Has the MMC gone rogue in the recognition of specialists?

 

The management of Malaysia’s healthcare system is showing some serious cracks. Using a medical term, some are saying it is now under the care of the high dependency unit.

Quick action by the health ministry and the Malaysian Medical Council has to be taken before it lands itself in the intensive care unit.

The figures in most health sectors are worrying, and some very telling.

With most leaders indulging in heavy politicking, pressing matters like this that affects the people are not being given the attention that is due.

More than 6,000 contract doctors have left government service in the past six years, mostly due to long waits for permanent employment. Some threw in the towel after claiming they have been overworked and underpaid. The number is set to grow, apparently.

However, the most telling figure that ought to have jolted the authorities is that about 1,500 heart and lung disease patients in government hospitals are forced to wait up to a year for life-saving surgeries. All because of a serious lack of qualified surgeons.

In addition, the Malaysian Association for Thoracic and Cardiovascular Surgery which gave this figure has estimated that two patients die each week. There are only 14 cardiothoracic surgeons left in public hospitals, working against time to save the lives of these patients.

A surgery in private hospitals can cost at least RM80,000. In government hospitals, patients pay only about RM500.

Despite this utmost urgency, the medical council, MMC, has taken a questionable stand by refusing to recognise cardiothoracic surgeons who were trained at the Royal College of Surgeons of Edinburgh under the health ministry’s parallel pathway programme.

The Edinburgh programme is recognised by the rest of the world.

Without this accreditation, the specialists cannot be placed in the national specialist register, and cannot practice, either in the public or private sector. Right now, there are four cardiothoracic surgeons who have completed the course and 28 more in various stages of completion.

This serious issue was raised by none other than the health ministry’s chief of cardiothoracic surgical services Dr Basheer Ahamed Abd Kareem. He should know best as he is also the president of the Malaysian Association for Thoracic and Cardiovascular Surgery.

With only 14 cardiothoracic surgeons in government hospitals, the situation can’t be more dire. Some are due for retirement in a few years, including Basheer. With a couple more expected to leave for the lucrative private sector soon, we are in serious trouble.

What many find hard to fathom is that the MMC chief and the director-general of health are one and the same person – Dr Radzi Abu Hassan. And yet a recent ministry circular made people wonder if he knew what he was doing.

The ministry invited those with specialist training in the fields of cardiothoracic surgery, family medicine and plastic surgery from Edinburgh and two other royal colleges to apply for the minimum six-month gazettement programme. This is a path for those in the parallel pathway to practise as specialists.

How can this happen when the MMC is refusing to recognise the very qualifications for registration as specialists? In response to media articles questioning this anomaly, Radzi replied wearing his MMC cap.

He said the cardiothoracic surgeons from Edinburgh were never recognised by the regulator. But this was strongly disputed by senator Dr RA Lingeswaran who pointed out it was in the MMC list until January 2022 before suddenly “vanishing”. MMC failed to respond to this claim.

Lingeswaran raised this again at the Dewan Negara with higher education minister Zambry Abdul Kadir, whose portfolio oversees specialist training at the 11 public teaching hospitals in the country.

His immediate response was that the MMC should answer. However, he went on to say that this non-recognition is a big loss for the country as there is a dire need for the specialists in our public hospitals.

Zambry said the Cabinet decided that a special committee should be set up by the MMC and the health ministry to resolve this matter once and for all.

Lasst week, Radzi announced that a special task force has been set up to reevaluate the recognition issue.

Now, questions are being raised by certain groups on the composition of the panel. According to records, MMC chief executive officer Dr Anas Hussain is a medical officer and not a specialist.

Based on the names of the members in the seven-man special committee, there is no cardiothoracic surgeon among them. The fraternity holds this to be indeed very odd as a major issue involves the recognition of these specialists.

A check with the thoracic and cardiovascular association confirmed that none of its members were appointed to the committee. To make it worse, none of them were also called up by the panel to give their views during the evaluation process.

If the MMC cares to look around, there are scores of experienced cardiothoracic surgeons who have retired or are still practising in Malaysia with qualifications from the Edinburgh college.

They are the best people who would be able to give valuable input before the MMC makes a final decision.

The Malaysian Medical Association has also asked the MMC for details of the background of the committee members in the special task force.

“As this is a matter of public interest, we demand full transparency and clarity with regards to the task force’s composition, terms of reference and timeline,” the MMA said.

“We seek MMC’s urgent clarification on this matter as many in the fraternity as well as members of the public have voiced confusion over MMC’s statement and recent developments concerning the issue,” it said in a statement.

The MMC is a body entrusted with powers to ensure medical professionals give their best to their patients and the nation. It also introduced the Code of Professional Conduct, providing the yardstick for the proper conduct and behaviour of doctors in their clinical practices.

Consonant with the council’s motto “Safeguarding Patients, Guiding Doctors”, there is a need to inject professionalism into the operations of the MMC. - FMT

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.