The final decision to place Dispensing Separation on hold was decided by the Ministry of Health in May 2016. However, the Malaysian Pharmaceutical Society (MPS) seems to be defying the MOH decision by attempting to pressure the ministry by making public statements.
In December 2015, PEMANDU from the Economic Planning Unit of the Prime Ministers Department organised a week long stakeholder meet in Port Dickson, where more than 100 stakeholders of the medical profession, including doctors, pharmacists, consumer groups and NGOs met to deliberate issues in the Pharmacy Bill, which incuded dispensing separation. We all stayed in Port Dickson for one week.
The Malaysian Pharmaceutical Society and its President, Amrahi Buang, were present at that stakeholder meet to present their concerns as well.
After much deliberations by the various stakeholders, the concerns were presented by PEMANDU to the MOH and it was decided that a hybrid system of dispensing (which we practise currently) was the best suited in the interim period, while waiting for the other building blocks of health reforms to be put in place before any changes were made.
The Government felt that the best time to implement dispensing separation – where the sick visit the doctor and collect their medicines at a separate pharmacy – is with the introduction of the Health Financing Scheme. However, almost immediately after the decision was made, the MPS started harping on the issue, despite being party to the discussions and deliberations.
This is not being professional.
At the meeting, doctors also urged pharmacists to work together in the primary healthcare GP clinics.
Doctors want a clause in the Pharmacy Bill removed, which bars pharmacists from working together with doctors in the GP clinic. The removal of this clause would allow doctors and pharmacists to work together rather than in silos , should dispensing separation come in the future.
Currently there is no law barring doctors from being employed by pharmacists, so we are of the opinion that pharmacists should not be barred from working in GP clinics therefore preserving the GP clinic as a one stop center for the convenience of the sick.
A decision was also made that a General Practitioner, has to provide a prescription to his patient upon request, if the patient intends to purchase his medication at a pharmacy rather than at the clinic itself. This is also nothing new, and is something which doctors have been doing for a very long time.
This decision was made after the work flow in the GP clinic was explained to all present in Port Dickson.
It was acknowledged that it was unnecessary to issue a prescription to all patients who attend the GP clinic as the person in charge (PIC) of the clinic and PIC of the pharmacy (located on the same premises and hardly 5 metres away) are actually the same person.
Hence it was decided that a hard copy of the prescription will only be issued should the patient requests it and intends to get his medication at a different pharmacy.
Dr Raj Kumar Maharajah is Vice President of the Medical Practitioners Coalition Association of Malaysia (MPCAM)
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