It was indeed heart-wrenching to read the media reports concerning baby Mohd Danish Mohd Aftan who underwent surgery to remove his infected leg, baby Nur Alya Sabrina Ruzaimi whose head was cut during a Caesarian section, baby Lai Yok Shan who lost part of an arm and the member of Parliament’s wife who is in critical condition after undergoing cosmetic surgery.
All these cases were probably due to adverse medical events. In addition, there have also been many other cases involving adverse medical as reported by the media in the past.
Former health minister Dr Chua Soi Lek and even the Health Ministry Director-General Dr Ismail Merican, have appeared to profess patient safety as the health ministry's priority. Ismail had in 2004 also announced that ‘...the Patient Safety Council will collect data on medical errors and negligence; investigate the root causes of such cases and recommend strategies for the safety of patients…’
He also said that the council would keep the public informed of such matters by publishing reports regularly. Incidentally, have there been any such reports in the last three years?
The former health minister said in 2006 that since government hospitals treated more than 40 million patients, an impending three to ten percent medical error rate in diagnosis and treatment was imminent. Did the ministry conduct an independent and transparent study to ascertain the potential true scale of the problem given the fact there could be serious under-reporting of medical errors and negligence? Even the World Alliance For Patient Safety (under the World Health Organisation) estimated that the preventable harm and adverse medical event rate in developing countries could be 'significantly' higher than ten percent.
But yet, according to the Malaysian Medico-Legal Society, there are still many serious shortcomings in the current healthcare system such as overworked doctors; absence of adequate attention and mechanisms to prevent or minimise medical errors; lack of proper medical audits in hospitals; absence of a mandatory reporting system encompassing all cases of medical errors and negligence and the poor aptitude of healthcare staff toward their jobs.
Has the health ministry instituted adequate measures to significantly improve the quality and standard of medical care and treatment apart from de-recognising Crimea State Medical University in Ukraine and enforcing the long-awaited Private Healthcare Facilities And Services Act 1998 (PHFSA) in May 2006?
Would the PHFSA alone be sufficient to protect the millions of patients from preventable harm and adverse medical events such as death, injury and permanent disability? How could it if the purpose of the PHFSA is to only ‘weed out bogus doctors who pose a threat to public health and safety’?
Have the Malaysian Medical Council (MMC) and the Medical Act 1971undergone comprehensive reviews and reforms to further protect the more than 40 million patients? Isn't the MMC still ‘not ordinarily concerned with errors in diagnosis or treatment, or with the kind of matters which give rise to action in the civil courts for negligence..’?
Even the Malaysian Medical Association (MMA) reportedly received RM764,650 in commissions for the year 2000 for acting as agents for the Medical Defence Organisation which provides professional indemnity cover for doctors. Could the MMA then act without fear or favour in the event of a legitimate patient complaint brought against a doctor who had purchased a professional indemnity cover through the MMA given the fact the concerned doctor could then be considered not only a colleague but also a customer?
The Advocates and Solicitors' Board reported that in the last five years 1,508 lawyers were either struck off the rolls, suspended, fined or reprimanded for professional misconduct and other offences. If the legal profession can be so transparent with their disciplinary actions, why can't the medical profession be so too?
At this time and age, is it fair to the more than 40 million Malaysian patients for them to accept unequivocally the ‘three to ten percent error rate in diagnosis and treatment’ given the fact that our healthcare system is still in dire need of comprehensive policies, mechanisms, systems, processes and procedures to avoid or minimise medical errors and negligence?
