Appeal to Minister of Health

I REFER to the letter entitled “Nursing profession needs attention, too” which appeared in The Star on Aug 23.

I belong to another profession in the allied health group. But I am not writing in to claim that my group too plays an indispensable role in healthcare and needs specific attention. Neither am I going to say that anybody else among the healthcare providers is a lesser being than the others.

I wish to emphasise that medical care is always about teamwork and nobody in the team is a lesser being than any other, be it a consultant specialist or a medical attendant who is critical in medical or healthcare teams. Thus any announcement or a gesture of kindness to a particular profession in the team demoralises all the other members. What we need to hear is not about improving the working conditions for the doctors or nurses or any other related profession but an entire overhaul of the healthcare system in the country.

Very often we compare our services with some other countries and have found it to be far superior in terms of accessibility and costs. But if we look at a micro level we find some alarming situations that are cause for severe embarrassment.

Recently reports in the local news have put Malaysia as the country with the highest number of diabetics, second only to Saudi Arabia. Reports also suggest that almost half if not more of the Malaysian population is either obese or in pre-obese stages. Cardiovascular disease remains the number one killer in Malaysia. Followed by other noncommunicable diseases – and the burden of complications arising from noncommunicable diseases are ever increasing. The re- emergence of communicable diseases is also worrying, and the death tolls are alarming.

Every now and then we are threatened with transborder infectious diseases that could inflict a catastrophe on the country. How prepared are we? What have we been doing? Are we not merely treating symptoms and complications? We are heading towards a population with high morbidity and co-morbidities, and yet the talk is about improving working conditions for certain professionals within the system.

Let’s also look at healthcare facilities and infrastructure. Let’s look at the last 10 years and find a new hospital or a clinic that has been built and delivered in stipulated time. You will find none. And are there any hospitals that were built and delivered without inherent structural defects that loom over the proceeding years? We have come across incidences where even simple basic specifications were not met in the buildings. Over the years, this has been accepted as a norm and “part of the culture”. Never mind if it delays or compromises the service or its quality.

Are we going to continue with this culture? Or can we look forward to a very strict professional adherence to timelines and quality finishing that would spur the occupants to feel proud and provide excellent service rather than work in constant fear of the roof falling on their heads and frequent breakdowns of essential infrastructure?

Based on reports in the media, the new health minister’s biggest concern seems to be the wellbeing of doctors, especially house officers. I do not dispute the fact they need special attention. But the bigger picture that begs his attention would be the welfare of the entire workforce in the healthcare sector. All categories of staff do double or triple shifts in hospitals while those in health clinics are forced to do extended hours and to be on standby 24 hours.

They are overworked and exhausted, which compromises the quality of service. It also compromises the quality of their families’ lives. No solution has been found for these dire states.

Public hospitals and clinics are ever overflowing with patients. Patients in need of admission are stranded in crowded emergency rooms for hours. Finally, when they do enter the wards, their misery increases many folds – crowded wards, sleeping on extended beds, shared bathrooms and toilets with broken tiles and fittings, overworked nurses and staff, immobile patients with no caregivers crying for attention, with unhygienic environments at times making patients end up with more complications than their initial problems. Even newly built facilities face severe congestions right from the carparks to the registration counter and to the wards.

Heart disease has become the number one killer in our country over the years. And yet there is only one public hospital dedicated to advance treatment. Try getting an appointment in that hospital and you may get another round of chest pain looking at the waiting time. What then is happening in the planning divisions in the ministry?

Sometime ago training schools for doctors, nurses and other allied health practitioners were opened without consideration for the needs and jobs available. This was like opening the floodgates for those who wish to be in healthcare; also, the aggressive marketing of the training providers attracted thousands of students. And now we have thousands of them jobless and unable to pay their education loans. The situation has also reduced the demand and thus the pay significantly. All this happened with the blessings of the health ministry, albeit under the previous government.

I could go on with so many other “illnesses” that has plagued the healthcare sector for decades. To me, in my humble opinion, these are symptoms of a failing system. It needs a total revamp. We need real captains who understand the state of affairs on the ground. We cannot have officers from the administration and diplomatic services dictating terms for the service. They seem to be flooding healthcare services, with increasing posts and promotions, and inflicting high operational costs.

It also advisable to do an audit on the number of medical officers who are doing administrative and management work. For rejuvenation we need captains who are not from those who are responsible for the current state of affairs. Those days it was said that to be a welltaken-care-of ministry, you had to have a minister who is a senior leader of Umno; if the ministry was headed by a minister from other component parties of Badan Nasional, it would remain a lackluster ministry. Is it a myth of a fact? Let’s “harap” for the best from “Harapan”.