As a dedicated government doctor, specialist, and senior consultant, and currently retired, I have served the Ministry of Health (MOH) for more than 35 years.
I was born as a member of the generation of baby boomers, thus becoming a doctor was a service with the ability to earn a good living and respect from the community.
I realised that 20 to 30 years ago, it didn’t cost the government much expenditure to sustain the service.
The reason being most of us were in hardship and doctors were service-oriented, with minimal expectations for monetary benefits. We served with the joy of caring for patients and assisting their healing process.
Besides, the government then had to fork out one-time lump sum payments for salaries and instruments. There was minimal expenditure on disposals like sutures or medications.
Also, there were no fancy investigation tools at that time. Treatment was solely dependent on the doctor’s or specialist’s ability to treat the condition with whatever minimal equipment that was available.
Hence, the government was able to sustain the public health service with minimal charges of RM1 and RM5. Patients who stayed for long admissions or underwent major surgeries could get away with paying RM100 or less. The population then was not that large and was much less demanding, as people understood the situation at that time.
However, if we fast forward to the past 10 years, and subsequently, current times, advancements in the medical field have changed health care from a labour-intensive service to a technology-intensive service. Technological advancement is so rapid that it is advancing even as I am writing this article.
With this rapid change in the mode of medical care, how is it possible to maintain the health service with minimal charges like how it was decades ago, and to retain doctors in the public service?
We need to understand that if medical treatment depends on technological assistance, this will cost the government a large sum of money as health care is free in our country.
Patients nowadays also expect the latest and the best treatment, since information regarding updated treatment is available on the Internet.
It is inappropriate to give substandard treatment in government hospitals just because it is free.
Retaining Specialists In Government Service
Medical and surgical services in Malaysia currently use lots of technology, like advanced radiological investigations, minimally invasive surgery, robotic surgery, and many time-saving tools to treat patients.
Unfortunately, most of this is widely available in private health care, enticing doctors and specialists to join private hospitals.
Public hospitals are expected to give the same treatment from 20 years ago, as the government lacks the budget to provide for advancements, since public health care is free in Malaysia.
The current generation become doctors because they want to treat patients using the best of their knowledge and technology, while also expecting a reasonable income to provide a safety net for their living.
However, the government can’t fulfil what doctors want. Instead, the government is pressuring doctors to stay and serve.
What do we expect from doctors and specialists who face high pressure from their superiors, heavy patient loads, and meagre earnings?
On the other hand, the mushrooming of private hospitals which come with state-of-the-art facilities and good benefits provide better opportunities and career advancements for doctors.
I suggest upgrading services in all major government hospitals, according to the latest technological intensive service, and introduce some form of social insurance to bear the brunt of financing the health care service.
This will enable us to render service that is equal to the private sector.
Otherwise, there will always be a disparity between the public and private health services. I foresee a severe brain drain of well-trained and dedicated specialists to the private sector and to neighbouring countries if we do not resolve these pressing issues.
Dr Nagarajan T. Vellasamy is a retired consultant surgeon from Penang.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
