30 July 2007

Not wise to go semi-private

The Star

IT IS disheartening to note that the Putrajaya and Selayang Hospitals will be accorded semi-private status 'Two government hospitals to adopt ‘full-paying patient’ concept' (The Star, July 28) in an effort to stem the brain drain from the government to the private sector.

The party that stands to lose most are the post-graduate medical and surgical trainees currently practising in these two hospitals and this problem is just the tip of the iceberg.

The concept of allowing subsidised private care in Malay-sian government hospitals was pioneered by two teaching hospitals in the Klang Valley.

The aim was to prevent the growing number of physicians and surgeons from leaving the government service to join the more lucrative private sector.

The reality is that, the exit door is still wide open and that eventually, the number of medical practitioners retained, especially at specialist level, is less than 10%, despite the incentive.

The reality is also that most specialists will use the private-practice incentive in those selected hospitals as a stepping-stone to the world of in-dependent practice in private hospitals.

There is inevitably a conflict of interest between caring for government patients and private practice.

In addition, there is also a conflict of interest between training postgraduates (in the teaching hospital/government hospital setting) and focusing on private work within the same institution.

Postgraduate training in specialities such as medicine and surgery rely on patient volume and appointed lecturers to guide students to be competent practitioners who can practice safely.

Somehow, Britain, Ireland, Australia and New Zealand as well as Singapore have succeeded in training their doctors to become specialists within the government setting, minus the interference from private practice.

There are several measures that the Government should consider:

· OUTSOURCE post-graduate training in various specialities especially internal medicine and surgery to Europe/Aus-tralia/New Zealand (in the form of scholarships) coupled with a longer bond to government service;

· MATCH the pay of private sector to stem the brain drain;

· SEPARATE private and government practice within the same institution; and

· MAKE post-graduate training a form of “national service” to all Malaysian-registered specialists and consultants.

Petaling Jaya.

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