Thursday, March 06, 2014


I must say that reading the alternative media for the last 3 days, this must be the hottest news in town, maybe after the Kajang by-election.
I have been closely involved in the negotiation, of the comprehensive amendments to the PHCFS regulations 2006. We met almost monthly from 2006 till 2008, to negotiate and show MOH why the original regulations were NOT applicable. For example, the original regulations asked that all clinics should be equipped with a public phone. It also required that private clinics be sited away from busy, public areas. The regulations dictated that clinic doors must be of a certain specific size ( and not an millimeter less ) and a certain height ( and not a millimeter less ). And the size mandated were NOT the usual building size, which cause GPs to have great difficulty finding doors and they were subjected to extensive costs to renovate their clinic. Many GPs in fact gave up practice because they felt that the extra cost was not worth their while. Then there was the issue of reapplying for a new registration if you are relocating from one shoplot to another in the same shopping complex. Each time you reapply you pay RM1,500 and be subjected again to all the specifics of the ridiculous regulations.  Do you know that clinic sinks for doctors and nurses to wash their hands must NOT have an outlet for overflow? Try finding one in town? Of course we also worked through the Fees schedule as that Fees schedule in the 2006 Regulations were based on costing done in 2002 ( the MMA 4th Fees Edition ).
Anyway, all these ridiculous regulations were slowly worked though. Took 2 years, meeting once a month.
I wonder what happened to the whole pile of amendments that we laboured through for 2 years.
This announcement by the MOH on Monday was just the amendments on the Fees schedule, we called it schedule 13.
The Regulations Fees schedule 13, was based on the MMA 4th Fees edition. When they were drafting the Regulations Fees schedule, the MMA were the only Association which had a fees schedule as a guide to private doctors, and so the government copy and paste that into the Schedule 13. When we first looked into the Fees schedule 13 ( in the original form ) we found so many anomalies. There were errors of transcription, duplication of procedures with different costing and of course between 2002 and 2006 medicine has progressed and there were many new procedures which were not prescribed for. So the Fees schedule had to be extensively revised.  Have recoded many many new procedures and corrected all the anomalies, we asked for a 30% increase in pricing, to take into account the rise in cost of living from 2002 till 2012. The Fees schedule was the last Regulations to be completed when we sat to amend the Regulations. We completed Schedule 13 sometime in 2011, I think. We also asked that Fees schedule be revised every 2 -3 years to reflect the rise in cost of living.
Actually, the then minister of Health agreed to the 30% fees rise and said that he will bring it to Cabinet, together with all the other amendments. I have a statement to that effect in my file.

Then after that meeting with the Minister ( with the press in attendance ), we heard nothing more. Whenever we ask we were told that it was in the AG chambers to be drafted into legal language.
So we waited, and our doctors were asking what happened. Many also use ingenious ways to give themselves more money whenever they did procedures. Their ways were quite creative, but I must say that I tried to dissuade them. I felt that we should follow the law or get it amended. These we did, but it was held up and so justice was delayed and denied.

Out of the blues, I now read that the Fees Schedule 13 has been gazetted and made into law in support of the PHCFS Act 1998.
What has happened to all the other amendments that we worked on for 2 years? That criminalises doctors?

I could not understand why the Minister chose to announce it now, when every Malaysian is feeling the pinch of "semua barang naik", by the BN ( Barang Naik ) government. I asked doctors to be prepared for another round of doctor bashing.

Of course the Fees schedule amendment has generated must comments in the alternative media. Many very vicious comments which I deem unfair with only a few comments in support. Some were genuinely upet about rising cost. Some were just making noise. Few were supportive.

Here is my reply in Malaysia Kini to some of the comments -:

drngsc Please do allow me to apologise to all Malaysians for the recently announced Amendment to fees schedule 13. I know that it will increase private medical cost marginally, and may cost some hardship. We are truly sorry. However, please note, 1. This is a 14.4% increase after 12 years. In these 12 years, what else have increased, petrol x 2 at least, roti, teh tarik, electricity, rental, should I go on? 2. The call should be for government to cut down leakages, to improve public health services so that we get value for money on our taxation. The public have a good choice then. 3. The high cost in private medical care is due to the hospital charges, not consultants' fees ( 20% ). That forms 80% of overall private hospital bill. Yet we do not hear anyone bashing the GLC hospitals ( which form 80% of all private hospitals ). 4. Please be reasonable. We do have to adjust fees to meet inflation too, after 12 years. We ask for understanding. On behalf of doctors who care.

Should I find the time, I will try and write a piece about Private Medical Cost and what the government can do to help the rakyat.


Winston Yap said...

This country is ruined by a bunch of lunnies and fools!
What more can be said except for everyone to do their utmost to kick them out.

hmatter said...

Winston, easier said than done. In GE 13, we did. We voted them out. BUT they cheated full scale. With the EC, Police and courts ( and I suspect ) the army behind them, how can we kicked them out, peacefully I mean?

Winston Yap said...

The police, civil servants and possibly even the army have relatives and friends in other fields of employment who maybe attuned to what is going on in the country.
Perhaps these relatives and friends can help the opposition to make them realise that the way the UMNO/BN government is behaving, the country will soon be bankrupt.
Make them realise that once that happens, the civil servants, the police and the army will be the first to bear the brunt of it.
Even in the US, when a state is insolvent, the civil servants, police and even the armed forces were severely trimmed.
This happened recently in Washington where civil servants were told not to turn up for work until further notice.
And they were not paid during this enforced "leave".
Another tack is for the opposition to check whether foreign governments like the US and EU can check on the foreign investments of our corrupted politicians and take action against them, e.g. by confiscating their properties or other assets that they have no legal means of buying.
The opposition must leave no stone unturned to take back Putrajaya and ensure a bright future for all Malaysians.