KUALA LUMPUR, Feb 24 — The Ministry of Health’s (MOH) town hall on reviewing its proposal to incarcerate doctors who reject patients’ prescription requests did little to dissuade concerns, stakeholders said.
In fact, stakeholders from the health sector who attended the February 13 meeting in Putrajaya were even more concerned than ever, after top MOH officials admitted that they were just as in the dark about these proposals until CodeBlue reported on the controversial Poisons (Amendment) 2019 Bill when it was tabled in Parliament late last year.
Doctors’ groups were also upset that the ministry has not indicated that it is changing its tune anytime soon on its proposed imprisonment for health care professionals who decline to issue medicine prescriptions on request. MOH instead appeared to be intent on bulldozing the Bill through in Parliament next month.
The proposed amendments would effectively criminalise doctors, dentists, and veterinarians who decline to issue medicine prescriptions requested by patients by sentencing them to maximum five years’ imprisonment, a fine not exceeding RM50,000, or both.
After uproar from the medical fraternity, lawmakers, and the public, Health Minister Dzulkefly Ahmad postponed the second reading of the Bill to the March Parliament meeting.
He also said that consultations with stakeholders would be convened to hear their views in order for MOH to improve the amendment Bill, the first of which was held on February 13. Dzulkefly had said the criminalisation of not complying with prescription requests could be changed to misconduct or a breach of ethics instead.
But the session only made matters worse, as it showed the move was done on a whim and not in consultation with senior MOH officials, the Federation of Private Medical Practitioners’ Association Malaysia (FPMPAM) claimed.
FPMPAM honorary secretary Dr G. Shanmuganathan, who was at the February 13 meeting, told CodeBlue that Dr Ramli Zainal, senior director of MOH’s Pharmaceutical Services Programme, came under heavy fire from Dzulkefly that day over the Bill.
“The minister questioned Dr Ramli on why fines under Section 32(2) on offences relating to poisons were increased from RM3,000 to RM50,000,” said Dr Shanmuganathan, who is also president of the Private Medical Practitioners Association of Selangor.
“Dr Ramli replied that this was raised to act as a deterrent. Furthermore, the Attorney-General’s Chambers had reviewed the proposal and wanted to streamline fines.
“The minister retorted, ‘Why not RM1 million?’. Dr Ramli had no answer.”
Dr Shanmuganathan added that he was shocked by Health director-general Dr Noor Hisham Abdullah’s own admittance at the stakeholders’ town hall that neither Dr Noor Hisham nor Deputy Health Minister Dr Lee Boon Chye were aware of the clauses on the fines and jail sentence for not providing a prescription on request.
“This prompted the minister to question an embarrassed Dr Ramli on how this was possible,” Dr Shanmuganathan alleged. “To which, Dr Ramli said presentations were done all the same, but that their ‘focus was elsewhere’.”
“They themselves were taken aback when the controversial jails and fines were highlighted by CodeBlue as they had not paid much attention to this,” Dr Shanmuganathan further claimed.
Two other sources, who attended the February 13 meeting, confirmed Dr Shanmuganathan’s allegations and similarly expressed shock. They requested anonymity to talk about internal discussions.
Dr Shanmuganathan said the process of proper drawing up of the amendments was “flawed” and, therefore, “did not deserve to be escalated to Parliament”, which convenes on March 9.
“One participant mentioned that previous DGs (director-generals) would go through such amendments line by line before putting their signature of approval,” he added, in a rebuke directed at Dr Noor Hisham.
When contacted, Dr Noor Hisham appeared to play down these concerns, saying there was “no issue” on the matter, except on implementing mandatory prescriptions upon request.
“What we can agree to agree on,” he told CodeBlue, is on solving these issues amicably before the Bill is tabled to Parliament, adding that the ministry took note of all the issues raised during the February 13 stakeholder session with 25 associations.
Various groups representing doctors, pharmacists, veterinarians, dentists, private hospitals, pharmaceutical manufacturers, and consumers attended the February 13 town hall with Dzulkefly, Dr Noor Hisham, Dr Ramli, MOH secretary-general Dr Chen Chaw Min, and MOH deputy director-general (Medical) Dr Rohaizat Yon.
A few more stakeholder sessions will be convened to come up with “common solutions”, Dr Noor Hisham said, the next of which was scheduled tomorrow in Putrajaya.
Asked if the sessions will be convened before Parliament starts again in two weeks, Dr Noor Hisham said, “Hope we can do it ASAP (as soon as possible).”
However, according to an invitation issued by Dr Ramli, tomorrow’s session will “finalise” the matter, which Dr Shanmuganathan noted contradicts Dr Noor Hisham. The FPMPAM officer said tomorrow’s town hall was unnecessary unless “they wanted to save face” and there was a political motive.
Dr Lee, on the other hand, said he was not present during the February 13 session and did not comment further, while an aide to Dzulkefly declined to confirm if a revised Bill would remove mandatory prescriptions and if a new version of the Bill would be tabled instead.