Monday, September 22, 2014

IMPROVING PATIENT SAFETY - REPLY.

I wrote this reply to A Prof Azmi article in Saturday's Star, on "Improving patient safety".

Having read the interesting article by Assoc. Prof Mohammed Azmi, it is important to emphasize a few crucial points. What ails Malaysian Healthcare is basically a lack of funding. With 4.6% of GDP, we have done remarkably well. Healthcare transformation with greater public – private integration of course is greatly welcomed. However, retaining a two tier system of public-private healthcare is crucial to a successful healthcare system. It provides for a check and balance. This promotes healthy competition and no one is left out without the care that he or she needs. Having just a one tier system ( like NHS-UK ) would be a step backwards, as the public has less choice, greater taxation and when that one system fails ( as evident in UK now ), many now buy their own private insurance. Alas, our wish would be that with a greater Healthcare expenditure budget the public sector may be transformed to be on par with the private sector.

We all agree that improving patient safety is very important. We differ that setting up another body is the answer. Medical care has now progress from just curative medicine to preventive medicine and in the area of curative medicine, from just diagnosing and treating a condition to diagnosing, treating and also counselling. It is in this area of counselling that much can be done to improve patient care especially patient safety. Doctors are spending more time to counsel patients on their illness, and their treatment regimes. And if drugs are involved,  their effects and side effects. In this y age of information and the internet, even if the doctor fail  to mention, the more knowledgeable patient will ask. This is the best way to improve patient safety. Patients talking to their doctors, and doctors empowering their patients. That is also why we are concern about this talk every now and then to restrict dispensing to pharmacy alone. Should the government be so silly as to do that, it invites trouble. Asking a family to go searching for a pharmacy at 2 am in the morning, when a crying, wailing child has fever is ridiculous, bordering on irresponsibility, when his doctor is sitting just in front of him and can explain the medications, the effects and side effects. Yes, the pharmacist has the theoretical knowledge of the effect and  side effects of drugs. but which drug and dose is  suitable for his illness and his body, only his caring doctor knows, unless the government is of the view that all patients are the same and all illnesses are the same and one size fits all. The current system of prescribing dispensing allows for choice.  No exclusiveness, allow free choice. We are certain that this is what the patient wants, although it may not be what the pharmacists want. 

This reply was send to the Star editor on Saturday evening.

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