EVERY time a new health minister is appointed, they will promise the same old thing – to reduce the waiting time and build more things to achieve it. Our new health minister is doing the same thing recycling same old Ministry of Health (MOH) Putrajaya press statement. Please any journalist do some digging and you will find the same recycled statement to perhaps challenge it.

I was reading with dread the six strategies MOH will undertake to improve service every time the term “waiting time” is mentioned. I am sure after Raya, MOH will recycle the directive to monitor waiting time as KPI for minister. Departments will recycle their root cause analysis on why the KPI is not achieved. Dear sir, we have been there and done that.

The question is where does the healthcare system stand in terms of quality and accessibility. MOH will proudly say quality is high because it is accessible. But the two are not the same. Accessibility does not mean quality. This is what many of us feel that the minister has missed.

Here is what accessibility has done to our healthcare system, it is overloaded with “warga asing”. We are very cheap. Best part is, if you don’t pay MOH will make the clinicians pay. For us clinicians whenever a very sick or injured “warga asing” comes in, it is damned if you treat and damned if you don’t treat. They jam up the system from the Emergency Department to the wards. They can’t be admitted because the fees are too high for them to afford, they can’t be discharged because their employers have abandoned them. Building new hospitals, increasing the fees or even increasing the MOH budget will not help. Perhaps it could build a hospital where the counters are manned by immigration officers who may launched an immediate investigation into their employers. Clinicians will gladly transfer the patients there. 

Quality healthcare: do we really have it? Answer is no, especially for cases of trauma, heart attack and stroke. We are seeing younger, hardworking and tax-paying Malaysians suffer heart attacks and strokes. Are they getting the best evidence-based treatment? Nope, a very small percentage of them enjoy evidence-based reperfusion therapy. Why? Because there is no incentive for the current centres to receive patients. Our system is “lesu” and having more doctors, bringing back those who have abandoned us to go overseas and building more hospitals will not solve it. 

It’s time the minister stops parroting MOH Putrajaya’s strategies and think outside the box. Building hospitals or daycare units is a long-term and slow solution. By the time the tender is approved, it’s election time again. We clinicians would like to see a blueprint for every issue the minister has mentioned in his six strategies – the short-term implementation and targets; mid-term implementation and targets; and the long-term targets. 

Bring in health-financing that rewards hospitals and clinicians for being competitive in implementing (1) evidence-based intervention in high volumes; (2) setting up of urgent care clinics to reduce the waiting time to see a specialist without needing referral from the Emergency Department; (3) reducing waiting time for admission (from days to less than four hours);  and (4) primary health clinics to operate like private general practice to abolish non-emergency patient queues in the Emergency Department. There are many more initiatives that may have been missed here. The bottomline is, the health minister must be on the ground, maybe even hold a townhall session with the heads of clinical disciplines and personnel, instead of accepting MOH desk-officer doctors’ words as the only truth. – June 16, 2018.

* A Doctor in the House is a Malaysian doctor proud to serve in Malaysia even though he is under-appreciated by minister who looks up to overseas Malaysian doctors.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.