Medical Act Amendments To Be Tabled In Fortnight: Health Minister

Dr Dzul says the Medical Act amendment will be tabled in the third week of the current Dewan Rakyat meeting, aiming to pass it the following week. He adds it’s “irresponsible” to question the safety of surgeons, noting there are 35 CT surgeons with FRCS.

KUALA LUMPUR, June 27 — Dzulkefly Ahmad announced today that the Medical Act amendment bill will be tabled in Parliament in two weeks’ time, with an aim to pass it the following week.

The health minister also said he plans to send the draft bill to the Health parliamentary special select committee (PSSC) on July 9, besides briefings for MPs, prior to tabling the bill formally for first reading in the full chambers of the Dewan Rakyat.

“The Attorney-General’s Chambers (AGC) has reviewed it; the blue bill is completed,” Dzulkefly told the Dewan Rakyat during Question Time.

“We’ll table the blue bill in the third week, and pass the bill in the fourth week [of the current Dewan Rakyat meeting].”

Dzulkefly also claimed there was irregularity not just with the parallel pathway programme for medical specialty training, but also with local Master’s programmes in medicine, even though the latter are accredited by the Malaysian Qualifications Agency (MQA).

“We’ll regularise the irregularity, and the quality and quantity for the 120 Master’s programmes and the 14 parallel pathway programmes.”

The health minister further claimed that the FRCS Edinburgh in Cardiothoracic Surgery has been “recognised all along”, noting that there are 35 cardiothoracic surgeons with that qualification.

He cited an “editorial error” in the transfer of the list of recognised postgraduate qualifications to the Malaysian Medical Council (MMC), after the National Specialist Register (NSR) was formalised following the enforcement of the 2012 amendment of the Medical Act 1971 in 2017.

All FRCS qualifications obtained before 2017 are recognised in Malaysia.

Kuala Langat MP Dr Ahmad Yunus Hairi, who is also a Health PSSC member, pointed out that the cardiothoracic surgery parallel pathway programme isn’t accredited by the MQA, questioning why action hasn’t been taken if there were contraventions of the Medical Act and MQA Act.

“What is the guarantee of the quality of specialists who underwent the parallel pathway organised by the MATCVS (Malaysian Association for Thoracic and Cardiovascular Surgery) and MOH (Ministry of Health) that are not higher education providers, without accreditation from MQA?” the Perikatan Nasional (PN) lawmaker told the Dewan Rakyat. 

Section 14B of the Medical Act amended 2012 states attending specialised training in that specialty in a “recognised training institution” as one of the criteria for a person to be entitled to specialist registration. “Recognised training institution” is defined under Section 2 of the Medical Act as a “higher education provider”, defined under Section 2 of the MQA Act.

In a June 15 affidavit filed in the High Court here, the MMC said that neither MATCVS nor MOH are “recognised training institutions”. MATCVS is a society registered under the Registrar of Societies (RoS). 

The Royal College of Surgeons of Edinburgh (RCSEd) told the MMC in March 2023 that the curriculum for the cardiothoracic surgery parallel pathway programme was designed and developed by MATCVS, together with its collaboration.

Dr Ahmad Yunus also asked about the progress of an independent committee formed by the higher education minister in August 2023, chaired by Prof Emerita Dr Sharifah Hapsah Syed Hasan Shahabudin, who developed the MQA Act, to resolve the issue of the parallel pathway and to make recommendations to the MOH and the Ministry of Higher Education (MOHE).

Dr Sharifah Hapsah was excluded from the MOH’s June 12 stakeholder engagement session on proposed amendments to the Medical Act.

Minister: ‘Irresponsible’ To Question Safety And Quality Of Surgeons

Ipoh Timor MP Howard Lee asked the health minister if there were any patient safety concerns with both the parallel pathway and local Master’s programmes for medical specialty training.

“If there are no safety issues, why do people suddenly want to burn sentiments? It has existed for decades, but suddenly there are safety issues,” he said.

Lee also called for a cardiothoracic specialist centre to be set up in Raja Permaisuri Bainun Hospital in his constituency.

Dzulkefly responded that it was “irresponsible” to raise patient safety concerns with the cardiothoracic surgery parallel pathway programme.

“All this while, we have 35 surgeons with the Edinburgh qualification. There has been no dispute…they were recognised by the MMC that’s very stringent. Suddenly, we’re questioning their safety and quality. I think it’s irresponsible to make innuendos and insinuations.”

Yet, Dzulkefly told the Dewan Rakyat special chambers yesterday that there has been an increase in medicolegal cases in the MOH that need to be addressed, but did not give figures or details on the seniority or specialty of medical professionals involved in such cases. 

Multiple cases of medical negligence have also been reported in the media of late, across both MOH and private hospitals. Statistics on medical negligence cases in Malaysia are not available publicly.

The medical negligence case of Siow Ching Yee v Columbia Asia Sdn Bhd – which saw a landmark verdict by the Federal Court last February that held a private hospital liable for negligence – involved a consultant anaesthetist who had previously been held liable by the High Court.  

RM10 Million Annual Government Scholarships For Parallel Pathway

Dzulkefly told Parliament that there are currently 120 local Master’s programmes in medicine offered by nine local universities, as well as 14 parallel pathway programmes in various specialties.

A total of 6,933 medical officers have received government scholarships to undergo specialisation, comprising 6,142 for local Master’s programmes in medicine and 791 for the parallel pathway.

There are also 2,622 medical officers undergoing the parallel pathway without scholarship.

For the cardiothoracic surgery parallel pathway initiated in 2016 that produces the FRCS Edinburgh in Cardiothoracic Surgery qualification, the health minister said the six-year programme includes five years’ local training in cardiac centres in the MOH and the National Heart Institute (IJN), as well as one-year training in the UK.

He added that the local cardiothoracic surgery postgraduate programme by Universiti Teknologi MARA (UiTM)-IJN was begun in 2020.

Government expenditure on annual government scholarships for medical specialty training comprises RM142.4 million for local Master’s programmes and RM10 million for the parallel pathway.

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