What is the Malaysian Medical Association's (MMA) stand on the issue of the full-paying patients? The MMA has always supported better remuneration for doctors and specialists in the public health sector, although in this particular issue of full-paying patients, the MMA has some reservations.

We have always been working closely with the Health Ministry (MoH) and the government including the JPA (Public Service Department) for better conditions and wages and other perks for our doctors. We recognise that doctors who opt to remain in service often place a lot of their potential earnings on hold and sacrifice a lot for their civic duty and responsibilities. In the recent announcement by the prime minister, the enhanced and accelerated promotional exercises and benefits for doctors are therefore greatly welcomed.

So in this context, should the MOH allow specialists in the public hospitals to be given a choice to have private practice? Earlier, this was in the form of limited private practice at private medical centres and the universities to help make their service conditions more attractive, and perhaps to help retain their much-needed services in the public sector.

Whilst this has possibly helped to stem the outflow of experienced staff to the private sector, this approach has been criticised for some abuses, especially when found within the same hospital’s private wing. It has been pointed out repeatedly that some specialists appeared to spend more time in private practice than in the public health facilities, thus undermining the services provided for the less privileged.