Tuesday, August 10, 2010

Malaysian doctor - population ratio is still far short of WHO minimum standards...

We must be interested in doctor-population ratio, not the doctor-patient ratio. {Note that here we are looking at both doctors in government service and private practice, and we really need to be more concerned about the government doctor - population ratios).

According to the 2008/2009 Economic Report produced by the Minisitry of Finance, in 2007, this was 1:1,145, and the same figures seem to be given by the Health Minister in 2008 and 2009.

KUALA LUMPUR, Oct 19 (Bernama) -- The government aims to achieve a ratio of one doctor to 600 people by 2020, from 1:1,145 currently, Health Minister Datuk Seri Liow Tiong Lai. - Bernama, 19/10/2009, Government targets doctor-population ratio of 1:600 by 2020
He said the the government was still facing a severe shortage of doctors in government, with only 60% or 13,000 positions filled. so far. This meant the doctor to patient ratio was 1:1,145, when the ratio for developed countries was 1 to 600, says Liow - Star, 13/6/2008, Doctors shy away from service at govt hospitals
 Population per doctor is 1:1,145 in 2007 - Malaysian Socio-Economic Indicators (Official Report)
Now, in a recent report, the Deputy Health Minister is telling us something different. Is she talking about doctor - patient ratio, or is she talking about doctor - population ratios? WHO Standard is talking about doctor-population ratios. A perusal of the Ministry of Finance report, shows that the doctor-population ratios for 2003 [1:1,377 ], 2004 [1: 1,402 ] 2005 [1: 1,300] 2006 [1: 214] and for 2007 [1:145]. Datuk Rosnah now tells us that last year (i.e. 2009), it was 1:940, and in 2000 it was very much better, i.e. 1:905.Is she telling us the truth? Is this the doctor-population ratios, or the doctor-patient ratios?

It is also shocking to note that the doctor-population ratios for Sabah [1:2248] and Sarawak[1:1709] seem to be far worse than the national figures. If Rosnah's figures are to be taken as correct, i.e. 1:940, this means that Sabah and Sarawak have been discriminated against. It is important for us to maybe try to get hold of other State figures to see if there is equitable distributions of doctors by the UMNO-led BN government - or is the Klang Valley and/or the Federal Territories being treated better compared to the other States? It is also important to see if the UMNO-led BN government has managed to overcome the shortage of government doctors remembering that the Health Minister in 2008 told us that there was a severe shortage - i.e.  40% of the positions yet to be filled.

The UMNO-led BN government has been pre-occupied with building projects...but less attention have been paid in getting sufficient  government doctors for all persons in Malaysia. Najib, when he became Prime Minister, had his own 1Malaysia Clinic projects - and these were open in many places where there already existed government clinics/polyclinics, when all we needed to do was to extend the services of these clinics(or part of these clinics) to 24 hours. There was no need for the renting of new premises, wasting money for renovations, etc. Money saved could have been better utilized increasing the number of government doctors, medical personnel and equipments. But alas, Najib wanted something for people to remember him by...besides the submarines, Altantuya, etc - and that would be the 1Malaysia Clinics...

PUTRAJAYA: Malaysia continues to face a shortage of doctors, with the ratio falling short of the 1:600 standard set by the World Health Organisation (WHO), Deputy Health Minister Datuk Rosnah Abdul Rashid Shirlin said Friday.

She said the Malaysian ratio last year was 1:940 while in 2000, it was 1:905.

"The Government, particularly the Health Ministry, has drawn up several measures, including making available various incentives to raise the number of doctors and medical graduates in the country.

"Going by the annual increase in the number of medical graduates, we are optimistic of attaining the (WHO) ratio by 2015," she told reporters after the signing of a memorandum of understanding (MoU) at the ministry here.

The MoU was signed by Newcastle University Medicine Malaysia and the ministry to enable the educational institution to use the ministry's facilities for its campus in Johor once it begins operations next year.

Rosnah said a drastic shortage of doctors was experienced in Sabah and Sarawak because many medical personnel were reluctant to be transferred to those states.

"The ministry has taken steps to overcome this shortage, among them allocating more doctors to the two states, especially those serving in government hospitals or clinics.

"Besides, we also have a mandatory rotation system," she said.

Sabah and Sarawak have a doctor-population ratio of 1:2248 and 1:1709, respectively. - Bernama, Star, 23/4/2010, Malaysia hopes to attain WHO doctor-patient ratio by 2015
Given the amount of money expended by Malaysians for the education and training of medical students and personnel, maybe the period that they be bonded to the government, i.e. the period that they serve in government hospitals and clinics should be increased. Those, who do not want to be so bonded could always pay for their own education at private universities. Our priority must be the achieving of the 1 government doctor for every 600 persons. Salary for doctors and medical personnel should also be increased to prevent an outflow of valuable resources and government investments. Other incentives could also be provided, i.e. government housing, pension benefits, further education and specialization opportunities, participation in international medical conferences, etc.

I am sure that latest statistics are so easily available as to the numbers of government/private doctors, nursed, medical personnel. Statistics should also be available for the different states, regions, etc... 

Malaysian government  should really minimize their efforts in promoting medical tourisms. In an internet age, the private medical facilities can do their own promotion/marketing. Why waste government and Ministry of Health resources, time, money and personnel promoting greater business for private medical establishment.

The shortage of doctors & medical personnel, hospitals, specialist hospitals, etc is very real - and, one who even go to the less crowded specialist hospitals (compared to general hospitals, clinics, polyclinics), find that after registration at 8.30am, one only manages to see the doctor, get the medicine and leave at about 2-3pm....and the reason is not that the government employees are lazy and slacking - but is really because of the shortages we face. It is this delays that have driven many to the private clinics/hospitals... Really, Malaysia can do better...so much more better. Our PM, Ministers, etc...should really utilize the government clinics, polyclinics and hospitals as normal patients (with no preferential treatment) for them to understand better....

There was a General Hospital in Mentakab - and then in Temerloh, Pahang a specialist hospital was build. The Mentakab General Hospital was foolishly shut down, and now this places extra burden on the Temerloh Specialist Hospital (which caters for Pahang) because you still have to have wards for mothers delivering babies, accident victims, minor surgery patients. Really poor planning - and we really need the Mentakab General Hospital build up and operational again - and being beside the train station, bus routes, etc - it served a very large population of people. How many similar foul-ups have happened all over Malaysia?


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