Malaysiakini Letter

Stop working in silos, build integrated healthcare together

Amrahi Buang

LETTER | The Malaysian Pharmaceutical Society (MPS) recognises the plea made by general practitioners (GPs) during a recent town hall session with the Health Ministry to harmonise their consultation fees. MPS supports their call for an increase in fees - provided community pharmacists dispense medicine to create an integrated healthcare ecosystem in the country.

Creating an integrated healthcare system that sees the active participation of all stakeholders, especially community pharmacists, is key to Malaysia achieving universal health coverage (UHC). This will also ensure healthcare is within reach to Malaysians of all walks.

An increase in consultation fees, which has been highlighted repeatedly over the years, will result in GPs not relying on selling medicines to earn a living - which they have done so all this while.

If the powers-that-be address the consultation fee issue, then by right, patients should be able to decide where to buy medicines If a patient requests for their prescription, then the doctor should rightfully give it to them. But in reality, will that happen?

If a GP refuses to give the prescription, the question is what can a patient do? If the matter concerning fees of the GPs have been addressed but they still insist on selling medicines, then this gives the presumption that GPs only want to increase their income at the expense of the patient.

We would also like to know how the government will ensure patients are handed their prescriptions upon request. By right, the onus is not on the patient. The onus is on the GPs to give the prescription regardless.

Such a move will see the rise of patient empowerment – being able to have control over health management to reduce dependence on physicians for a better quality of life.

The WHO's “Health 2020” initiative sets patient empowerment as the main goal for achieving better results in healthcare. Malaysia scored 70 per cent in the UHC index as stated in the "2017 Global Monitoring Report: Tracking Universal Health Coverage".

Health Minister Dzulkefly Ahmad had at the 72nd World Health Assembly in Geneva on May 21 said the government will strengthen public-private partnership with the establishment of the Health Advisory Council.

MPS believes an integrated system, instead of a partnership, will help break the silos within the industry which will benefit the rakyat, especially those from the B40 and M40 groups.

For the left to talk to the right to form any partnership, we need to be fully integrated especially regarding UHC. We want the whole healthcare system integrated. Right now it is very silo-ed.

There seems to be control in the public sector, but there’s no control at all in the private sector. It’s not a level playing field in the private sector as there are dominant players.

Also, the lack of awareness regarding non-communicable diseases (NCD) in Malaysia compared to other nations is the main cause of the plateauing lifespan of Malaysians at around 75 years.

This is where pharmacists and doctors should join forces and be the primary healthcare team to support patient care and educate the masses.

The new schemes by the government for the B40 group – mySalam and Peduli Kesihatan B40 – should involve community pharmacists as our pharmacists are trained and competent in responding to symptoms and are able to prescribe a wide range of medications under the category of Group C scheduled medications.

Pharmacists are ever willing to support the government’s aspiration of UHC through our professional services. Our community pharmacists are easily accessible to all. Furthermore, the prices of medicines are very much transparent compared to GPs and private hospitals which do not practice itemised billing for medications. Therefore, the allocation via these healthcare cards go a longer way if patients are able to see community pharmacists for minor ailments.

MPS has been urging the decision makers to adopt dispensing separation to allow community pharmacists to play a bigger role to serve the community.

There are over 2,780 community pharmacies in urban and rural areas nationwide. However, community pharmacists have always been seen as mere medicine sellers. This view has to be corrected.

Community pharmacists are part of the community. We are medicine experts, we are guardians of medicine and we are healthcare professionals. A strong referral system which involves community pharmacists referring patients to GPs can greatly benefit the rakyat.

The writer is president, Malaysian Pharmaceutical Society.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.

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