The health minister recently made a decision in allowing its specialists at the Putrajaya and Selayang hospitals to charge patients private sector fees.

The primary reason of this policy appears to persuade such specialists to remain in government service instead of opting for private practice for financial reasons. No doubt efforts must be made to ensure the continual presence of senior specialists in government service to enable taxpayers the benefit of proper treatment, but is this 'modus operandi' legal?

1. Unlike private hospitals which are built and managed through private financial initiatives, public hospitals are built with public funds sourced via income tax, etc. Is it lawful for government doctors who are civil servants to charge or profit using such facilities without undergoing a corporatisation exercise like TNB, Telekom, Klang Port Authority, etc, that is usually endorsed by our courts and advertised accordingly in the newspapers after of course the whole exercise is agreed upon in Parliament and an Act passed?

This is a dangerous legal precedent. If by all means policymakers feel that this is the way our specialists or skilled staff need to be rewarded then indeed this is what needs to be done. Which will then bring into question how is it the other GLCs took the right legal steps to privatisation but the health minister, who is known for his lack of tolerance for 'illegal' clinics but instead promotes traditional medicine in our hospitals, has suddenly decided it is okay if his ministry does not follow the rules?

2. Secondly, media reports state that the government policy is that general hospitals and clinics are meant for the lower-income group and that it was also difficult to verify the financial status of everyone seeking treatment. The implication is that those with financial means should seek private treatment. Now this is indeed news. Government hospitals are put up using taxpayers' money. It does not matter if the taxpayer drives into HKL with a Rolls Royce. He should, like every other taxpayer, be entitled to proper treatment and not be told that he needs to pay additional private specialist fees or shooed away to seek treatment at a private facility. Has the Treasury, auditor-general and Attorney-General's Chambers been advised of these arrangements?

3. More alarmingly is, who is going to screen if a patient has the ability to pay or not? Is there going to be subtle lobbying to solicit patients and information regarding their illnesses this modified to compel apprehensive patients to seek earlier paid specialist treatment at government hospitals? Worse still if touts (as in Hospital Kuala Lumpur's infamous mortuary) crop up - who will be there to monitor and protect ignorant distressed relatives who may mortgage their houses in a rush to save a loved one? Will the minister then set up yet another Special Health Branch Police Unit to prevent this from happening?

4. Is this a pilot project? Will specialists in Temerloh, Muar, Batu Pahat and Gua Musang also benefit ultimately from this exercise or will it be confined to presumably urban hospitals whose populace may perhaps afford this new endeavour? And if it is restricted to only these urban hospitals, would it mean that our specialists located in these rural towns will be making a bee line to Putrajaya and Selayang Hospitals using whatever 'cables' necessary and in the process abandon their posts in these not-so-profitable rural district hospitals?

5. The health minister has further stated that some of these hospitals will be internationally accredited so that the medical tourist dollars could be raked in. Again, will dollar and euro rich patients have priority in being treated in a hospital built with government and taxpayers' funds at the very expense of our own citizens who helped put up the institution in the first place? And indeed, if these 'arrangements' go awry, will the average Malaysian patient, after 50 years of Merdeka, be actually left on the wayside?

6. And while the health minister dwells on which specialist gets to do what, perhaps he should consider the fact that if this scheme indeed becomes successful, there is a real possibility that specialists earmarked to earn from this programme may then be tempted to keep the cake to themselves and prevent other specialists from coming in as is now rampant in UKM and UM. What will he do then when he is faced with such a situation? Will he overrule sometimes self- seeking heads of departments who currently have the final say in conjuring up an excuse to keep a specialist out? Or will the minister decide to cross the bridge when he gets there, by which time he may not be in office?

These patchy policies to fix chronic problems the ministry has been facing is in danger of not only failing but more importantly may bring this government into greater disrepute then it already is in. The minister clearly appears to be in short supply of properly informed or experienced advisors. There are of course better ways and methods to solving these issues contrary to some who think 'best arrangement for the time being'. Perhaps the minister should read the book 'An Old Man Remembers' written by a previous director-general of health as to why resident-generals and this country's earlier prime ministers took healthcare seriously and personally looked into it themselves.

It is also important to note why prime ministers of that genre paid special attention to the post of director of planning and research at the ministry which was almost always reserved for only the most able and experienced officer and how Malaysia, a Third World nation, was able to achieve First World standards in healthcare statistics with the smallest of budgets in its early years.

The adage that the ultimate healthcare objective is to provide the population with the highest obtainable standard of health and medical care must still be this government's objective. And this can only be attained by long-term planning. There are no shortcuts.