From Dr Gunalan Palari Arumugam
I refer to the interview of Dewan Rakyat Speaker Johari Abdul on the BFM radio station on Sept 26.
I take this opportunity to express my deepest sympathies to him and the rest of the parliamentarians on the meagre salaries they receive as MPs and the amount of money they have to spend to deal with their constituents’ incessant requests.
He said while doctors got to keep all of their salaries, MPs had tonnes of other expenses that needed to be deducted from their salaries. As expected, the response from the healthcare fraternity was fast and furious.
The healthcare fraternity needs to understand that they are not the only ones working hard in this country. The poor MPs are toiling away in the air-conditioned Dewan Rakyat with well-thought intellectual arguments and points on par with Oxbridge-level debaters.
After gruelling days of debates and standing up and being told to sit down repeatedly, damaging their knees and vocal cords in the process, they have to sleep in discomfort, hurting their spines in their five-star hotel beds every time Parliament is in session.
Don’t forget the hassle of travelling from one city to another in business class flights, while formulating strategies in the discomfort of airport lounges, sipping on cheap drinks while waiting to board. These things definitely take a huge toll on the poor MPs’ mental and physical health. All in all, what they are going through and the sacrifices they make in pursuit of delivering policies that impact our daily lives must be applauded.
I do wonder how they make ends meet while wearing expensive watches and dressing impeccably, with nice houses and cars the envy of many doctors and nurses who, despite keeping their salaries to themselves, don’t really show the same style exhibited by the struggling MPs. Maybe we healthcare professionals need to have a session with the MPs on financial management, so we can all learn from them. Another live interview on radio will indeed be helpful.
I did find one comment made in his interview rather worrying though. Malaysians are generally kind and well-natured, and want to be good hosts to their friends, neighbours and relatives. When you are invited to their weddings or social gatherings, it’s usually because you mean something to them.
Eleven invites in a day may be one too many, but you must be a popular MP, so take it as a sign they want you back as their MP in the next election. Don’t bemoan their invites.
After hearing from you, I’m rather curious to know whether my hosts in the many weddings I have attended secretly retreated to a corner and judged me by what I put in the envelope and called me a cheapskate private specialist. I better be careful next time.
For funerals, on the other hand, you show up because it matters to the person grieving that you cared enough to be there not only in the good times but the bad as well. If you intend to give donations, do it sincerely. This is where your entertainment allowance might come in handy, but I guess you would know that already, as I can’t imagine any other kind of entertainment is expected of you.
In fact, I strongly support an increase in the entertainment allowance as the comedy showcased to us every morning during the live telecast of the Parliament proceedings exceeds Dave Chappelle’s one-hour Netflix specials.
By the way, most of us know the existence of “Peruntukan Ahli Parlimen” under the auspices of the prime minister’s office, in case your salaries are still not sufficient. You get about RM2 million from what I understand, where a small portion can be set aside for emergency needs of the constituents. Just make sure you are in your bosses’ good books to get this allocation.
Don’t forget the role played by the corporate sector as well. Most businessmen and individuals with good intentions and no agendas are also known to be quick to help with some cash and other contributions in your constituents’ time of need, as they know you will help them as well in their time of need after you successfully defend your seat.
The moral of the story is – don’t cross the line, or your allegiances, or you may end up doing a 200km run to raise money, which we all know is not recommended for you as the heart centres of most of our public hospitals are filled to the brim.
Our morally conscientious MPs are also not the type to use their influence to cut queues, but will strictly follow their turns as they understand everyone is equal. Just because you’re an MP, you don’t expect doctors to bump others off the list, and give you the priority for a procedure when the waiting period is more than a year. That’s definitely not going to happen as you are strong advocates of healthcare equality where everyone is treated equally, whether you are an MP or a fisherman from a village in Terengganu.
Over the years, we have set the bar on expectations of our MPs pretty low. We have seen talk of reform many times at the beginning of their terms, only for implementation to be delayed because these constitute political suicide. Political survival seems to be the order of the day more than any reforms. A bitter pill is always hard to swallow, but if that is the cure for the problems plaguing our healthcare system, so be it.
We give you five-year mandates to do the right thing. For about two weeks every five years, you come to us with all kinds of visions and promises. You convince us our lives will be much better if we give you a chance.
I’ve been involved in medicine for close to 30 years now and seen so many promises made, yet nothing much has changed. I’m looking at retirement in a few years’ time, and it’s sad to see the state of the country’s healthcare system.
I understand that issues like the National Healthcare Financing Scheme, general practitioner and specialist fees, private hospital charges and private insurance premiums are not easy discussions. Many committees, think tanks and consultants have come and gone, and even with the health white paper prepared, argued and discussed in depth, we still do not see light at the end of the tunnel, other than the usual remarks during grand speeches.
On behalf of all healthcare professionals both in the public and private sectors, let me say we are not the problem. Doctors aren’t taking all our money home. On top of the taxes and zakat that we pay, we contribute to the running of tuition centres, and give donations for the needy to our local mosque, temples, schools and many more. No one is forcing us to do so; this is mainly to share our earnings with the communities we are part of.
As in any profession, there are bad apples, but the vast majority of doctors in the country have the nation’s well-being at heart and constantly go above and beyond to do the right thing despite all the hurdles and obstacles in our way. The hours they put in without appropriate remuneration is mind-boggling. In fact, it is such an insult that it is still being discussed and not implemented.
The lack of foresight in human resource planning, such as the contract medical officer situation, downsizing of nursing schools and new proposals like diagnosis-related groups are among the many issues the medical fraternity has highlighted from the very beginning, but we are often brushed aside by bureaucrats and their consultants who claim they know better.
We are now experiencing the effect of the poor policies put in place 10 years ago and seeing the loss of high-calibre doctors to other countries who see their potential.
We are constantly bombarded with regulation after regulation that aren’t really a priority in the larger scheme of things. Why the urgency in drug prices display when the doctors’ fees have not been revised for many years? You don’t have people to enforce smoking bans in eateries and yet you want to dedicate resources to police doctors.
If you have surplus, send them instead to the road transport department to clamp down on the many errant drivers, drunk drivers, mat rempits and owners of poorly maintained buses and lorries killing more people on the road.
And so we wait patiently, like the many hundreds of patients attended to by our healthcare colleagues in the public sector, for your meaningful reforms. Maybe when you or your loved ones access the public healthcare system and understand the challenges, you may then make it your priority to ensure all the promises made in healthcare reform will be carried out, and we no longer have to talk about being under-resourced and underfunded.
What we have now is a situation akin to kicking a can down the road so far away you see no solutions in sight, but only constant meetings, task forces and town halls to say you have engaged the stakeholders. And after engagement, promises are broken and you go back on your words and do the opposite thing.
Reforms are only meaningful when they come with concrete action and appropriate timelines after listening to the stakeholders’ viewpoints. We have had enough lip service. If you truly deserve the salaries we taxpayers are paying, then get down to action, listen to stakeholders and implement the suggestions made without delay – lest your plan is to actually buy time and not do anything about it.
Please don’t blame private hospitals, the insurance industry or doctors and healthcare workers trying their level best in difficult circumstances to make healthcare work for everyone. Look at yourselves and your roles, ask whether you are doing the right thing and to achieve the necessary reforms within the timeframes given.
Set timelines for when you will achieve the visions set out. If you can’t, then at least say it to our faces so we don’t have to spend days in your meetings and hang on to your empty promises and be disappointed at the end of it all. And while you are at it, please don’t rub any further salt into our injuries.
Dr Gunalan Palari Arumugam is a consultant anaesthesiologist and critical care physician.
The views expressed are those of the writer and do not necessarily reflect those of FMT.