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In Malaysia, common sense is all but common when it comes to the civil service enacting new regulations as was the case with the genesis of the PHFSA (Private Health Care and Facilities Act) when it was first mooted in 1993. EJB
When the notorious Dr. Amit Kumar alias Dr. Santosh Raut was arrested by Nepalese police from a jungle resort camp in the southern town of Sauraha, about 60 km from the Indo-Nepal border town of Raxaul on February 7 for stealing more than 600 kidneys and selling them illegally there was a clamor in India to clamp down on India’s illegal but lucrative organ trade. India’s Health Minister Anbumani Ramadoss, in a typical knee jerk reaction, stated that India’s Organ Transplantation Act would be amended to simplify the procedure and make the punishment for illegal transplant more stringent to curb unlawful practices. However a week later, common sense prevailed when the Chief Justice of India K G Balakrishnan, speaking at a conference on kidney disease at the All India Institute of Medical Sciences (AIIMS) at Delhi, when asked about the need for stricter laws to check illegal transplantation of organs simply asserted that "Sufficient laws are there, they just need to be implemented properly”. In Malaysia, common sense is all but common when it comes to the civil service enacting new regulations as was the case with the genesis of the PHFSA (Private Health Care and Facilities Act) when it was first mooted in 1993. Consumer Associations in Malaysia, for whom this law was created to appease, claimed that they often handled complaints from the public to the MOH regarding poor services provided by private hospitals and clinics but were told that the ministry's hands were tied. This was of course a lie. The Medical Act 1971 is very clear especially in trying to apprehend bogus doctors. Doctors wanting to practice in Malaysia must have graduated from a recognized university, must have registration with the Malaysian Medical Council and must possess a valid Annual Practicing Certificate. Anyone not complying is a fraudulent or unlicensed doctor and is liable for a fine or jail term of two years or more. The Medical Act 1971 is in itself comprehensive. But what was absent, as in India, was enforcement. Everytime consumer associations indulged in their favourite pastime of doctor bashing, the MOH instead of enforcing existing laws, made themselves look relevant by trying to create new ones. The MOH is run by a combination of doctors and civil servants. But it is common knowledge that civil servants posted to the Ministry of Health are the least intelligent available in the civil service and are either easily overawed or hoodwinked by doctors there. So when the Amalan Perubatan division at the MOH created the con about the bizarre requirement of a new law that will apply only to private doctors but not government ones, the administrative officers from the civil service pool just looked on without a whimper. Among others private practitioners will need to work in specified clinic conditions, pay a suspicious registration fee of RM1500 and buy medical equipment they may never use, The deceit developed a life of its own when mysteriously Dr A Krishnamoorthy, MMA’s (Malaysian Medical Association) president for the 1993-94 term was barred from discussing the Act with member doctors with the MOH and Minister citing the OSA (Official Secrets Act) on a policy that affects public interest and the very futures of doctors themselves. His successor, Teoh Siang Chin submitted a 37-page memorandum to Chua Soi Lek outlining four areas under the Act which were clearly vague giving credence to reports that the Act was the hurried “cut and paste” job of an amateur officer. Changes were promised but never ratified. Despite all the disapprovals, still the administrative officers from the civil service looked on while the medical authors of this half-baked law imposed their will by trying to sell this to parliament. The lie for a new law found an ally in an obstinate Chua Soi Lek and despite objections from almost the entire medical profession, it became law. The complete absence of the check and balance of an efficient civil service frequently espoused by the KSN Tan Sri Sidek Hassan was completely mown down by a couple of doctors and a DG intent on having their way. So much for Sidek’s trying to eradicate the “I know-what’s-good-for-you” attitude of government officials Parliamentary Opposition Leader Lim Kit Siang was more direct. He called for the Act to be scrapped immediately. His statement that “public interest in affordable quality healthcare even in the private sector is not served if the Act imposes bureaucratic controls and creates loopholes for graft and abuses of power” not only fell on deaf ears but came true with devastating consequences. Dr. Basmullah Yusom, a USM graduate, registered with the Malaysian Medical Council with a valid Annual Practicing Certificate. was fined an unjustifiable RM120,000 and languishes still in jail as he could not afford to pay this fine. Chua Soi Lek’s assurance that the Act was not meant to criminalize registered doctors and the DG’s assertion that it was to make private hospitals carry out their social responsibilities and not meant to be punitive is of course now all water under the bridge. With a registered doctor still in jail while quacks still get to roam the country practicing anything sundry right from exorcism to homeopathy, alternative and complementary medicine, the DG and Ministry of Health statements hold no credibility. If anything it further demonstrated how in the Malaysian civil service the left hand knows not what the right hand does. It was also further evidence that the check and balance expected of senior civil service officers at the MOH such as Nasir and Ahmad Kabit is distressingly deficient if not completely absent. Till date the KSN seems to have avoided this issue like the plague. But his silence at the expense of Basmullah’s continued incarceration only makes Sidek’s clarion call for a more accountable civil service ring hollow. This is a civil service that has gone awry where Little Napoleans overrule general orders, the rule of law and protocol while administrative officers of the civil service have been reduced to spectators. If Sidek doesn’t set this right, we can only hope to see more bizarre regulations dished out of this particular Ministry. This country appears to have exchanged democracy for the rule of Little Napoleans as the de facto method of governance in the civil service. And for this the ruling party may pay a heavy price at the current elections.
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Please visit my blog www.rights2write.*********.com and read the topic under " The Basmullah Act"
It is quite obvious the government do not think doctors views on this matter is important. I suggest the doctors vote accordingly in the coming GE using their intellect.
Dr Rafick