KUALA LUMPUR, Oct 30 — Several general practitioner (GP) clinics have complained about tedious and unclear processes in the Peka B40 health screening programme, forcing one doctor to drop out.
The Ministry of Health’s (MOH) Peka B40 aid, since hitting the nation in April, has been bearing the brunt of criticism from many quarters and stakeholders nationwide.
One particular community that is disgruntled is the doctors who have registered their private clinics as screening providers for the scheme.
Speaking to one such doctor, Dr Razman Abdul Rahman told CodeBlue that despite registering for Peka B40 with the intention of helping the less privileged group, he found that the procedures were too taxing and complicated to continue.
“The Peka form has to be printed from website by the clinic and the questionnaire is too lengthy, too detailed, and time-consuming,” he explained, adding that this is a burden as he has other patients to look after as well.
Dr Razman, who runs a clinic in Bandar Tun Hussein Onn, Cheras, said that a person-in-charge of the scheme told him the findings and results of the health assessments must be keyed into the Beneficiary Management System (BMS) IT system on the same day as well.
CodeBlue previously reported that doctors’ forms for Peka B40 patients are seven pages long, comprising questions on the patient’s race, religion, education level, work status, address, phone number, social media platform, medical history involving 12 diseases, family history of 11 conditions, tobacco use, alcohol consumption, physical activity, physical condition of various body parts, and data from rectal and breast examinations.
Dr Razman insisted that this is too time-consuming as he sees an average of 120 patients per day. His clinic is equipped with 10 staff and two doctors. It takes about 40 minutes on average to see one Peka B40 patient.
“Most of my patients are children and doctors do need [an] extra hand when examining children or during blood taking.”
Dr Razman has discontinued his services for Peka B40 as he does not “agree with the procedures.”
“The Peka B40 staff acknowledged the issues, but could not do anything,” he said, when he told the staff he would not be participating in the scheme anymore.
“They told me if I’m ready to proceed with the programme, I can just call them again.”
Another GP, Dr Steven Ngo, whose clinic is located in Miri, Sarawak, shared Dr Razman’s concern with his own reluctance of the programme.
He said that the Peka B40 system has no way of letting clinic GPs know the status of the patient in regards to getting the aids and incentives they deserve.
Besides free health screenings at certain private clinics, Peka B40 also offers those from the bottom 40 per cent (B40) of income earners aged 40 and above medical devices (RM20,000 lifetime limit); RM1,000 cash for cancer patients to complete treatment at MOH hospitals; and a transport cash incentive of RM500 and RM1,000 respectively for travel to MOH hospitals in the peninsula and East Malaysia.
“After their second visit, the patients will be referred to relevant departments for aid or follow-up as necessary,” Dr Ngo said.
“We, GPs, wouldn’t know what they are eligible for, when they might get it, or who would actually handle it.
“We are just briefed that the hospital will settle it, and that is quite frustrating, to us and the patients.”
Dr Ngo also lamented that this is especially difficult when the GPs want to know how many of their patients have received the necessary aids.
“I can’t tell you how many received because I never see them after that,” he said.
“Even though they call it a private-public partnership, we are really kept in the dark on a need-to-know only basis.”Dr Steven Ngo, GP from Miri, Sarawak
Dr Ngo complained that the Peka B40 system only allows GPs to check eligibility of patients for the programme, to key in data on their screening results, and to review their payments, without information on their patients’ progress after the screening.
“Only way is to call the patients — but that is only an act of curiosity. There is no way that we can help expedite or navigate the process.”
He also stated that its not an easy task keying patients’ data into the BMS as he too takes time looking into each patient.
Dr Ngo said he takes about 15 to 20 minutes, depending on the patient as if the patient has many health problems, more time will be required.
What Can Be Done?
Dr Ngo was skeptical about the programme’s progress or its future.
“How do you fix something that wasn’t working properly to begin with?” he asked.
“The problem is that the public service is forcing the private sector to follow their system, a system that GPs left because of its inadequacies.”
Dr Razman, on the other hand, said steps can be taken to ensure a holistic programme and clearer terms for the Peka B40 aid to reach more people.
“Simplify the questionnaire. Simplify the whole programme.”Dr Razman Abdul Rahman, GP from Cheras, Kuala Lumpur
“The patients should bring with them the forms, and give more time (for doctors) to key in the results (of the screening).”
Response for the aid has been lukewarm in the six months of its launch.
And with only three months for the year to end, serious measures are needed to ensure a better success rate.
The Peka B40 programme only recorded 87,449 people who underwent the health screening as at September 23 2019, Deputy Health Minister Dr Lee Boon Chye told CodeBlue. He later told the press last October 6 that over 100,000 people have signed up for the programme.
With a target of 800,000 beneficiaries by year-end, the aid has only captured about 13 per cent of its intended target by the end of 2019.
During the same period as of September 23, in terms of its spending, the programme has only disbursed about RM14 million out of its RM100 million budget for the year.
Dr G. Shanmuganathan, the Federation of Private Medical Practitioners’ Association Malaysia’s (FPMPAM) honorary secretary, opined that the programme’s developer should be responsible for its functionality.
“We as an association have advised member GPs that we cannot support the fees Peka offered, for the rate of work demanded. Further, the acceptance of such fees will contradict our demands for the rectification of Schedule 7 with Schedule 13 which the Ministry failed to gazette,” he said.
Dr Shanmuganathan was referring to clinic GPs’ consultation fees of RM10 to RM35 under Schedule 7 of the Private Healthcare Facilities and Services Act 1998 that were not synchronised with their hospital counterparts’ rates when these were increased in 2013 to RM30 to RM125 under Schedule 13.
“Socso has had a similar scheme for years for contributors above age 40, and their penetration rate is still low,” he said, referring to the government’s social security scheme.
“Really, there is no demand for the preventive service by the rakyat,” he said, suggesting that the government put in measures to cut wastage in its processes instead.