In a letter to The Star

Outsourcing of medical services will benefit everyone I REFER to your report, “Chua wants waiting time at hospitals cut,” (The Star, April 3). The long waiting time at government hospitals has been a perennial problem since the Government expanded the outpatient services both in the urban and rural areas. There has also been a recurrent exodus of doctors from the public sector to the private sector since Independence. As a result, the Government is unable to cope with the large number of patients seeking free medical treatment at government outpatient clinics and health centres. It must now make a paradigm shift in its archaic and failed policy of caring for the sick. The management and treatment of patients at government hospitals must be outsourced to the private doctors who can manage them at a lower cost. Outsourcing of services is the trend in all sectors to create a cost-efficient outcome. Banks today have outsourced a major portion of their workload to concentrate on their core business. The Health Ministry should concentrate on hospitalisation and outsource all rudimentary clinical services to the private general practitioners. It is wasting its limited resources in competing with the private general practitioners and overloading the limited number of government doctors. The fees structure for these services will be far cheaper than that which is costing the government hospitals. A study done in the 1990s found that the Government was spending an average of RM25 per patient at its outpatient clinics, excluding rentals and infrastructure cost. Outsourcing of medical services will ultimately lead to the re-emphasis on the role of family doctors in the country's primary healthcare delivery system. DR MAHENDRAN MARKANDOO, Petaling Jaya.

Outsourcing will benefit everyone, will it? Most probably the General Practitioners! I disagree with Dr Mahendran that outsourcing is the way to go. For a start, if GPs want a greater role in alleviating the long waiting lines, then they must be prepared to give free services or at least rock-bottom prices. It would cost the Government $25 per patient as meticulously calculater by Dr Mahendran, but how much would it cost the general public if they were to visit a GP?. Mind you not many in the rural areas will be able to fork out even $10, let alone $25!

Secondly, the practice of certain GPs are not in line with the latest in clinical practice guidelines. This creates a problem if outsourcing is allowed. There will no longer be uniformity in the treatment patterns and the Government has no control over them except perhaps through the Malaysian Medical Council. I have come across several GPs that prescribe exotic and at times experimental treatment. Some even prescribe traditional medications to their patients!

However , noble the intention, i believe outsourcing is not the answer. It would only solve matters in the short term! The strategy is to maintain and improve the current resources that are available. There is a need to improve human resource and administrative skills in the Government. We need individuals trained in business administration to help run the Ministry and hospitals. Doctors do not know how to manage people in a corporate manner. This is the main reason why many government employees are not happy and thus showing in their declining productivity. The Government needs to take the cream of the crop not the discards, as is happening today!

IN short, we need an overhaul of our administration. Our current system is weak , thus our current predicament. But will this be possible? *shrugs*