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PEOPLE FIRST, PERFORMANCE NOW: RHETORIC OR REALITY

Health Services

Healthcare service is a basic necessity for all people. In our country the
government has taken the responsibility of providing the main healthcare service for the
people with minimum payment. Healthcare is given utmost importance and this is evident
in the unveiling of the 9th Malaysia Plan where the then Honorable Prime Minster, YAB
Tun Abdullah Ahmad Badawi pledged that facilities for healthcare will be improved to
provide for an active and alert society. Current facilities were upgraded whilst new
facilities were built to provide a comprehensive package of services. This includes
building 8 new hospitals, replacing 14 old hospitals and building specialist centers.
Mobile clinics were increased to improve healthcare services in rural areas. Primary,
secondary and tertiary healthcare services were integrated through an efficient and
effective referral system. A human resource action plan was drafted and RM1 billion was
allocated to human resource development in healthcare.
In terms of improving service delivery and easing the patients’ burden, the
Government, through the Ministry of Health (MOH) has taken initiatives to shorten the
waiting time in clinics. This came into effect following the complaints from the public
that it takes about 2 hours to see a doctor in the government hospitals and clinics. Since
then the ideal waiting time that was pledged to the public was 30 minutes, that is from the
time the patient gets the waiting number till he or she sees the doctor. Other measures
that have been taken to expedite treatment and care for patients include conducting
elective surgeries on Saturdays. Elective surgeries are surgeries that are deemed as non-
emergency (life threatening), but is vital in improving the conditions of the patients
health; such as removal of tumors. This surgery is usually done on weekdays, but as the
number of emergency surgeries increased, the operation facilities and personnel has to be
dedicated for the emergency surgeries. This results in longer waiting time for patients
who are scheduled to undergo elective surgery. To remedy this situation, MOH decided
to implement elective surgeries on Saturdays, whereby this action has successfully
shorten the waiting time and thus improving their quality of life. For a similar reason,
MOH also came up with the policy of lengthening the working hours of designated
clinics till 9pm on weekdays as well as opening its operations on weekends. This was
because the public were flocking to the emergency departments to get treatment for non-
emergency cases after working hours and on weekends. This led to the increase in work
burden for the emergency department staffs and resulting in delayed treatment for true
emergency cases. With the operation of clinics after working hours and on weekends, this
problem was rectified.
The MOH also provides flying doctor services to remote areas especially deep in
the mountains of Sabah and Sarawak, to ensure that no one is excluded from getting
access to healthcare services. In this spirit also, the telehealth conferencing was initiated
whereby clinics and hospitals without specialist were able to discuss medical diagnosis
and interventions with specialist from other parts of the country. This virtual healthcare
service certainly saves money, energy and most importantly time which is very valuable
for the patients. And in times of pandemics such as the H1N1 Influenza A outbreak, the
full strength of the MOH was thrown into curbing the infection, with health personnel
serving at the entry points, hospitals, clinics and labs working round the clock. Indeed,
the slogan “People First, Performance Now” is perhaps best described in the health care
service where the core business of it is to serve the patients first with a sense of urgency,
meaning to act in the fastest possible manner.
However, satisfying peoples’ need is not that easy a task, and this is even truer in
the healthcare service where people now are more knowledgeable and expect the best
explanation and effective treatment for their ailment. With a high workload, sometimes it
is not easy to cater for everyone’s needs precisely. The Public Complaints Bureau
statistic shows that for the year 2009 (till 30th September 2009), MOH received 517
complaints putting it as the fourth government agency with the most complaints. From
time to time also, there is news concerning the medical mishaps that was caused by
medical personnel. To the patients and family members who have had a bad experience
in the government hospitals or clinics, it will be hard for them to really believe that the
government actually puts great emphasis to give the best possible care to the people.
Realizing the many shortcomings that are within the healthcare service, the
government needs to address the root causes of it. The main problem that seems to be
plaguing the Government is the shortage of health personnel especially Medical Officers
and Specialists. According to the statistic from Health Informatics Center MOH in the
year 2008, there were about 25, 102 doctors in the country with 15, 096 serving in the
public sector and the rest in the private sector. But in terms of workload, the government
health facilities had about 40 million outpatient cases as compared to 2.4 million in the
private hospitals. Efforts were and are taken by the government to curb this problem by
several measures such as improving the salary and benefits, improving the career
development and working conditions for the medical personnel. Other than that, contract
doctors are also recruited from foreign countries to serve in rural areas especially in
Sabah and Sarawak. There is even a system created where doctors from the private sector
can serve in the government hospitals according to certain terms and conditions. Apart
from addressing the human resource problem in the MOH, other measures to improve the
service delivery are also implemented such as placing Public Relations Officers and
Customer Service Officers in hospitals and clinics to provide fast and precise information
to patients who are waiting to see the doctor. Better facilities and medical technologies
are roped in to give quality care to the patients.
It is certain that although the road to a perfect healthcare service delivery is not as
smooth, but the right interventions are being taken by the government to ensure that it
lives up to the spirit of 1Malaysia. The healthcare service directly touches the people
when they are usually in their most vulnerable or feeble state. Thus this is where the
quality of the service is felt most sensitively. Hence, utmost importance must be given to
enhance the quality of service in this field, particularly in ensuring that the government
does not lose its most important asset, the healthcare personnel to the private sector or to
other countries. Efforts should also be taken to make sure that the medical staff are of
indisputable standard and are capable of carrying out their task and responsibility
diligently with a humanistic touch. If these aspects can be strengthened, the spirit of
“People First, Performance Now” can surely be achieved.
Diversity

Diversity of the Malaysian population is one of its greatest strengths and assets.
First of all the value and importance of diversity must be understood. Diversity is about
valuing people’s differences and treating people with dignity and respect. The fact is that
providing an equal service to local people is not about treating everyone the same as this
works against equality because not everyone has the same service needs. However, this
very fact has seemed to become one of the hindrances in achieving the goals of
1Malaysia. This is because as much as the government wants to cater to everyone’s
needs, it is just nearly impossible to do so. Malaysians differ in many ways; race,
religion, economic status, gender, educational status, political affiliations and many more.
Thus their needs, wants and opinions are really diverse.
Taking for example the stand on Teaching of Science and Mathematics in
English, the government needed to take into accounts the many factors and views from
the people before coming to a final decision. Although the decision did not meet the
needs of all Malaysian, remedial measures were in line to make up for it, such as
extending the teaching hours for English. The same applies to the issue of the schooling
policy, with some quarters expressing their view that only a single stream national school
system can ensure the unity of the people in the true sense, whereas the other parties
standing firm with their opinion that the current multiple stream school system is needed
to ensure that the language and culture of the various ethnic groups can be safeguarded.
The government has no choice but to consider all these voices in whatever policy that has
to be implemented. This is because it is committed to responding to the diverse needs of
the people who are the end users of the services.
One way the government can rectify the quandary is by making the best decision
based on many factors such as previous decisions on similar issues, best practices from
different countries, researches and studies regarding the matter, seeking advice from
prominent experts or scholars in the field and calculating the positive and negative
elements expected if the decision is made. Once the decision is made, it should be made
firm and the government should explain to the public about the factors that taken into
considerations before making the decision and provide justification for it. As for the
parties who were against the decision, the government must ensure the decision made is
beneficial to all and will not sideline anyone’s needs. The government must take the
responsibility to make sure the decision is implemented as planned without hiccup and
prove to the people that in the long run, it is indeed not as detrimental as it was thought to
be earlier.
As mentioned earlier, it takes a monumental task to ensure everyone’s needs are
fulfilled. Sometimes, the service provided by the staffs at the ground who doesn’t really
understand or embrace the spirit of 1Malaysia, may seem to be discriminating against
certain groups directly or indirectly, intentionally or unintentionally. Direct and indirect
discrimination can occur when services are inappropriate, insensitive or inaccessible. An
example of this is related to the disabled people. There used to a lot of complaints that the
government has not taken into considerations the plight of this group when designing
public transport and walkways. However, in realizing the problem faced by them, the
situation has changed for the better. Nowadays in almost all public amenities and
facilities there is sure to be specialized service or facilities for the less fortunate group. In
fact, the government has taken concrete steps to employ the disabled in the government
agencies because many of them are actually capable of doing work efficiently. Thus it is
the onus of the government to ensure that the government servants are well aware of the
needs of the various groups of people and provide the proper service for them. The
government servants should also have all the intended values instilled into their mind and
soul so that the expected quality of service that is aimed by the Honorable Prime
Minister, Datuk Seri Najib Tun Razak is delivered as expected to the public.
As the largest provider of a wide range of services for Malaysians, the Malaysian
government is should and believed to be committed to challenging inequality,
discrimination and disadvantage. This includes achieving the highest standard of service
delivery and employment practice. Equality of opportunity for all sections of the
community should be an integral part of this commitment. Not everyone has the same
access to services or the opportunity to take part in the planning of these services. To
ensure that services are provided to all sections of the community, it is best that the
government systematically monitor and review its existing services and develop the
provision of new services as required and where resources allow. Equality of opportunity
in service delivery is cost effective because it helps the government to plan and target its
services efficiently. Equality in service delivery has to involve consultation with service
users about their needs to take full account of the views and expectations of people who
are traditionally less involved in the decision-making processes.
Although diversity seems to be a hindrance in achieving the spirit of “People
First, Performance Now”, the government can take this as a challenge and prove that the
diverse requirements of people with different needs and opinions can be met, albeit not
totally. In reality, this is exactly what our country has been doing all these years since
independence, without which, it is unlikely that we would have reached this state of
development that all Malaysians enjoy currently. But of course there is still room for
improvement, where it has to be admitted that there are some areas that need to be
polished in terms of dealing with issues regarding different groups such as gender and
socioeconomic.

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