PRICE HIKE IN APC FEES. FROM RM 50 TO RM 300 ANNUALLY.

MMC Meeting with Doctors Associations on May 13th , 2015, held at the MMC Office in Jalan Chenderasari , Kuala Lumpur at 230 pm
The meeting was chaired by the Head of the Sub Committee for Fee Schedule Revision, Datuk Seri Dr Abu Hassan Asaari Abdullah . Also present was the member of the sub committee, Dr Milton Lum, and MMC Secretary Datuk Dr Azmi Shapie from the MMC side.
Medical Associations were represented by
1. Malaysian Medical Association
2. Medical Practitioners Coalition Association of Malaysia
3. Federation of Private Practitioners Association of Malaysia
4. Pertubuhan Doktor Islam Malaysia
5. Academy of Family Physicians of Malaysia [ College of GPs ]
6. Association of Private Hospitals of Malaysia
7. Academy of Medicine
8. College of Paediatrics
9. College of Surgeons
10 College of Anaesthesia
The Chairman called the meeting to order at 235 pm and introduced himself and the 2 members from the MMC. He then proceeded to stress that he understands the feeling of the doctors on this hike, but he would like us to view a presentation from the MMC side, to see their point of view.
A slide presentation then ensued where APC fees of other countries was compared. The reasons for the corporatisation of MMC was given. Among the reasons given, the main reason was that the MMC wants to be a independent body free from Government dictates. This is so that MMC can make decisions free for the improvement of the Medical fraternity. The National Specialist Register [NSR ] will also be then taken over by the MMC. Once independant MMC will most probably have to pay rental for its office or probably asked to get its own office to function. The staff salary and any litigation brought upon the MMC will then be solely borne by the MMC, without any financial assistance from the Govt.
It was also noted that there were 118 feedback from the ? 2 mths feedback done by MMC on this issue. Datuk Abu Hassan said that nearly ALL were against the feedback.
However Datuk Abu Hassan said he would be grateful if we could reach a compromise on this issue as he could then take this issue back for discussion with the Minister, Director General and MMC Councillors.
After the presentation the floor was then open for discussion
1. MMA President Krishna Kumar said that the doctors rejected this increase as it was too sudden and too steep at this current time, when the economy of everyone was difficult. Citing GST and PDPA amongst other recent fees incurred by doctors. MMA also disagreed with the comparison of the fee structure of other countries, as we should take into consideration , the conditions and consultation fees charged by our doctors here in Malaysia.
2. Doctors Fees have not increased in many years however we see increase and introduction of new fees for doctors [MMA ] . For this the MMC suggested that the fee structure included in the PHFSA be removed from the PHFSA.
3. Fee increase is too steep too sudden and too much – this was raised by all associations at the meeting . It was suggested that the increase should be gradual over the years. Datuk Abu Hassan agreed that the increase should be gradual so as to be more palatable to everyone. However we have not given our suggestions as to how much should be increased over how long [ period ]. No association objected to the fee increase after the presentation
4. Datuk Jacob [ APHM ] suggested that MMC look at other sources of income and ways how members could benefit from this increase . This could be studied from the models from other medical councils from other countries.
5. PERDIM highlighted that the feedback from doctors was conducted over a period of 2 weeks and not 2 months as noted and there were about 500 respondents to the survey. MMC said they will look into this.
6. MPCAM highlighted that in the event of litigation, MMC does not do the payment from its coffers, as the insurers of the MMC will do the payout. If ever , the insurance premium for the MMC will increase the following year. Hence examples of amounts of money being payed out [ RM 6.8 million in a recent O&G case ], cannot be included as an expense for the MMC should it be corporotised.
7. PERDIM questioned the reason why the Director General of Health remains as the President of MMC as this defeats the purposes of the main objective that MMC be free from Govt interference, as the post of the DG is a Govt post, hence a Govt appointment. This was agreed also by the MMC members present at this meeting and they promised that the will bring up this matter with the Minister as all associations present at the meeting agreed that the post of President should be an elected post and not an appointed post. The MMC stressed that the Govt, though agreeing that the MMC be corporatised, wanted its appointee as the President.
8. MPCAM question the election process of the MMC . It was highlighted that many did not get their ballot papers in the 2013 elections. Datuk Abu Hassan said the MMC had formed a election committee and the committee was looking into the suggestion to change the regulations [ which needs approval from the Govt ] for the voting to be more transparent and conducted online.
9. AFPM asked if the APC fees could be charged according to the risk of survice given. MMC will look into this suggestion
10 Academy of Medicine suggested that the fee for senior doctors be exempt as most of them are working either for charity or for survival. Datuk Abu Hassan said he will bring up this issue with the MMC Council and relevant authorities as well.
11. MMA suggested that the GPs be charged lesser for the APC as our revenue was not as high as other doctors. Datuk Abu Hassan said he will bring up this issue with the MMC Council and relevant authorities as well.
There being no further issues Datuk Abu Hassan called the meeting to an end with a vote of thanks to the Chair at 4:20 pm.
Datuk also said the doors for more suggestion is welcome and all suggestions will be read and taken into account. He welcome more suggestions to be emailed to the Secretary of MMC at drazmis@gmail.com .
Datuk Abu Hassan promised that no decision will be made unilaterally by MMC, and another meeting will be called for further deliberation on this issue, this time with an earlier notification.
The MPCAM team met Datuk Seri Dr Abu Hassan after the meeting and thanked him for his openess and professionalism in the way the meeting was conducted.
Prepared by Dr Peter Chan Teck Hock and Dr Raj Kumar Maharajah for MPCAM



My response.

The issue of Exorbitant increase in APC fees.

1. Obviously the fees suggested is too high. The reason given ( that we are independent and not answerable to the government) sounds good but NOT POSSIBLE. WE ARE NEVER INDEPENDENT. MMC can never be for the medical fraternity as the other stakeholders are the government and also the patients. Medical Act 1971 is about administration by doctors of medical care to the patients. So the Public are also stakeholders and also the government has a responsibility as they run the public service and also regulates the private medical facilities. They are all inter-related. They just want to make it sound good ( That MMC is independent ).
2. If MMC is truly independent and for doctors only, then the first thing to insist is for free and fair election of the whole board without quotas. Everyone gets elected for a term including the President of MMC. How can you keep reserving places for your lackeys and also say that you are independent. ALL MUST BE ELECTED IN FREE AND FAIR ELECTIONS REGULATED BY LAW AND CAN BE CHALLENGE IN COURT. The only exception perhaps would be for our East Malaysian colleagues as some of the issues faced by them may differ from Peninsular Malaysia. Otherwise it is independent in name but not in practise.
3. All doctors must pay one fee ( I suggest RM 100 per year ) for the APC. We must not allow them to divide using APC eligibility. It is not an issue of affordability. It is an issue that we are all equal as doctors.
4. If MMC wants to indemnify themselves, they may have to buy medical insurance. It is naive to think that members money can ever be enough for insurance payout. That is a separate issue and cannot be used as an argument to increase APC fees.
5. MMC if truly independent, must employ their own staff so that their staff will not be getting orders from the Chief Secretary of the government. The very fact that they mention that means that they DO NOT intend that the new MMC be truly independent. They just want you to pay more fees while everything remains status quo.
6. Insist that 2 weeks notice at least be given for the next meeting, so that we can band the doctors together in one effective vice. This is an attempt to catch us by surprise so as to divide us ( prevent a unified response ).
7. What began as a meeting on APC fees has wide ranging implications including the workings of the new MMC under Medical Act 1971 Amendments. DOCTORS BEWARE.
8. All like minded Medical Associations should consider drafting a memorandum to be forwarded to the Minister. I am not sure if the Chairman will “remember” to pass on all the sentiments.

No No No. It is not just an issue of super-rising fees. There is more to it then meets the eyes.