1Malaysia Clinics and the PHFSA – Mortal Brew of Health Ministry Connivery and a Lame Duck MMA President

I refer to the MMA Presidents comments in his recent article “1Malaysia Clinics: An exercise in futility” in the Malaysiakini and the continuing nationwide harassment of General Practitioners especially in the state of Penang by elements at the Ministry of Health led by its disgraced and controversial Director-General, Ismail Merican. The current fault where private practitioners are now being treated as quasi-criminals by health authorities and continue to do so must decidedly lie with these doctors themselves. Unlike the majority of post-2008 Malaysians, they have chosen to remain silent and must now, like all unregistered voters, pay that proverbial high price for remaining cloistered in their shells.




Their grouse, the Private Health Facilities and Services Act (PHFSA) is the demonic brainchild of consumer groups in particular the Consumer Association of Penang. Two out of work doctors at the Ministry of Health put together a disparate chunk of ambiguous edicts from various different countries and called it the PHFSA. These two doctors who tried to do a hard sell on the then Health Minister, Chua Jui Meng throughout his tenure failed when, Jui Meng, being a trained lawyer, refused to buy it.


For starters, he knew both of them had obstructed discussion of the proposed legislation by blocking inputs from the very doctors it was going to be applied upon by lumping all discussions pertaining to the act under the Official Secrets Act.  Secondly, Chua Jui Meng, now a stalwart with the Pakatan Rakyat, discovered their motives of wanting to force doctors to purchase equipment peddled or attend courses driven by health ministry cronies as the main reason behind the application of the OSA on a medical law. However both Khairy Yaakub and Wan Mazlan realized their opportunity when an ignorant and harebrained Chua Soi Lek walked into the picture. This time the sales pitch worked.


Appalled doctors who realized the gravity of their connivance and implications of the proposed law threatened to march to parliament but were let down when their own representatives – Steven Chow, Ng Swee Choon, Mary Cardosa and Teoh Siang Chin sold them out lock, stock and barrel to Chua. The PHFSA became a reality and soon enough despite all of Chua’s pronouncements (who himself was proven to be untrustworthy by subsequent video revelations at a Batu Pahat hotel) engulfed a bona fide, unsuspecting Malay doctor from USM, Dr. Basmullah Khan who did not even have the financial means to engage counsel.  Despite ambiguity virtually popping out of every line of the Act, a poorly read judge decided to throw Basmullah into the slammer instead of reading the PHFSA together with that of the duties of a medical practitioner as outlined in the Medical Act 1971.


MMA doctors who were stung by his jailing, tried to sign-up for an MMA EGM to discuss this issue but yet again were foiled by their own brethren at the MMA in the form of its government employed Secretary-General, Mary Cardosa who instead of focusing on the gravity of such a law on the profession instead chose to split hairs regarding inadequate number of members who had asked for the EGM (apparently, like the current MMA President, David Quek, some had not paid their subscriptions on time and therefore not eligible to call for an EGM, let alone vote).


David Quek, from whom much was expected for something to be done about this law, remains quiescent and ineffective to say the least. He appears consumed by a mixture of blogging, novel writing and poetry peppered occasionally with eloquent statements muddled with the now infamous MCA purr…meow. Indeed he appears hopelessly lost. Perhaps bringing into focus the very fact why many in the MMA were very suspicious if he could deliver his election promises considering the fact that Teoh and Cardosa had sold them outright to the altar of Chua and Merican in the past. If it was the Bar Council, David would not only have had to vacate his position but may likely end up being investigated and struck off for dereliction of duties.


The MMA President has failed in two very important tasks. One is his role in the MMC. To the disgust of many, David has been part and parcel of MMC hearings involving the suspensions or reprimanding of 6 leading specialists and 10 senior GPs, one of whom subsequently died of a heart attack after being informed he was suspended for employing a Medical Assistant (now glamorously coined Assistant Medical Officer – the types that don’t do housemanship and take only three years to graduate after Form 5 and appear today as possible stand-ins for urban run 1Malaysia clinics proposed by the government).What irony? Of the specialists some have been informed that they stand to loose their practices by their employers. A significant number of these doctors lost their clinical rights based on an archaic misdemeanor called infamous conduct. What’s that? Is that when a doctor knocks off a baby’s arm or a Health Minister is caught bonking a hooker while holding public office? Apparently not.


The MMA President, by lending the name of the MMA, nay indeed being an active member in prosecuting and doling out “punishments” by taking away doctor’s livelihoods in hearings led by a hopelessly biased government establishment unschooled or poorly advised on medical litigation matters has no buisness being President anymore. Legal advisors to the MMC have complained about the blatant abuse of PIC heads and the DG himself in not following legal procedures but choose to become judge, jury and executioner against all legal advice despite evidence to the contrary. Some of these advisors have even walked out in protest. But the MMA President remains.  Shouldn’t the MMA President, like the BMA, be wearing the other shoe and taking the MMC to task or even to court instead of being part of this shameful charade.


Clearly, this MMA President does not hold similar views as that of the previous DG of Health Tan Sri Mohamad Taha, who not only went out of the away to protect doctors knowing very well the imperfect milieu all of them function in especially in this country, but to his credit Taha made every effort to bring back doctors to clinical practice those of whom were suspended or struck off the register by his predecessors. Of great disappointment is that almost all the doctors suspended, reprimanded or struck off are from the PRIVATE SECTOR, the very doctors whom David and the MMA purpotly represent.


Pray tell Mr. MMA President, despite the Ministry of Health being the Ministry with the highest number of complaints this government has ever had to face, why isn’t there even one single doctor from the government sector struck off, reprimanded or suspended. If this is not persecution then this President is clearly out of depth and ought to call for early elections or just leave. And please spare all private practitioners the ignominy and humiliation of having to tolerate Mary Cardosa, yet another government lackey, as their President. She may this time round, even sign off the MMA building to the government for a 20-storey shopping complex.


But more ominous is the President’s complete lack of action regarding the PHFSA. Clearly the harassment continues unabated. Doctors in Penang are up in arms, some even considering leaving the profession as the Ministry’s “enforcement officers” who clearly have nothing better to do continue to prey on their practice. While Basmullah spent 3 months in the slammer and private practitioners continue being harassed by all these government doctors who appear impervious to MMC regulations, the road side pile jabbers and sinsehs peddling leaves and acupuncture continue to do roaring buisness, no thanks to Chua Soi Lek’s and Merican’s endorsement of traditional medicine. Further, 1Malaysia clinics run by Assistant Medical Doctors- a lobby far more powerful then the impotent MMA are now threatening to come on aboard. The MMA President appears lost, dazed and is probably getting ready to unleash another slumbering article.


When doctors threatened to march during the time of the PHFSA implementation, they should have been allowed to do so. On hindsight trusting an adulterous Health Minister and a DG who danced with the powers that be to deny immorally, unethically and surely infamously a justified post-mortem of the battered body of Kugan has done far more grievous harm to this profession. Indeed Merican’s blurtings and blackmailing in the use of the PHFSA at every drop of the hat including billing disputes and sodomy cases has clearly proven the ulterior motives for the passing of this Act. It is evident now that all the players involved in the marketing and implementation of this law are of poor character and had hood-winked BN parliamentarians possibly contributing to their massive losses in the 2008 general elections.  But that was yesterday.


Much has changed since. The political scene is now heavily colored by a resurgent and formidable opposition. Chief Ministers think nothing of declaring seats of delinquent assemblymen vacant. Ministers are sued regularly. Even judges and Mahathir have been hauled up. No one is spared. And many have sacrificed much. Some lost their freedom to Kamunting. Some have resorted to exile. Some sadly paid the ultimate price and lost their lives. The age of information and reality are here. Make no mistake. Almost every sector of the Malaysian strata from Sampoerna to Balik Pulau is wide awake and fighting back. But the MMA President dithers. Devoid of courage and possessing a pandering reminiscent of some component parties of the ruling party, the current MMA President surely must sense doctors’ intense disgust and impatience for more concerted efforts pertaining to their rights as practitioners.


By now he should have written to every private practitioner if they want an EGM to discuss the PHFSA. By now he should have consulted a team of lawyers to seek leave to look into a judicial review and stay all further actions of this acrimonious act. By now he should have gone to the ground and provided legal assistance (no, not the MDU/MMI crony lawyers) to doctors severely harassed by enforcement authorities. By now he should have pooled funds from all GPs affected and sued any authority who acted or trespassed clinics illegally or have contravened in the legal restitution of medical care to the infirm by qualified doctors. By now the President should have decided whether he is up to the mark in delivering and discharging his duties to the very doctors who (and to those who didn’t) put him there. And by now the President should have decided that perhaps he may not be capable and instead of deluding himself and hogging onto the seat just so he can go on a safari jaunt, should perhaps vacate the seat and his place at the MMC to someone who is willing to stand up for doctors.


If he doesn’t have the gumption nor nerve to stand up to all the bullying, he at least should not be part of it. But for David, like Koh Tsu Koon, it may be too late in the day and he should perhaps just to do the honorable thing and resign. All future Presidential hopefuls should perhaps note that if they want to be yes men like many of our Court of Appeal judges, then they should just perhaps focus on their practice instead of assuming an office they very well know they cannot discharge their duties effectively and in the process invite ridicule to themselves and the profession.