The Rising Cost of Halthcare Part 3

This is part of a series about the Rising Cost of Healthcare
Part 1 - Cost versus Standards
Part 2 - Measuring standards
Part 3 - Improving delivery
Part 4 - The PHFCS
Part 5 - Conclusion

Part 3
Improving Healthcare Delivery

It is true that there are problems in the current healthcare delivery system. The recent move by the Government in semi-privatizing some government hospital by creating private wings will not solve all the problems. An in depth study of the deficiencies in the current system should be done.

From simple observations, there is clearly evidence of many deficiencies as indicated by the long waiting list for surgery and procedures, wastage of investigations and drugs, the use of consultants to attend meetings and do paper work (when they should be attending to patients), lack of supervision of junior staff, low morale of medical staff, etc. Correcting these deficiencies immediately be the most direct and effective way of improving our current healthcare system.

The Never-Ending Brain Drain

For many decades the often-quoted reason is that the private sector is pinching the best staff from the public sector. Ten years ago, the call for a seamless integration of the private-public sectors seemed like the ultimate answer to this problem. Of late, this catch phrase has slowly faded from prominence. This problem deserves special attention.

The most common reason is that the monetary considerations are better in the private sector There is no doubt that doctors in private practice earn more in absolute monetary terms at the end of the month. Some doctors do leave public service because of this reason. Often this is not the only reason.

We have to accept that many of our colleagues left public service because of the “push” from government service. The so-called “temporary measure” of introducing a three-year compulsory service in the early 70’s to stem this problem has now become permanent and is still unsuccessful. With the implementation of the Private Healthcare Facilities and Services Act 1998 and Regulations 2006, better promotion prospects and allowing government doctors to do locums and after-office hours private practice, perhaps we may again see a temporary slowing down of this brain drain. Unless other measures are put in place to make public service attractive, we are afraid that with time, the market will adjust to the new landscape and the problem shall then continue.

For many years, there has been low morale in public service with constant complaints of lack of promotion prospects, lack of opportunity for career advancement and poor working conditions. Many well-trained specialist are constantly being bogged down by administrative work, attending meetings (often at short notice) instead of taking care of patients and the list goes on; almost too many to enumerate, each one a little cut of a thousand which can kill the strongest resolve to stay in public service. The good news for the public sector doctor is that of late things have indeed improved. Perhaps the time have come when the “push” from public service is replaced by the “pull” to remain in service.

In the next part we will deal with the PHCFS...