AMENDMENT TO THE 13TH SCHEDULE ( FEES SCHEDULE ) OF PRIVATE HEATLHCARE FACILITIES AND SERVICES ACT 1998

I spend yesterday morning at the Ministry of Health, Putrajaya, at an ad hoc meeting chaired by the Minister of Health, to discuss amendments to the Fees Schedule for private doctors. As we all know, the Private Healthcare Facilities and Services Act ( PHCFSA ) 1998 has attached to it, the Regulations 2006. Included in the Regulations is the 13th Schedule, which is a fees schedule for private doctors. This 13th Schedule was based on the MMA 4th schedule which was drawn up in 2002. It was 4 years out of date in 2006, and now 8 years out of date. So, we have been asking for an amendment to the 13th Schedule to increase our fees in line with inflation. Of course, the negotiations started in July 2010, but after about 7 meetings, we could only agree on about 80% of the fees. You will be surprise ( or are we ), almost all the "cutters" or surgeons, want to increase their fees by 100%. But of the Ministry's reason to allow fees increase, was because they realised that the fees now were too low, and creative doctors were unbundling their charges, so that one procedure became 5 procedures with their individual piecemeal codes.
The Minister also let out yesterday, that the main reason why the government is allowing fees increase was because of health tourism, which the government want to use in a big way to increase government revenue. It is health tourism, that is driving the whole exercise.
Anyway, he has allowed a 30% increase across the board, on all the existing items listed in the 13th Schedule. GP consultation fees will be a minimum of RM30-50. He has also allowed ad hoc procedures to follow diagnostic procedures with full charges for both. He has also assured us ( the DG also reassured us ), that there will be no fee reduction for MCOs and insurance companies, who come asking for discount. In fact, they clarified that they had a meeting with the MCOs and insurance companies and hospital owners, to say that asking discounts from doctors will not be tolerated and action will be taken against offenders. The DG said that he had already made a statement to that effect and will be issuing a circular soon to put it all in black and white, as we express that the practice was still going on. All new procedures not presently in the 13th schedule will be upgraded following the College of Surgeons proposal. All these fees amendment will be passed to the cabinet in March 2011 and operational ( hopefully ) by April 2011. Work will begin on the 14th Schedule soon after that.
We also made a speech to ask that hospital fees be controlled through a fees schedule. He agreed in a nice way, but kept mum. Obviously, there is no will to control hospital fees.
The members also brought out the " Competition Act" which cause the Singapore government to withdraw the doctors fess schedule in Singapore in 2007. He acknowledge the Competition Act but said that he do not think that the present government will be enforcing it, any time soon.
30% across the board increase? of course the last hurdle will be the public. I suppose upon the announcement, say in April of a fees increase, there will be a hue and cry, and with elections around the corner, everything may be shelf. So do not hold your breath. I am apart of the committee, but I am not confident that it will come true, may be a token bit will.
Anyway, the next committee meeting is scheduled for the 27th Jan. to hear the 20% who have not submitted their proposals. They still have not decided how much of the sky they wish to ask for. Doctors, they say that they are underpaid!! can anyone believe that. I think only the GPs are underpaid.