Sunday, October 16, 2016

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Lack of funds leads to suspension of clinical laboratory tests in Malaysian hospitals

Health DG Dr Noor Hisham Abdullah has assured that laboratories will continue to perform crucial diagnostic investigations.
A circular recently issued by the Pathology department of Tengku Ampuan Rahmah Hospital in Klang has swiftly appeared in doctors’ chat groups and forums, and stirred up an intense discussion amongst Malaysian healthcare professionals. 

The letter, which was dated 6 September and written in Bahasa Malaysia, notified hospital staff of a temporary halt in pathology laboratory investigations, as the department was unable to purchase necessary chemical reagents due to inadequate funds. 

“Temporary” suspension appears to affect other hospitals, too

The notice came with an attachment, which itemised the various tests provided by the Microbiology Unit, the Chemical Pathology Unit as well as the Haematology Unit, and listed the respective dates that they will come to a temporary suspension. 

However, the Tengku Ampuan Rahmah Hospital does not seem to be the only health facility affected by the lack of funds.

A doctor who is currently serving in a district hospital has turned to the forums to share on the situation at his workplace. According to the healthcare practitioner, staff from the hospital where he is working have received circulars from the laboratory of a tertiary hospital located an hour away, informing the suspension of investigations from district hospitals due to lack of reagents or budget. 

“Even if I did send it off, no results would be returned to me,” the doctor wrote. 

Health DG: “Biggest challenges” to provide good healthcare services with limited resources

The director general of Health, Datuk Dr Noor Hisham Abdullah, has responded to this matter on social media by acknowledging the challenges faced by the Ministry of Health (MOH) in providing quality healthcare services with restricted resources, especially with increase in demand. 

“As the MOH strives to provide excellent health services at reasonable costs with high satisfaction to the Rakyat, surely the demand for the health services at the MOH will also increase,” he posted via social media. 

According to Noor Hisham, the Health Ministry has seen an increment in the numbers of patients seeking healthcare services in public health facilities, with an estimated 8% increase in patients from January to May this year, compared to the same period in the past year. This translates to over three million additional patients who are visiting the public health clinics.

“This greater demand for our services has led to more complex challenges in managing our existing resources,” Noor Hisham stated. “Therefore, to ensure that crucial health services provision are not disrupted, the MOH is evaluating the extent of our financial shortcomings, and optimising and reallocating our limited resources to wherever it is needed the most. This is to ensure our laboratories will continue to perform crucial diagnostic investigations.”

He concluded his post by reassuring readers that the MOH remains committed in providing health services to citizens. 

“Let us translate these challenges into opportunities for us to improve the way we do things; for it to be better, more efficient and effective, avoid unnecessary duplications and cut wastages towards achieving better outcomes,” he said.

Not just labs: Limited funds affecting supply of medications

The Health Ministry has also responded to the unease that has stirred amongst citizens following speculations of a shortage in medicines in government hospitals, with patients claiming that their supplies have been limited to prescriptions suffice for up to two weeks or a month compared to the previous two-to-six months’ prescriptions.

“The pharmacist gradually gave me only two weeks' worth of medicine. When I asked why, the pharmacist admitted they're currently facing a shortage and a month's prescription would only be issued if there's a letter by the doctor," said Michael, a restaurant manager, who used to receive a month’s worth of medication after every medical appointment since his recovery from tuberculosis earlier in the year.

According to 57-year-old homemaker, Kiran, the monthly prescriptions has caused some difficulties as she now has to make monthly trips to the hospital for her diabetic medications, with each trip taking approximately an hour depending on road traffic conditions. 

In response to the situation, Noor Hisham has reassured that "There is no shortage of medicines or supplements at public hospitals and clinics. What we have done is to supply medicines for a month. This is to reduce wastage.” He added that it was the ministry’s policy to ensure sufficient supply of medicines and necessary supplements at all government health facilities. 

Pharmacists share frustrations at medicine shortages

However, medical personnel have stepped forward to share on the current circumstances.

A government-based pharmacist from Malacca has said that shortages of medicine used in the treatment of blood pressure and diabetes have forced pharmacies to cut down prescriptions from the usual two months’ supply to one.

"Hospitals and clinics here have resorted to borrowing and lending medicine supply to sustain ourselves. After recalculating their remaining stock, most are wondering if the medicines could last till year-end," she said.

Meanwhile, a pharmacist from Johor expressed frustration on having to see diabetes patients face a shorter supply of insulin. "The pharmacy is currently issuing only two weeks’ prescription for it. While the situation is manageable at the moment, it can't be prolonged because diabetes is a critical illness. This shortage will add further complications for patients," he stressed. 

Although Noor Hisham admitted that there has been some disruption in the supply of insulin due to problems faced by manufacturers overseas, he reassured that the ministry was keeping a close watch on the matter and urged all health facilities to take proactive measures to secure alternative supplies of insulin. MIMS

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