14 TELLING IT AS IT IS theSun | WEDNESDAY JANUARY 7 2009

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Safeguarding a
Ministry scales. The IJN,
however, would continue to
be subsidised by public funds
although not to the extent of
90-95 per cent as was com-
monly the case for the regular
Health Ministry facilities.
quality healthcare provided
by the public sector is in the
interests of all Malaysians,
regardless of whether one
patronised the public or the
private healthcare sector.
Good quality, no frills, needs-
In Malaysia, an added pitals public (ownership)? or
complexity arises from the private (commercial modus
fact that government (-linked) operandi)? Is this a “nation-
agencies (federal and state) in alisation” of private enterprise
effect own and operate three space, or an extension of the
parallel systems of healthcare logic of capital into strategic
providers: adjuncts of the state? What
»

price bulwark
WHEN the cardiothoracic
and cardiology departments
were hived off from Kuala
Lumpur Hospital in 1992 and
corporatised as a government-
owned referral heart centre,
Institut Jantung Negara (Na-
tional Heart Institute), one of
its explicit missions was to
provide high quality services
in cardiovascular and thoracic
medicine to Malaysian citizens
at medium cost.
Civil servants and gov-
ernment pensioners would
continue to receive treatment
for heart ailments at IJN at
government expense, as an
employment health benefit.
For citizens who were not
civil servants, patient charges
at the corporatised IJN would
be increased from the hitherto
highly-subsidised rates, and
IJN staff would be paid salaries
markedly above the Health
The intention was that
IJN should also act as a price
bulwark, ie a fallback option
which would serve as a com-
petitive price check against
steep price increases in the
private healthcare sector.
Indeed, going beyond IJN,
this is a strategic role that
subsidised, publicly-provided
healthcare plays in the Malay-
sian healthcare system, as a
price brake against ever-esca-
lating fees and charges levied
by a profit-driven private
healthcare sector.
It is also the reason the
continued existence of well-
funded, widely accessible
based healthcare funded and
provided by the public sector
should be supported by all.
In Singapore, government
polyclinics offer price compe-
tition and help to restrain fee
increases of private clinics. In
Hongkong, well-remunerated
publicly provided healthcare
achieves a similar effect.
It is noteworthy that both
territiories enjoy among
the highest levels of health
indices worldwide, at mod-
est levels of national health
expenditures (Singapore 3.5%
GDP; Hongkong 5.5% GDP)
which bracket Malaysian
expenditures (4.2% GDP).
the regular Health Ministry contending interests and
facilities (as well the health policy conflicts are being
facilities of the Defence Min- engendered, exacerbated, or
istry); attenuated by these develop-
» corporatised hospitals (IJN
ments? What balance between
social vs economic objectives
and teaching hospitals); and is desirable on the part of
» a huge “private wing”: public owners?
the Pantai chain of hospitals, At a time when the role
operated as commercial of the state in social and eco-
hospitals with Khazanah as nomic affairs has re-emerged
a controlling shareholder, worldwide as a burning issue,
similarly with the Kumpulan these questions are among the
Perubatan Johor (KPJ) chain priority concerns that deserve
of hospitals, controlled by the extensive public debate in
Johor government through Malaysia.
its corporate arm, the Johor
Corporation. Prof Chan Chee Khoon
Are KPJ and Pantai hos- Universiti Sains

Climate change link

to dengue and malaria
THE Health Ministry must take change health effects require a
cognisance of the effect of climate multidisciplinary approach and
change on dengue and malaria. collaboration with other agencies
Rapid urban development contrib- like agricultural, meteorological,
utes to environmental degradation environmental and planning agen-
that magnifies airborne diseases cies.
through warmer temperatures. It is essential to see that ad-
Delegates to the Asia-Pa- equate weight is given to health
cific Regional Water Conference in impacts due to climate change.
Kuala Lumpur last year said climate Policymakers must be pragmatic
change could cause more severe in linking key environmental issues
floods and droughts bringing ad- with health, social and economic
verse health effects. interactions.
Studies suggest urbanisation Local councils must plan for
and changes in natural vegetation interventions that include commu-
do have an effect on the distribu- nity responses. Public education
tion of mosquito vectors. and awareness campaigns on
Evidence suggests that increase climate change are effective in
in rainfall leads to proliferation reducing the risk of diarrhoeal and
of mosquito breeding sites and vector-borne diseases.
transmission of parasites. Augmented by relevant ex-
When temperatures rise malaria pertise, the local councils should
parasites develop more quickly in take advantage of residents’ local
the mosquito vectors. Higher tem- knowledge and perspective to
peratures shorten the gonotrophic build awareness of climate-related
cycle of the mosquitoes and wors- health impacts and adapt meas-
ens their biting habits. ures on water and food hygiene,
There is a clear relationship and construction sectors.
between high temperature, rain- Local councils must also embark
fall and the occurrence of dengue on a continuous campaign to edu-
Stegomyia (previously called cate the residents on the reduction
Aedes) aegypti outbreaks. of air pollution – green house gas
Climate change could alter the emissions and concentrations of
incidence and geographical range surface ozone – for the benefit of
of malaria and dengue, largely public health.
confined to urban areas.
Effective long-term measures Joseph Lim
to prevent or mitigate climate Kuala Lumpur

Spare not traffic offenders

LATELY, there is a new trend to on camera are not clear.
outwit traffic police and Road The RTD and traffic police must
Transport Department officers. come down hard on this new road
Some motorists have lightly menace.
blacked out the registration num- It is unlawful to blacken out
bers on their vehicles. number plates, use non standard
The plates are blackened out plates, and silver coloured num-
in such a way to like it is muddied, bers that reflect light.
dirtied or unwashed. A closer in- Gerakan Selangor Youth would
spection reveals that the darkened like to propose that the laws be
parts of the registration numbers amended to allow the seizure of
have been spray painted. vehicles found racing on public
This trend was initially confined roads. The same for motorcycles
to the Klang Valley but is slowly owned by Mat Rempit.
spreading nationwide. Vehicles with illegal blinking
Errant motorists with the modi- lights, non-standard colour indica-
fied plates will be able to evade tor lights and illegal modifications
speed traps as the cameras will should be impounded on the
not be able to record the registra- spot. Vehicles with faulty lights
tion numbers. should be impounded too and
The owners of this vehicles will only released upon conforming to
continue breaking the speed limit specifications.
and running traffic lights and es- Let’s start 2009 with a resolu-
cape from any punitive actions or tion to enforce the law strictly.
worst. Also, summonses may be
wrongly issued by the traffic police Delren Terrence Douglas
to innocent vehicle owners when Selangor Gerakan Youth
the registration numbers captured Information Bureau