Monday, July 16, 2012


I spend the Sunday at the Academy house attending the " National Ethics Seminar 2012 " jointly organised by the Ministry of Health and the Academy of Medicine. From my point of view, it was poorly attended ( mainly by Ministry staff ) and a sprinkling of private doctors. The content ( in my opinion was also rather isoteric. They were dealing with ethical issue is Stemcell Research and Artificial Reproductive Techniques. In my opinion, important as these topics maybe, it pales in comparison with the ethical issues that GPs and private specialist face in their day to day practice. The issue of MCO / TPP and medical practice, the ethical issues of too many medical schols and falling medical standards, the issues of the encroachment of business corporations into specialist practice - the issue of fees-splitting and control of referrals, the issue of poorly trained nurses and their effects on practice. Ethics on the bread and butter issues.

Anyway, while there, I had chance to speak to the Deputy DG of MOH who was there to declare open the Seminar. We had a few minutes to discuss the Minister's announcement yesterday about the Ministry sending their out-patients for follow-up in private GP clinics. So the Deputy DG discussed a few more details. They are quite serious about doing this It was inline with their Healthcare Transformation program, to improve Public / Private integration. Nice terms, so I asked for details. He said that the Public hospitals OPD are overcrowded ( we know ), and so they are planning to send these stable patients for follow-up by GPs in the locale. The MOH will pay for these visits ( the quantum has not been decided ). The GPs must first be integrated into the system and they can do these by attending CMEs in the Public hospitals near them, so that the doctors there would know them and so know who they are referring their patients to. He even volunteered that should this work well, they will allow GPs who refer patients to take an observational ppart in their management, like going into OT to see the surgery. In so doing, the GPs will be updated, get involved, improve their Public / Private integration and also get more patients. In fact, there is a proposal for the hospital doctors to run a clinic a week seeing their outpatients at the private clinic.
Of course the idea is very good and should receive our support. As usual, the devil is in the details, which we are waiting to see.
The other big announcement which I just read this morning is the Minister's announcement that workers should exercise and reduce weight, and that there should be a reward in people who take few or no MCs a year. I gather that this is an attempt to reduce the incidence of chronic non-communicable diseases. This is also a good idea, and we should support. It is always good to use a carrot approach first to promote healthy programs. We would as usual, like to see the details, to see whether Putrajaya has thought through and whether it is workable. The first, I am quite sure they are working on. In fact, there is a pilot program being run at the moment, to study the above Public / Private integration.
As for the second announcement this morning, we await the details.

No comments: