Tuesday, August 04, 2015

Malaysian doctor-population ratio 1:633 but for Sabah(1:1,500) and Sarawak(1:1,104)?

There is a serious lack of doctors in Sabah and Sarawak - Why? Is it not the government's obligation to ensure equitable distribution of doctors all over Malaysia? 

The targeted doctor-to-population ratio for Malaysia is1:400
Malaysia's doctor-to-population ratio 1:633(2014)
BUT...Sarawak's doctor-patient ratio is 1:1104 [as of April 2015]
Sabah's doctor-patient ration is 1:1,500 [as of May 2014]
* I wonder what is the doctor to population ratio in the various States in Peninsular Malaysia? Is there equitable distribution - or is the doctor to population ratio in some of the States just as bad as in Sabah and Sarawak?

Whilst this BN government should have been focused on getting us more doctors - that is more doctors in the government hospitals and clinics. It is already sad that even now, Malaysia seems to be too focused on 'medical tourism' - trying to get foreigners to come to Malaysia for healthcare for profits, when primary object always should be to ensure that the ordinary person in Malaysia has enough doctors in our government hospitals and clinics all over Malaysia - especially in the rural areas.

Our Prime Minister's focus seem to be Kuala Lumpur - when really it should be everywhere else in Malaysia that is lagging behind in development and now even healthcare - doctors?

What is Malaysia doing to ensure more doctors and a more equitable distribution of doctors all over Malaysia? 
* What is sad is that Malaysia is lacking places for housemanship - they claim that there are too many medical graduates. 

* It was also sad that Malaysia in 2011 imposed a moratorium on new local medical programmes and institutions of higher education offering such courses

WHY? ...when Malaysia still lacks doctors... [We need more doctors, and it will be really good if there were doctors at the various Klinik 1Malaysia. Each such clinics that operate 24 hours really would need 3 doctors at least - each working for 8 hours per day] 

Too many medical graduates - but apparently their quality is in question. 
“The problem is 30% of those who do housemanship need to extend their training, so they will take up the posts for new intake,” he said. Such delays, he added, could be due to housemen failing their training, resulting in extended training of between three and six months, depending on the hospital.
For now, Malaysia needs to increase the number of hospitals that have positions for housemanship...

Malaysia needs to demand a higher standard of medical graduates - 30% of those offered housemanship failing to to pass within the stipulated time frame is shocking...

Malaysia should also ensure we have doctors equitably distributed all across Malaysia - it is shocking that the doctor-population ratio in Sabah and Sarawak is so far behind the national doctor-population ratio.

Malaysia should do the needful to encourage doctors to remain in public service for a longer period beyond the compulsory period that we have..

Many Malaysian Specialist Hospitals do not even have a Rheumatologist > noting the number of patients in Malaysia who need to have access to Rheumatologists... Every specialist hospitals must have all the necessary Specialists..

Malaysia should be striving to provide universal health care - Thailand is able to provide full medfical care to its population for the payment of 30 Thai Baht(equivalent to RM3) - which covers ward charges, surgery, etc.. Malaysia should also strive to achieve that noting that healthcare is and should be an essential right for all Malaysian..

Private Hospitals and facilities are really for the rich and those who can afford to pay exhorbitant fees - but most Malaysians really cannot avoid such prices...While those in the public sector are taken care of rather well, Malaysians in the private sector and self-employed who now are really earning much lesser than those in public sector need to be taken care of...Let Private healthcare facilities promote 'medical tourism', but our Health Ministry should stop it - focusing rather in getting more doctors and specialist for public healthcare facilities, and getting current medical charges down - preferably FREE. 

Some say that the BN government was moving towards 'privatization of healthcare' - and it is something that many trade agreements are pushing for. They want to 'kill' of government(or public) healthcare facilities to be replaced with a marketplace of competing private healthcare providers. 

Healthcare should never be considered a 'business' - but an obligation and duty of a government to its people, and target should be to be able to provide FREE healthcare services, or where patients need only pay a minimum token payment of RM1-3. 

Too many medical grads, too few housemanship spots

There are 43 government hospitals, three of which are university hospitals, providing housemenship. But demand has outstripped supply, leading to long waits for medical graduates. – The Malaysian Insider file pic, July 18, 2015. 
There are 43 government hospitals, three of which are university hospitals, providing housemenship. But demand has outstripped supply, leading to long waits for medical graduates. – The Malaysian Insider file pic, July 18, 2015. 


The future is uncertain for Ashraf who has already waited for six months since graduating from a foreign medical school but has been unable to find a houseman placement in any of the country's public hospitals.

The 25-year-old Public Service Department (JPA) scholar, who graduated from Egypt's University of Mansoura, is among many medical graduates who have been waiting three to six months for housemanship placements, a situation caused by the high number of medical graduates.

Director-general of Health Datuk Dr Noor Hisham Abdullah said there has been a significant increase in the number of graduates reporting for housemanship training in the last few years.

According to Health Ministry records, there were 3,564 medical graduates reporting for duty as housemen in 2011, and in 2012 (3,743), in 2013 (4,991) and last year (3,860). Many graduates held qualifications from medical schools overseas and their number has increased from 877 in 2008 to 1,600 in 2011.

In 2012, there were 1,563 graduates from foreign medical schools and this grew to 2,403 in 2013, Noor Hisham said.

“Although there are 32 institutions offering medical programmes in Malaysia, their intake is smaller in numbers compared with universities overseas,” he told The Malaysian Insider.

Of the 32 local institutions of higher education with medical programmes, 11 are government-run institutions and 21 are private.

Malaysians can also opt to study medicine in 36 countries which offer 360 foreign medical programmes approved by the Malaysian government.

To stabilise the number of medical graduates which has outstripped the number of housemanship placements available, the Health Ministry in 2011 imposed a moratorium on new local medical programmes and institutions of higher education offering such courses, Dr Noor Hisham said.

But there are still other reasons for the long waiting period, such as the availability of positions and the location of hospitals.

Additionally, 30% of housemen do not finish their training in the stipulated period.

Dr Noor Hisham said placements were easier to get in hospitals in Sabah and Sarawak, for which the wait was about one to two months. But housemen applications at hospitals in Kuala Lumpur usually had to wait for six months.

Medical graduates have the freedom to choose the hospital they want to do their housemanship.

“The problem is 30% of those who do housemanship need to extend their training, so they will take up the posts for new intake,” he said.

Such delays, he added, could be due to housemen failing their training, resulting in extended training of between three and six months, depending on the hospital.

“That’s why we have delays (in housemanship placements) as we cannot simply add new training sites.”

There are 43 government hospitals, three of which are university hospitals, providing housemanship.

Better planning is needed to remedy the situation and to prevent unemployment among trained medical personnel, former Malaysian Medical Association (MMA) president Dr H. Krishna Kumar said.

Also, Malaysia has not met the desired doctor-to-population ratio of 1:400, despite having so many medical graduates. As of last year, the ratio was 1:633 among registered doctors in Malaysia.

He said foreign medical programmes had contributed to the competition between local and overseas graduates.

“Local and overseas graduates want to work here and they have to compete with each other, it is a matter of first come, first serve at the moment.”

He said joblessness among medical graduates was a worrying trend that could lead to medical practitioners setting up unregulated practices.

He said it was important for the government to have a proper planning to address the issue, despite there already being a moratorium on new medical programmes.

“We already met the government and we want them to reduce the number of universities or reduce the intake.”

It did not help, he added, that people tended to view the medical profession as one where big money could be made straight away. – July 18, 2015, Malaysian Insider.
1:1104 doctor-patient ratio in Sarawak
Published on: Thursday, April 23, 2015

Kuching: The doctor-patient ratio is 1:1104 currently in Sarawak which still lacks doctors, said state Public Health Assistant Minister Datuk Dr Jerip Susil.

He said the main challenge faced in providing medical services in Sarawak was to dispense efficient and effective health services in line with the requests of the people.

"This requires more medical officers and specialists to be placed in hospitals and health clinics statewide with sufficient health facilities." he said when replying to Hazland Abang Hipni (BN-Demak Laut) at the Sarawak state legislative assembly here Wednesday.

Dr Jerip said there were 2,237 doctors serving in Sarawak and, of the total, 1,7759 worked in government hospitals and clinics while 478 with private hospitals and clinics. He said 30 per cent of these doctors were from the peninsular.

"Due to the lack of doctors in the state, the Health Ministry encourages more doctors from the peninsular to come and serve as well as stay longer," he said.

According to Dr Jerip, doctors and medical specialists serving in the state would receive special allowances and could get promoted faster.

"However this method has its advantages and disadvantages because normally doctors from the peninsular who are promoted while serving in the state will immediately apply to return to the peninsular," he said.

Meanwhile Deputy Chief Minister Tan Sri Alfred Jabu, who is also Sarawak Modernisation of Agriculture Minister, said three permanent food production parks had been implemented by the Sarawak Agriculture Department starting 2009.

Replying to Mohammad Razi Sitam (BN-Saribas), he said up to date 29 participants had been involved in bananas, papayas and vegetables cultivation with agricultural produce exceeding five metric ton from January to August last year.

Jabu said the state government was still studying the need to create a Temenggong post for the Muslim community in Kapit division. Replying to George Lagong (Independent-Pelagus), he said currently the Muslim community in Kapit were being represented by a pemanca and three penghulu.

Meanwhile Sarawak Early Childhood and Family Development Assistant Minister Rosey Yunus said the overall average attendance of students for four secondary schools in Telang Usan was higher than the state and national percentage of 95 per cent except for SMK Tutoh Apoh (87.53 per cent).

Replying to Dennis Ngau (BN-Telang Usan), she said among the causes for low attendance in SMK Tutoh Apo was because many students enrolled late in January and February, as well the hysteria incident that forced the student to return to their home. – Bernama

Rosey said the other four schools overall average attendance were SMK Long Bedian (96 per cent), SMK Temengong Datuk Oyong Lawai Jau (96.2 per cent), SMK Long Lama (96.22 per cent) and SMK Tinjar (95.86 per cent). – Bernama - Daily Express, 23/4/2015

Sabah Health Dept targets 1:400 doctor-patient ratio

KOTA KINABALU: The Sabah Health Department is pushing for a 1:400 doctor-patient ratio to improve the healthcare in the state.

Its director, Dr. Christina Rundi said the current ratio is 1:1,500, and admitted that the target of 1:400 is still far from achievement.

“Sabah with a population of over 3.5 million is the second largest state in Malaysia. It is obvious that we need more doctors to reach the target.

“We are calling for more medical officers to take the opportunity in becoming specialist as we are also facing a shortage of specialists in Sabah,” she said this to reporters in a press conference after launching 1st Borneo Paediatrics and Paediatric Surgery Conference at Universiti Malaysia Sabah (UMS) School of Medicine, yesterday.

Rundi, in her speech earlier also expressed her appreciation to the university for its contribution towards improving the doctor-patient ratio.

“In the past 20 years, UMS has genuinely advanced the causes of Sabahan healthcare and medical research.

The opening of its Medical School has seen many batches of graduates, and some of whom are already specialist with the Ministry of Health.

“We at Sabah State Health Department would like to thank the UMS School of Medicine for all its contributions towards improving the ratio,” she said, adding that UMS School of Medicine has almost produced 400 graduates since the medical school’s inception in 2003.

During the two days’ conference which ended yesterday, a total of 493 local and international participants had benefited from the working papers presented by experienced doctors.

Rundi said the department hoped the conference would be the beginning of many more collaborations, both with paediatric surgeons and paediatricians from other countries, and with many institutes of higher learning to further improve knowledge of the medical team in Sabah in treating and managing their patients.

Also present at the event yesterday were Sabah Women and Children’s Hospital, hospital director Dr Tan Bee Hwai and UMS dean of School of Medicine Dr D Kamarudin D Mudin.

Kamarudin, in his welcoming speech, said the conference marked another step in the school’s medical education, continuing professional development in collaboration with specialist clinicians from two different countries, Australia and New Zealand.

“It is a great encouragement to see so many health professionals from around the country, representing diverse backgrounds and experiences, gather here at UMS to share as well as pursue knowledge.

“We hope all the participants will be able to forge lasting and productive friendships and working relationships through this event, and we also hope that it will spark off inter-state and inter-institutional collaborations for many years to come,” he said.

On the first day, seven presentations were shared with the participants, namely Congential Heart Disease: Facts We Should Know by UMS paediatric cardiologist Associate Prof Dr Asmiati Hamid, Neonata; Cardiac Emergencies by Queen Elizabeth II paediatric cardiologist Dr Siva Rao, An Overview of Cardiac Surgery in Congenital Heart Disease by Queen Elizabeth Hospital II consultant cardiothoracic surgeon Dr Abu Bakar Mamat, Approach To A Collapsed Child by Sabah Women and Children Hospital consultant paediatrician Dr Matthew Chong, Acute Encephalopathy in Children by Sabah Women and Children’s Hospital paediatric neurologist Dr Heng Hock Sin, Paediatric Rehabilitation by UMS rehabilitation physician Associate Prof Dr Khin Nyein Yin and Child Protection Issues by Sabah Women and Children’s Hospital consultant in community paediatrics Dr Fauziah Zainal Abidin.

Meanwhile, another seven papers were presented on the final day yesterday by Associate Prof Dr Deborah Bailey from Australia (Transportation of Ill Children and Management of Burns in Children), Dr Phillip Morreau from New Zealand (Recent Advances and Management of Congenital Diaphragmatic Hernia & Congenital Lung Lesion and Recent Advances and Management of Necrotizing Enterocolitis), Dr Abdul Latiff from Wagga Wagga Australia (Paediatric Airway Emergencies), Janice Hui Ling from Brunei (Diagnosis and Management of Neonatal Obstruction) and Celine Hamid from Wagga Wagga Australia (Diagnosis and Management of Abdominal Pain in Children).

1 comment:

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