Doctors Suspect Mandatory Prescriptions Bill ‘Backdoor’ To Dispensing Separation

A 2015 stakeholders’ meeting saw an agreement on separating the prescribing and dispensing of medicines to doctors and pharmacists respectively only if a national health insurance scheme is implemented.

KUALA LUMPUR, Dec 3 – Physicians have alleged that legal amendments mandating medicine prescriptions upon patients’ request may lead to dispensing separation that was previously postponed in 2015.

In 2015, the previous government, run by Barisan Nasional (BN), tried to table a Bill on dispensing separation (DS), which means that doctors prescribe the medication while pharmacists dispense the drugs to patients, but it was halted because of opposition from doctors’ groups.

“Honour the decisions made at the 2015 stakeholder meet on Pharmacy Bill in Port Dickson. Please stop backdoor entry to DS. Don’t sabotage the new government and Minister,” Medical Practitioners Coalition Association of Malaysia (MPCAM) president Dr Raj Kumar Maharajah tweeted.

“There seems to be a concerted effort by some, to frustrate the GPs (general practitioners) by new legislations, until we willingly give in for Dispensing Separation,” he added.

Physician groups have slammed the tabling of the Poisons (Amendment) 2019 Bill in Parliament last week, as it proposed a maximum five years’ jail, a fine not exceeding RM50,000, or both for doctors, dentists, and vets who decline to issue prescriptions requested by their patients. The Bill also enhanced powers of Health Ministry enforcement officers, protected them from lawsuits, and allowed evidence from agents provocateur.

Currently, many private GP clinics do not issue prescriptions unless requested by their patients because they typically dispense the same medicines that they prescribe, amid low consultation fees capped by legislation at the same rate of RM10 to RM35 for almost three decades.

Dr Raj Kumar explained that the government organised a meeting among stakeholders in 2015 after doctors found out that a Bill on dispensing separation, the Pharmacy Bill, would be tabled, supposedly without their input.

“Due to negative publicity as it was done in secrecy just like what happened now, the government organised a stakeholder meet in Port Dickson (PD) for five days. We had to stay and discuss with consumer associations, industry players, doctors, pharmacists, dispensers and civil society,” he said.

He added that there were 100 participants, with all stakeholders represented in the meeting, moderated by Pemandu.

“They wanted dispensing separation, mandatory prescription, there were jail sentences for every offence, even trivial ones. The pharmacists wanted their own director-general (DG), independent of the health DG. They barred pharmacists and dispensers from working in GP clinics with doctors.

“Excessive powers to enforcement officers were included in the bill,” he added.

The meeting concluded with stakeholders agreeing that dispensing separation can only come in once there is a national health insurance scheme.

“At the conclusion it was decided that the DS can only come once doctors’ fees are harmonised and there is a national health financing scheme. So we were all asked to wait till the system was in place,” said Dr Raj Kumar, adding that the Pharmacy Bill was never tabled in Parliament.

Malaysia’s public health care system is currently financed by general taxation, rather than a social health insurance scheme.

Other doctors also took to Twitter to voice their displeasure.

Deja-vu of the 2015 DS onslaught by some and now a backdoor attempt. Five days RUUF stakeholders’ engagement held in PD in 2015. Findings were clear and rakyat centric,” posted Dr Arasu, the honorary general secretary of the Malaysian Medical Association (MMA), referring to the stakeholders’ meeting on the Pharmacy Bill.

MMA past president Dr Mohamed Namazie tweeted: “DS only with National Health Insurance to safeguard patient safety. There should be no monetary benefit for doctors and pharmacies will not sell drugs without prescription. Pharmacies must show prescriptions for reimbursement.”

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