‘Why Use Agents Provocateur Against Doctors?’ Government Asked

MPCAM questions “excessive” powers given to MOH enforcement officers, noting that patient confidentiality can be compromised in their searches and seizures.

KUALA LUMPUR, Dec 2 — Doctors’ groups today repeated their call for the health minister to withdraw proposed amendments to the Poisons (Amendment) 2019 Bill despite his explanations.

Besides asking for the removal of Section 19(2A) that mandates physicians to issue prescriptions upon their patients’ request, the Malaysian Medical Association (MMA) also expressed concern with the vast powers granted to Ministry of Health (MOH) enforcement officers, who are protected from lawsuits under the Bill.

“In the same vein, we feel that the clause on agents provocateur should be redrafted to ensure that malicious and mischievous persons do not cause damage to the practice and reputation of doctors,” MMA president Dr N. Ganabaskaran said in a statement.

“The MMA strongly urges the Minister of Health to withdraw the proposed Poisons Act 1952 Amendments Bill. We feel that it has been drawn up without meaningful or significant consultation with the profession, especially the private medical practitioners, who will be most affected by it.”

The largest group of doctors in Malaysia said the provisions in the Bill on mandatory prescriptions by doctors, dentists, and vets upon request — with violations punished by maximum five years’ jail, a fine not exceeding RM50,000, or both — should be removed because the Medical Act 1971 and the Private Healthcare Facilities and Services Act 1998 already provide for patients to receive on request any information about their disease and treatment, including the drugs prescribed.

“The MMC (Malaysian Medical Council) has heard cases of complaints against registered medical practitioners for refusing to provide prescriptions on request, and has the power to fine, reprimand, suspend or remove from the medical register any practitioner found guilty of this offence.

“In our view, the inclusion of a jail sentence is needlessly draconian. The Ministry of Health, of all government bodies, should avoid criminalising those it oversees,” Dr Ganabaskaran said.

Health Minister Dzulkefly Ahmad announced yesterday that the Poisons (Amendment) 2019 Bill would be reviewed, after criticism from several physician groups against the criminalisation of doctors for not issuing prescriptions upon patients’ request.

He also denied claims that doctors would be sentenced to prison for not issuing prescriptions upon request, saying that patients must first undergo a doctor’s consultation before asking for a drug prescription.

But the Medical Practitioners Coalition Association of Malaysia (MPCAM) said the option for incarceration still remained in the Bill.

“That’s bad enough. Jail terms should be limited to criminal activities,” MPCAM president Dr Raj Kumar Maharajah said in a statement.

Like MMA, MPCAM also asked for full withdrawal of the Bill, describing the Section 31 and Section 34 amendments on the new powers of MOH enforcement officers and agents provocateur as “suicidal”. The Bill empowers enforcement officers to search private clinics, hospitals or other premises and to seize documents or other items if an offence was suspected.

“Section 31 gives excessive powers to the pharmacy enforcement unit, bypassing checks and balances and can condemn the doctor forever. Clinic records are open to abuse and patient notes and confidentiality will be compromised,” Dr Raj Kumar warned.

“Section 34 agents provocateur appointed to provoke doctors to do wrong are protected. We don’t see why we need agents appointed to provoke doctors,” he added.

“While the government talks about decriminalising drug addicts, they are now criminalising doctors.”

Dr Raj Kumar Maharajah, president of the Medical Practitioners Coalition Association of Malaysia (MPCAM)

The MPCAM president also criticised provisions in the Bill that protect MOH enforcement officers from lawsuits if they wrongfully embarrassed doctors as long as their actions were done in “good faith”.

“What is ‘good faith’?” he questioned. “It is very subjective.”

MMA president Dr Ganabaskaran added that the inclusion of a new clause in the Bill on electronic prescriptions must be much more comprehensive, expressing concern that apps providing online doctors’ consultation and treatment could lead to an environment where patients never meet their doctors and can simply select their medicines based on a menu of symptoms.

“Unregulated antibiotic use, suboptimal treatment of non-communicable diseases, and abuse of benzodiazepines will cause a whole new public health nightmare,” he said.

Correction note: The Poisons (Amendment) 2019 Bill enhanced the punishment for offences against the Poisons Act from maximum one-year’s jail, a fine not exceeding RM3,000, or both to maximum five-years’ jail, a fine not exceeding RM50,000, or both. Under the Bill, declining to issue prescriptions upon patients’ request is defined as an offence against the Act. The article has since been corrected to reflect the new proposed punishments.

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