1st MOH Healthcare (1Care) Roadshow – the aftermath

In this day and age of ICT it is always good to get your news and sources from various perspectives and not just stick to one. As mentioned, the MOH held it’s first “Healthcare transformation” roadshow (the MOH is now avoiding the use of the much maligned 1Care name).
This is The Star’s version – “Healthcare roadshows off to a good start”
However, the Malaysian Insider reports a different perspective from one of the attendees, Dr. Steven Chow – What really happened at the Ministry of Health roadshow
Steven makes a number of interesting points:

The title of the event was “Pelancaran Siri Jejalah Public Engagement-Kajian Sistem Kesihatan Malaysia” but what really happened on March 31 was a paradox. As a media event it was well organised.
The members of most of the mainstream media were at hand. They, together with the large number of government servants still in their uniforms or with their name tags, virtually made up the bulk of the crowd. The robust public presence that was supposed to be the objective of this engagement was clearly missing.
Thus it was not surprising that the discussion was devoid of substance and spirit.
Firstly, the announcement was only made known a mere three days prior to the event. Insufficient notice and the choice of the busy Saturday morning hours for the event were effective in excluding many doctors and members of the public who were genuinely interested in providing some useful feedback.
Secondly, the time allocated for actual public engagement speaks well for itself and reflects on the sincerity of the call for meaningful public discussion.
The minister’s speech alone took 30 minutes. The three invited panellists took more than 30 minutes and the chairman took another 10 minutes in introduction and comments. Then the panellists’ rebuttal before closing took another 20 minutes. So what was left for questions and comments was less than 30 minutes. That was the level of the public engagement and discussion for this much-touted event.
Thirdly, the call for transparency and how this would avoid the politicising of the issue was loud and clear. One would have expected the minister to lay out clearly on the table the details of the second 1 Care paper (which is the follow-up of the first concept paper) for public knowledge and debate. Revealing details of this would have gone a long way to reassuring the public that the Ministry of Health was indeed on the path of meaningful public engagement for its programme to reform, evolve or transform (or call it whatever) the national healthcare system for the betterment of the rakyat.
Instead, valuable time and effort was used spinning old yarns and overused rhetoric that we have heard over the past four months. The usual menu of “denials, things are too early, nothing is decided, still in concept stage/option stage, profiling of critics, etc, etc” was repeated for the benefit of the Press. It was clear that the strategy was to avoid talking about the details.
To make things even more patronising, a member of the panel (a GP) and a similar-minded speaker from the floor (another GP) were going on and on about how terrible life as a GP is today, i.e. long working hours, falling patient load and how 1 Care would make it better for GPs, for themselves, their income, shorter working hours and their judicious use of power as gatekeepers for patients.
The ultimate important question on how much more would the already over-burdened 1.5 million or so taxpayers are expected to pay for the new healthcare delivery system was left silent and untouched.

Short notice, limited spaces (only 100 vs > 500 for the TakNak1Care roadshows) makes one wonder how open the meeting really was. Were members of the public and profession really given much opportunity to question the MOH on important matters pertaining to future healthcare transformations? It’s not much of an engagement with such a small limited audience but it is a start and I hope the MOH will hold larger roadshows and allow greater audience participation and hard questions.
Doctors are by nature a cautious lot. They perceive there already exists a system which by world health indicators is reasonable, flexible and already working. No doubt there are areas which can be improved (particularly the public sector – which the Government needs to spend more on) but does it mean we need radical transformation? On the matter of funding, no one in the know wants to address or discuss it in detail. Saying “it’s still be assessed” when various financial models have been proposed (see the 1Care Info Pack) ,and might have gone on to implementation if not for the publicity by the TakNak1Care initiative, is insufficient. We want the Government and the MOH to be more transparent and consultative in their approach to any future healthcare transformation.