Parents refuse to honour children’s pledge after their deaths

Star, 15th May 2008

PENANG: Some parents are refusing to honour the pledge of their children who have agreed to donate their organs upon their death.

This is one reason for the low number of cadaveric donors (deceased donors) in the country.

Penang Hospital Nephrology Services head Datuk Dr Rozina Ghazalli said according to Health Ministry records, 112,300 Malaysians had pledged to donate their organs from 1997 till March 31 this year.

“However, the actual donors was only 214 from 1976 till March 31 this year,” she told The Star in an interview here on Tuesday.

Dr Rozina said some parents refused to allow doctors to remove the organs of their beloved ones because they were in doubt of the wishes of the deceased.

“Even if a person pledges his organs, his relatives are still required to give consent upon the donor’s death before the organs can be harvested,” she said.

Dr Rozina said another reason for poor organ harvest was the failure of doctors to explain to the family the meaning of “brain dead” – the patient is technically dead but the family members still want to hold on.

“In such instances, the doctors do not want to be seen as vultures waiting to get the deceased person’s organs or to be seen as not doing their best to save the patient’s life,” she said.

Dr Rozina said although all religions encourage the act of compassion to save lives, Muslims in particular were still reluctant to donate organs.

“They think it is disrespectful for the dead to be buried with organs missing although there is a fatwa which allows Muslims to donate their organs,” she said.

Dr Rozina pointed out that with the numerous campaigns organised by hospitals and the Tissue and Organ Procurement teams in the 16 government hospitals, the number of pledges by Muslims had increased from 2% in 1997 to 12% in 2007.

The highest number of actual donors were Chinese (52.4%), followed by Indians (26.6%) and Muslims (6.1%).

Those interested in becoming a donor can contact the National Transplant Resource Centre at Kuala Lumpur Hospital at 03-2615-6576 / 2694-2704 or the Transplant Resource Centre at Penang Hospital at 04-222-5780.

Retirement age now 58

Star, 11th May 2008

PUTRAJAYA: The mandatory retirement age for civil servants has been extended from the current 56 years to 58, effective July 1.

Civil servants now have a choice of opting to retire at 56 or work until they reach 58.

Among the goodies announced by Prime Minister Datuk Seri Abdullah Ahmad Badawi was discontinuing the written test for Grade 1 to Grade 16 officers under the civil service Efficiency Level Assessment (PTK).

He, however, said the PTK would not be abolished but its methods would be improved from time to time.

The PM also said effective Jan 1 next year, the calculation of pension for pensioners and pension recipients would be based on a maximum of 30 years of service compared to the current 25 years.

However, the recalculated pension will only be paid from Jan 1 next year without any arrears.

Abdullah said the decision to increase the retirement age was made based on Malaysians’ current lifespan.

He added that based on a government study, extending the retirement age would not affect the employment opportunities of fresh graduates.

“The new generation of public employees should not feel there is a slimmer chance for career development; instead, it should be better,” Abdullah said during the public sector Workers Day celebration here yesterday.

Abdullah also announced the abolition of the depreciation of derivative pension received by the next of kin, starting Jan 1 next year. Currently, the next of kin receives only 70% of the pension after a lapse of 12½ years.

“Studies showed that this had posed a financial burden for families with young children, so the Government agreed to abolish the depreciation of the derivative pension, meaning that 100% of the pension will be paid to the next-of-kin,” he said.

The Government, he said, agreed that parents of civil servants who had passed on without leaving behind any heir would get a lump sum ex-gratia payment.

On Cuepacs’ other demands such as a review of the housing allowance and the absorption of contract employees as permanent staff, he said the Government was still studying them and would announce its decision before tabling the 2009 Budget in Parliament in August.

He said the Government always had the people's interest at heart.

“If I can make you all happy and enjoy a better standard of living, why should I deprive you of this? If today I cannot (give what you demand), I hope I can do so later,” he said.

Come back and we’ll treat you right, Malaysian medical specialists told

Star, 11th May 2008

Health Minister Datuk Liow Tiong Lai said the ruling was being reviewed as the Government wanted to attract Malaysian doctors home.

Currently, all doctors are required to undergo three years of public service in government hospitals.

“We are making it easier for Malaysians who want to come back and practice. A one-stop centre has been set up to help facilitate their return,” he said.

Liow said there was no way that the Government could match doctors' salaries offered at private healthcare institutions.

He said about 1,500 medical students graduated from public universities each year, and another 1,500 from private institutions. “We have housemanship and the compulsory service, but after that, they leave for private practice, so we are short (of doctors).”

Liow said only 60% of the positions for doctors in Government hospitals and clinics were filled, and encouraged doctors in the private sector to help ease the shortage.

“Giving more money (higher salary) is not the way to solve the shortage. We need to find a mechanism where private and government doctors can work hand-in-hand,” he said.

Liow said private doctors who helped out at public hospitals were paid RM80 per hour, and added that they should consider the act as a social obligation and national service.

“They can come (help) on their day off,'' he said after launching Sunway Medical Centre’s outpatient satellite clinic in Damansara Heights.

“Let us keep in mind that the practice of medicine is a noble art, not a trade; a calling, not a business.”

Later, when launching World Lupus Day in Bandar Utama, Liow said that a national registry of systemic lupus erythematosus (SLE) patients would be set up to monitor the disease among Malaysians.

He said the exact number of SLE (commonly known as lupus) patients in the country could not be ascertained as there was no registry. “It is important to diagnose and treat lupus early because it can cause disfiguring rashes and scarring, multiple miscarriages, kidney, heart and lung failures, impaired neurological function, strokes, heart attacks and even death,” he said.

Liow said SLE was an auto-immune disease in which the body produces antibodies that attacked its own organs. It can affect virtually any system in the body, particularly skin, heart, lungs, kidneys and brain.

“It is like a self-allergy where the body’s immune system runs riot.''

Liow said the Ministry would grant RM250,000 to the SLE Association to help kick-start the formation of the registry.

Health Ministry did act on complaint

Star, 2nd May 2008.

I REFER to the letter “No action taken to nab bogus doctor” (The Star, April 30). I would like to respond to the comments made with regard to the Private Healthcare Facilities and Service Act 1998 (Act 586) and the issue related to insurance companies.

He stated that the Act “seems more interested in penalising genuine doctors than bogus doctors”.

He notified the Health Ministry (MOH) about a bogus doctor working in the emergency department of a private hospital. We acknowledge receiving such a complaint and would like to clarify matters.

The complainant first wrote to the Malaysian Medical Council (MMC) on Sept 20, 2007, to inquire about the registration status of one foreign doctor, a Myanmar citizen, formerly employed by Universiti Malaya Medical Centre.

MMC referred the case to MOH for investigation. Subsequently, the MOH received another letter from the complainant regarding this matter.

The enforcement team of the Health Department of Federal Territory, Kuala Lumpur, visited one of the facilities of the alleged group hospital but could not trace the said doctor.

Another team from the Selangor State Health Department went to another hospital of the same group but was told that the service of the said doctor had been terminated.

Following this, the MOH issued a warning letter to the private hospital not to employ any non-registered medical practitioners. The latest follow-up visit by MOH officials on March 13, 2008, revealed that the group hospital has stopped engaging him.

I would like to remind all private hospitals and clinics to check the registration status and Annual Practising Certificate of any locum doctors they wish to employ.

It is the responsibility of the licensee or the holder of the certificate of registration to ensure that this requirement of engaging doctors be complied with, as provided for under Section 31(1)(c) of Act 586.

To date, the MOH has acted on 37 healthcare facilities with 39 offences (with one facility having two offences), 17 of which were operating without registration/licence and another 13 guilty of employing unregistered practitioners.

Three cases have been prosecuted. One pleaded guilty and two others are being heard. The rest of the cases are awaiting prosecution by Deputy Public Prosecutors.

Act 586 is effective in ensuring that bogus doctors are not wilfully employed by private hospitals or clinics. However, the law does not provide powers to prosecute bogus doctors directly.

To address this anomaly, the Medical Act 1971 is being amended.

With regard to the insurance issue raised in his letter, the MOH is addressing this issue by registering all Managed Care Organisations (MCO), including insurance companies that deal with patient care.

In addition, we will gazette them as health-related services, which will then allow us to regulate the MCOs under Act 586.

I hope the writer can contact me directly via e-mail (ismailmerican@moh.gov.my) or any of my officers should he have more information regarding any hospital or clinic that employs unregistered doctors. I also welcome any suggestions to improve our healthcare services.

TAN SRI DR HAJI ISMAIL MERICAN,
Director General Of Health, Malaysia.

Hospital review apt in costly times

COMMENT
By TOMMY LEE

Star, 2nd May 2008.

The staggering fees charged by private hospitals and the competency of doctors at 24-hour clinics are matters that the new Health Minister needs to deal with to ensure good and affordable healthcare reaches the rakyat.

THE recent statement by Health Minister Datuk Liow Tiong Lai that private hospital charges for room, equipment and medicine will be reviewed is certainly timely, especially when the rakyat is faced with spiralling prices of goods.

Although the announcement augurs well for the people, the minister must show the public that he means business and is not just paying lip service.

He should walk the talk and see to it that these hospitals balance their profit impetus with compassion by providing affordable health care for the people.

There have been far too many complaints of patients being charged exorbitant fees after undergoing treatment at private hospitals.

I remember a friend telling me sometime ago that her grandmother was taken to a private hospital in Sungai Petani where the doctors removed a fish bone stuck in her throat.

The bill came up to a whopping – and absurd – RM3,000. Any patient would have choked on seeing the bill.

It was a non-invasive procedure. I was told that the doctors knew the lady was from a rich local family.

Here is a fine example of overcharging. Similar laws and punishment meted out on traders profiteering from overpriced goods could perhaps be introduced for hospitals to check indiscriminate charges.

Then there was also a case of either wrong diagnosis or was the doctor suffering from “money face” disease?

Another friend went to a private hospital in Penang complaining of severe stomach pains and diarrhoea.

After examining her, the doctor told her that she has to be immediately admitted for surgery for acute appendicitis.

Not knowing what to do, she called her father who advised her to get a second opinion.

She went to another private hospital and, to her relief, was told she was suffering from an upset stomach as a result of some food that did not agree with her. It has been three years now and her appendix is fine.

These are just some anecdotes. There must be many, many more. Can the ministry do something about it?

Last week, the minister said that he would instruct his director-general to set up a committee to conduct a thorough study on the issue of private hospital fees.

He should get this committee established and functioning soon. It would be better if the committee is also given the task of drawing up a list of reasonable charges.

Of course these charges would vary as hospitals might argue that their rooms were of five-star quality and so forth.

A watchdog body, along the lines of the government hospital board of visitors, could perhaps be set up to ensure private hospitals adhere to a list of fair charges. Complaints could also be channelled to such a body.

However, not all hospitals are overly profit-conscious. There are compassionate hospitals that set aside funds to help the needy. One notable one is the Penang Adventist Hospital that has so far sponsored 450 heart surgeries.

Its community relations coordinator Chin Hsien Hui said the hospital set up its heart fund in 1988 and has so far disbursed RM5mil for heart surgeries for the needy.

Another matter the minister might want to look into is the 24-hour clinics in the country.

They should be well equipped to handle emergency cases and have proper equipment to deal with common emergencies such as heart attacks and strokes.

More importantly, attending doctors should also be competent and able to cope with emergencies such as this at the clinics.

This competence can be critical. Ten years ago, on the first day of Chinese New Year, I rushed my father to the nearest 24-hour clinic after he complained of chest discomfort after dinner. I thought he had indigestion. He certainly had no history of heart disease.

The doctor took his blood pressure and took some blood for tests, then he asked my father to go to the next room to have a chest X-ray.

My father sat down on the bench after the X-ray and suddenly began gasping for air.

I immediately called the doctor who rushed out and did not appear to know what to do.

He looked helpless and kept saying my father was having a stroke. Someone must have called an ambulance, because it came 20 minutes later while the panic-stricken doctor had earlier placed some kind of breathing apparatus over my father's mouth.

I followed the ambulance in my car and when I arrived at the hospital, I was told my father had passed away. My experience could be an isolated case and out there thousands of patients visit 24-hour clinics everyday.

If doctors are competent and such clinics are better equipped, we can be assured of proper treatment. This is another area the minister might want to look into.

As for private hospitals, it is time to consider some “national service” or better still, call it “dana”. It is good for the soul. As they say, it blesses him that gives and him that receives.

No action taken to nab bogus doctor

Star, 30th April 2008.

I REFER to the various articles in The Star on the PHSFA (Private Healthcare Services and Facilities Act). In my opinion, the Medical Act 1971 is enough; the only thing lacking is enforcement.

Sad to say, the PHSFA is lacking in enforcement to catch bogus doctors. It seems more interested in penalising genuine doctors than bogus doctors.

This has been demonstrated in the case of a bogus doctor working in the emergency department of a private hospital for the past few months. The MOH was notified but refused to conduct any raid to catch him.

The bogus doctor was let off without even a warning and so was the private hospital. The bogus doctor nearly killed a few patients because of his lack of knowledge.

The MOH refused to act even though it had been informed of the days and time the bogus doctor was working. The private hospital even promoted the culprit responsible for hiring the bogus doctor, who is still around working in various clinics.

The MOH can still act to persecute the hospital as the bogus doctor has worked in the hospital emergency department for several months, and all the records, his signature on prescriptions, medical certificates, death certificates are there. Witnesses are aplenty – consultants, doctors, nurses, attendants, patients – they can testify that he worked there.

The reluctance of the MOH to persecute is baffling. Is it due to political influence or is it trying to cover up?

The same private hospital has also been cheating patients and insurance companies by charging patients for non-existent products that the patients never used. Patients have not complained because they are not aware of this as their bills are paid by the insurance companies.

Even though the insurance companies pay because the patients are covered by insurance, it is still cheating the patients because the patients have an annual limit. The insurance companies should blacklist and boycott this hospital.

The specialists in the hospital also cheat the insurance companies by admitting patients for general check-ups and altering the diagnosis of patients.

There is widespread cheating of the insurance companies by specialists. Consultants charge exorbitant fees and make unnecessary visits amounting to five or six times a day. Patients are charged consultant fees even for a simple hello by the consultant. In the end, the public suffer as the premiums go up.

ANOTHER DOCTOR,
Kuala Lumpur.