If you haven’t, it is time you got acquainted with the man: Aneurin Bevan was the Minister of Health in post-war Britain who played a key role in setting up the National Health Service.
Aneurin Bevan - Photo courtesy of Wikipedia
It was Bevan who uttered these immortal words: “The collective principle asserts that… no society can legitimately call itself civilised if a sick person is denied medical aid because of lack of means.”
Which means health care is not a commodity but a basic right that should be made available and accessible to all. It also means we need a top-class public health care system with adequate funding. That was what the speakers at a Sembang-Sembang talk this afternoon, Dr Jeyakumar and Dr Jayabalan, stressed.
Many among the audience at the Caring Society Complex in Penang were moved when they heard a woman, Roszita, describing how she lost her husband, Ahmad Nazri, 49, a heart patient, because the couple were unable to raise RM19,000 in time to buy three stents that were needed to deal with blockages.
Since the privatisation of the hospital’s pharmaceutical services, patients have had to buy such things on their own before surgery can be performed.
In Ahmad’s case, he did have the money – but it was tied up with the EPF, which was then apparently involved in a ridiculous ding-dong with the Penang GH over a guarantee of payment letter. By the time, the EPF finally issued the guarantee letter it was too late for Ahmad, who passed away on 19 January 2010. He leaves behind Roszita and five children.
As Ahmad noted just a month earlier: “Tak ada wang pun mati, ada wang di EPF pun mati. Ini adalah wang sendiri bukan nak minta wang EPF!” (Full story here.)
We can see the Health Ministry and other “health care industry” players rushing to turn health care into a commodity and trying to capitalise on so-called “medical tourism”. Hello, health care is a basic human right! What happened to rakyat didahulukan? How many more Ahmad Nazris are out there? I remember my plumber too succumbed to heart failure in very much similar circumstances a couple of years ago.
Steeped in its neo-liberal mindset, the Health Ministry now plans to extend a ‘Full Paying Patients’ pilot scheme to even more hospitals on the quiet. Basically, under this scheme, patients in general hospitals can now jump the queue to see specialists if they have the money. Apparently, the specialists are happy with the scheme (because they make more money, perhaps up to RM20,000 more a month) while patients – the ones with the money, that is – are pleased they can see the specialists more quickly.
But what about those patients without the money? No money, no talk.
What a ‘caring’ society. People First, Performance Now? More like Money First, Surgery Later.
This idiot PM Najib come out out and deceived all of you with the clinic in town and shopping complex that has NO DOCTOR.
IS THIS NOT A LIES AND DECEITS TO DECEIVE THE PEOPLE IN THE FIRST PLACE. AND THEN COME OUT WITH A FULL PAYING SCHEME.
LET US ALL KICK HIM & UMNO (OUT) IN THE NEXT GE
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I would forward all the comments here to the Prime Minister’s Office. First time I see so many knowledgeable comments on a posting by Anil. If we continue to offer opinions like that apart from attacking one another, it would be a great way to encourage our Health Minister to push for reforms.
Regards,
Deputy Chief,
Public Services Bureau,
Pemuda Gerakan Penang.
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Were you there at the forum, Anil?
If you were not, how did you get the information?
If you were, how come you did not write more?
I hope you will respond to this in your website.
Thank you for your honesty.
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Yes, I was there. Just didn’t have the time to write more.
You can find out more about the state of our public health care system here:
http://www.aliran.com/index.php?option=com_content&view=category&layout=blog&id=18&Itemid=24
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Doctors are so lowly paid in the government service and they are leaving in numbers. Not just out of the government service but out of the country.
Doctors are still earning RM2000 and RM3000. I know of a doctor who left for Australia and he now earns AUD$20,000 a month. Before that, he was struggling to make ends meet when he was in Malaysia.
Everyday, he used to eat chap fan because his take home pay was pathetic. That also, he just eat only one meat and one vege to keep his chap fun cost down.
All boils down to remuneration at the end of the day. And can you imagine, if the doctors earn so low, what about the nurses then?
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Anil,
There have been too many “errors” on your blog lately.
Just minutes ago I got the “database error” thing when trying to access your blog.
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Thanks for the tip off. I haven’t spotted such an error of late. Has anyone else experienced the same problem?
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Your site was – up until a few days ago (can’t remember exactly) – the fastest to load of the half-dozen or so in my ‘News’ bookmarks. It has been the slowest for a few days. Iron’s error can happen when the server is overloaded (but also when the server admin mucks about with the database).
WordPress sites often include a comment at the bottom of the page source to tell you how long the pages are taking to build. Variations in that amount for the same page could give you a clue to help you know if your host is struggling. Just now it said “0.96 seconds” which does seem a bit long for a single page. You’ve got some kind of WordPress cache, so it doesn’t generate the pages from scratch each time it sends them out – those timings may only change when you update a story or add a comment to it.
Maybe you could ask a fengshui expert if sharing a server with kimkardashian is auspicious?
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Thanks Sean for the feedback. That slowdown could be due to a couple of plugins/widgets I added around that time, which I have since removed. And it does seem a bit faster now.
The 0.92 secs for loading the page today could be due to the slideshow on the Botanic Gardens, which extracts the photos from a photo-hosting site.
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Dear Anil
Here is something I wrote for the MInistry of Health:
SAFEGUARDING ACCESS TO MEDICAL SERVICES (SECONDARY AND TERTIARY CARE) FOR MALAYSIAN CITIZENS WHILST PROMOTING HEALTH TOURISM
The Government of Malaysia has decided to promote health tourism in order to move the economy up the value chain and spur economic growth.
Although this policy will contribute to an increase in the Gross National Product, there are certain negative effects that can be anticipated and which should be pointed out clearly. This will enable the Government and the Ministry of Health to take action in order to safeguard access to medical services for our own citizens.
When evaluating health tourism, the focus should NOT be on the citizenship of patients. Promotion of health tourism is simply the equivalent of encouraging more consumption of medical services by more affluent patients (i.e. patients who are able to pay for higher end or more expensive medical services).
We can anticipate the following negative effects:
Increased demand resulting in higher prices in the short run for Malaysian patients seeking care in private hospitals
Increased demand for higher end services, thus influencing the distribution of health personnel supplying the different kinds of medical care (“secondary/tertiary care” versus “primary care”) and the distribution of doctors between the different medical specialties (such as more doctors specializing in cosmetic surgery)
Increased outflow of personnel (especially specialist doctors) from the public hospitals to the more lucrative private hospitals that cater to medical tourists – this will further exacerbate the shortage of specialist doctors in the public hospitals
In the light of the above, the Government and the Ministry of Health need to take action to safeguard access to medical services by our own citizens, e.g. regulating prices or setting price guidelines for private hospitals; making it easier for doctors to specialize in certain areas (such as cardiology to treat the growing number of heart disease patients) while making it more difficult to specialize in other less essential areas (such as cosmetic surgery); making it more rewarding for specialist doctors to stay in the public sector and so on.
We can also learn from other countries about the positive and negative effects of promotion of health tourism, e.g. Costa Rica, South Africa, Thailand, India, Singapore, the Czech Republic and so on.
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Im a little confused…what is wrong with people who are richer being able to pay for faster treatment? There is a shortage of resources in every public system, and it is their basic right to be able to pay and get faster access to a specialist. What should be of concern is not this, but how long a person of low income should have to wait before being seen. It may not be immediate, but it must be fast enough for the patient’s own good. Surely that is enough? Also the quality of care/facilities/expertise should be no different for different income groups.
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Surely prompt treatment is part of the quality of care – and as you say, it should be no different irrespective of ability to pay.
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I heard the cost of Britain’s National Health Service is unsustainable. They are on the verge of bankruptcy. Is this true?
Complete Government control is not the most efficient system. There must be some degree of free market and entrepreneurial competition to ensure efficiency and sustainability from a financial perspective.
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How much does Britain spend on defence? If only a fraction of that was used to support NHS, it would not be unsustainable, would it?
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Dear Fong
There is no health system without problems.
From comparative data, we know that Britain’s NHS
(actually not one but a number e.g. the NHS of England, the NHS of Scotland etc)is one of the most cost-effective of the “developed” nations in terms
of percentage of GNP.
The most heavily market-oriented (the USA) costs the most but yet an estimated 40 million of the citizens are uninsured.
In the English NHS, the GPs contract with the NHS and are paid on a “capitation” basis, i.e. depending on the number of people on their list. The
hospital-based specialists are paid (high) salaries.
The healthcare market is prone to market failure for various reasons. You can read Princeton University health economist Uwe Reinhardt’s writings on this.
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