Friday, August 18, 2006

Medical Act - Education not laws is the solution

It is commendable that our Health Minister is so concerned for the emergency treatment of acute cases, especially accident victims. I fully support his moves to equip all clinics with the facilities for basic resuscitation of emergency cases. I am sure most doctors would welcome his endeavors.

All clinics must be equipped with basic gadgets like intravenous drip sets and oxygen for use in dire emergencies. They must be ensured to be in working condition at all times, which regrettably may not be the case even in many of our hospitals and ambulances.

Moreover the doctors must be responsible enough to attend to the patient and make necessary arrangements to transfer him to the nearest hospital as quickly as possible.

At the same time Dr.Chua must remember that treatment of major emergencies requires the expertise of specialists and modern equipment. The duty of the clinic will be to resuscitate and transfer him to a bigger centre as soon as possible. The patient should not be stranded in a clinic for too long, as that would result in irreversible damage and poor prognosis.

In this context it would be wise for the ministry to come up with better rescue operations especially in areas that are prone to accidents. Mobile units properly staffed and equipped with resuscitating facilities must establish as in advanced countries. It is not uncommon to see the arrival of an ambulance that is ill-equipped and inadequately staffed to render proper resuscitation to a seriously injured victim.

Dr.Chua argues the Private Healthcare Facilities and Services Act 1998 is necessary to enforce basic standards are met in all clinics but the Act includes so many provisions that are more than just to fulfill those noble aims. The detailed structural requirements of the clinic, elaborate paperwork for registration and maintenance of the clinic, the additional payments required and above all the threat of punishment with exorbitant fines and imprisonment are beyond the comprehension of members of the medical profession. This drives us to wonder whether there are other sinister motives why the Ministry is so adamant in enforcing the Act.

What is needed is education, training and proper incentives for doctors to adhere to a quality and ethical medical practice. Enforcement of stringent laws will not bring any permanent and lasting results; rather it would invite abuse and corruption.

It may be better for the rakyat and the nation as a whole if the ministry spends more time and energy to look into the numerous problems that plague our government hospitals such avoidable morbidity and mortality, long waiting time for basic investigations and specialized treatment, exodus of experienced trained staff, just to name a few.

Dr.Chris Anthony

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