah Penting Tidak Lagi Dapat
Dilakukan Di Semua Hospital Dan Klinik Kesihatan Di Negeri Sembilan Kerana
Kekurangan Wang
Salam sejahtera.
Saya seorang pesara kerajaan Malaysia
dan pesakit masalah tiroid dan kencing manis.
Saya perlu melakukan ujian darah
untuk memastikan paras tiroid dalam badan saya adalah sihat.
Dua hari lepas saya telah pergi ke
sebuah klinik kesihatan kerajaan di Negeri Sembilan untuk mendapatkan rawatan.
Doktor memberitahu saya beliau tidak
boleh lagi melakukan ujian darah untuk saya.
Saya terkejut apabila saya
diberitahu bahawa kebanyakan ujian darah telah diberhentikan oleh
klinik-klinik mahupun hospital-hospital kerajaan di Negeri Sembilan.
Saya dimaklumkan ini perintah
daripada pihak kerajaan.
Lewat-lewat ini, masalah kehabisan
bekalan ubat di hospital-hospital dan klinik-klinik kerajaan telah dibahaskan
di Parlimen dan perkara ini masih belum selesai. Sekarang ujian darah pula
tidak boleh dibuat.
Pelik sekali krisis seperti ini
boleh berlaku di negara kita yang aman dan makmur. Boleh diterima sekiranya
ujian darah dan pemberian ubat tidak dapat dilakukan di zon peperangan seperti
Gaza di Palestin, tetapi apakah situasi di Negeri Sembilan sudah tenat
seperti di kawasan peperangan?
Bayangkan, sejumlah 50 ujian
darah telah disenaraikan tidak dapat dilakukan lagi. Ini termasuklah
ujian-ujian darah yang mustahak seperti:
- Ujian untuk HIV
- Ujian untuk penyakit barah/kanser
- Ujian untuk demam denggi
- Ujian kawalan untuk kencing manis
- Ujian untuk hepatitis B dan C
- Ujian untuk rawatan lanjutan tiroid
- Ujian untuk penyakit 'thalassaemia'
- Ujian untuk pasangan kurang subur
- Ujian untuk penyakit barah/kanser
- Ujian untuk demam denggi
- Ujian kawalan untuk kencing manis
- Ujian untuk hepatitis B dan C
- Ujian untuk rawatan lanjutan tiroid
- Ujian untuk penyakit 'thalassaemia'
- Ujian untuk pasangan kurang subur
Saya menerima maklumat bahawa ini
berlaku kerana kerajaan negeri tidak ada peruntukan wang lagi untuk
membeli bahan ujian makmal.
Malahan bahan ujian makmal
bernilai RM500,000 yang diperolehi sebelum ini dikatakan didapati secara
pinjaman (atau hutang) daripada pihak pembekal.
Ramai pesakit termasuk saya sudah
memberikan sampel darah mereka tetapi kemungkinan semuanya terpaksa dibuang
sekarang kerana ujian-ujian darah tidak dapat dibuat lagi.
Ini satu pembaziran masa dan wang
rakyat.
Saya marah dan kecewa dengan sikap
sambil lewa yang ditunjukkan dalam menangani perkara yang serius ini.
Tidak logik apabila kerajaan pusat
mampu membelanjakan berjuta-juta ringgit untuk KR1M/BR1M dan untuk wang bonus
pegawai kerajaan.
Apakah gunanya semua itu kalau
kerajaan tak mempunyai satu sen pun untuk menjamin kepentingan asas seperti
kesihatan rakyat?
Minggu lepas kerajaan Negeri
Sembilan mengumumkan penerimaan geran bernilai USD400,000 (~RM1.2 juta)
daripada syarikat komputer IBM untuk menjadikan Negeri Sembilan 'bandar
pintar'.
Apakah status 'bandar pintar'
diutamakan manakala kesihatan rakyat yang menderita dikebelakangkan?
Semoga keluhan saya ini membuka mata dan hati para pemimpin kami dan tindakan segera dapat diambil demi kebajikan asas rakyat.
Semoga keluhan saya ini membuka mata dan hati para pemimpin kami dan tindakan segera dapat diambil demi kebajikan asas rakyat.
Sekian.
MASIH BERKHIDMAT UNTUK NEGARA
Seorang pesara kerajaan Malaysia.
