Health commission needs to be established, says Health experts

A health commission needs to be established to enable access to funds, to reduce bureaucracy and address health practitioners maldistribution and remuneration issues effectively, say health experts.

Health Ministry former deputy director-general (Medical), Datuk Dr Azman Abu Bakar said the discussion on the creation of a health commission was nothing new and such commission should be responsible and accountable to Parliament.

“We can move faster as there is no red tape. My hope is that the health commission will not be totally detached from the Public Service Department (JPA) but given autonomy to make some decisions as advisor in terms of government’s directions and policies.”

Dr Azman said this as a panel speaker on the second day of the Health Policy Summit 2022: The Future of Our Healthcare – Health White Paper Development on Tuesday (Aug 16).

On his hope of the Health White Paper on the allocation of human resources, he said medical practitioners needed to be bold and brave enough to come out and think out of the box to have them heard on human resource issues in the health services.

Meanwhile, Universiti Malaya’s Prof Datuk Dr Adeeba Kamarulzaman echoed Dr Azman on the establishment of the commission saying that in health human resources, training of personnel was important in order to fill in the gap.

“We need to increase the number (of workforce) and the quality, and a system put in place as the current state of training is fragmented and can be improved in substantial ways, especially funding,” she said.

On the health commission, Dr Adeeba also said that it should have a high-level committee chaired by a minister or even the prime minister, as Indonesia has its president as the chair.

“We definitely need to be out of the JPA as the system doesn’t allocate appropriate pay remuneration. It’s not just doctors but also nurses who are in worse conditions.

“We need to alleviate this situation as health is a service industry which requires the best people because they’re dealing with lives,” she said.

On the prevailing issues in public healthcare other than workforce shortage, Dr Adeeba noted the maldistribution in terms of public and private providers as 70 to 80% of the healthcare burden in Malaysia was borne by public healthcare facilities, both in the primary and secondary/tertiary care settings. – Bernama


Khairy: 4,053 contract staff to be absorbed into permanent positions this year

The Health Ministry (MoH) has approved 4,053 out of 8,672 initial applications for permanent positions involving contract medical and dental officers and pharmacists for this year, its minister Khairy Jamaluddin said.

He said it covers 3,215 medical officers, dental officers (438) and pharmacists (400), while there are 225 candidates on the standby list.

“This is the highest addition of permanent positions since 2016 since the contract policy started and after this we have (requested) at least 1,500 permanent positions every year which we will offer to contract officers,“ he said.

Khairy said this at a press conference here today after appearing as a panel member at a dialogue session ‘The Future of Our Healthcare’ in conjunction with the 2022 Health Policy Summit here today.

He said MoH will hold talks with the Public Services Commission (SPA) to determine the policy on whether those who are unsuccessful in applying for a permanent position can reapply or not.

“I do understand that some will be disappointed, and that is why MoH will look into the matter after our discussions with MMA (Malaysian Medical Association) on career options for those who could not be absorbed as permanent staff, to at least ensure that they are given good incentives and opportunities for specialised and sub-specialised training.

Meanwhile, Khairy said the MoH will is also looking at a suitable model to determine whether a health service commission should be established by law or administratively.

He said although the matter was not the main focus of the ministry at the moment, it would nevertheless be discussed in the Health White Paper which is expected to be tabled in Parliament at the end of the year.

“If you are to ask us (MoH), of course we would want our own Commission so that we will not be subjected to regular SPA policies. An example would be that (currently) if we are to fight for certain allowances in the MoH, we are subjected to policies under JPA (Public Service Department), which means this policy must be in tandem with other (public) services.

“We go one step at a time… We want our own Commission but the question of when to push for this (and) to approve can be discussed during the drafting process of the Health White Paper,” he added. – Bernama


NHG and Tanoto Foundation partner for diabetes reversal in Singapore

The National Healthcare Group (NHG) is working together with Tanoto Foundation (Tanoto) to combat diabetes amongst the populace through a “Diabetes Reversal Programme.” This programme aims to control blood sugar levels in diabetes patients through behavioural changes, without the need for medication or surgery.

Contributions from both the NHG and Tanoto Funds, at S$1 million (approx. U$D0.73 million) and S$2.6 million (approx. U$D1.88 million), respectively, are also expected to boost diabetes research in primary care and in the community.

In Singapore, obese individuals with early diabetes are commonly prescribed glucose-lowering medications, or recommended to undergo bariatric surgery, to regain control over their increasing blood sugar levels.

However, diabetes control and reversal can be achieved and maintained more thoroughly through positive health behaviours instead of medication and surgery, as suggested by the researchers from NHG – they seek to study the barriers and facilitators related to such behaviour.

The researchers will also conduct a clinical trial for an intensive weight management regime in reversing early diabetes in obese patients. The trial will entail a close partnership between diabetic patients, doctors, and dietitians, to create custom, low-calorie meal plans.

Senior Minister of State for Health, Dr. Janil Puthucheary graced the official launch of the much-anticipated Diabetes Reversal Programme at Kallang Polyclinic recently, in addition to a host of senior representatives from NHG and Tanato and primary care physicians.

Associate Professor Chong Phui-Nah, CEO of National Healthcare Group Polyclinics (NHGP) and Primary Care, said health education, patient engagement, and empowerment of diabetes patients are of “paramount importance” to successful modification of self-care behaviours and lifestyle, and to manage diet and level of physical activity.

“Our aim is to better understand the challenges that patients face in their social environment and how we can better support them to take greater ownership of their health outcomes through research. The Diabetes Reversal Programme is one such study that proposes a new model of care to help patients reverse diabetes and manage their condition well,” said Assoc. Prof. Chong.

Professor Benjamin Seet, Deputy Group CEO (Education and Research) of NHG, added, “At NHG, we do things differently by putting the patient first, and focusing on real world research that directly leads to better health outcomes and quality of life. A good example would be the programme we are launching today – this partnership, where a philanthropic organisation like the Tanoto works closely with primary care doctors, dieticians, and patients, right within the community, can only bring about impactful change.”

Meanwhile, Bey Soo Khiang, Executive Advisor at Tanoto, disclosed that the collaborative programme between NHG and Tanoto will be conducted in the local primary care setting, to better study and address how the Singaporean diet, environment, and culture can affect health and disease patterns.


Health DG: No Covid-19 tests required to enter Malaysia

Travellers are no longer required to undergo Covid-19 tests to enter Malaysia, the health ministry announced.

Health director-general Dr Noor Hisham Abdullah said pre-departure and on-arrival tests were no longer required from Aug 1.

This comes after all travellers were no longer required to fill up the traveller’s card in the MySejahtera app before entering the country, regardless of vaccination status.

However, vaccination requirements remain subject to airline regulations.

Travellers found to have symptoms upon arrival will be referred to the health ministry for examination, said Noor Hisham.

“All travellers arriving from abroad are urged to monitor their health and comply with SOPs,” he said in a statement.

“Those with symptoms are urged to visit the nearest health facility.” – FMT


Are migraines eating away at your life?

Migraine attacks are accompanied by a throbbing pain either on one or both sides of the head. Unlike a regular headache, the consequences of a migraine is likely to seep into and impact all areas of our lives. Sunway Medical Centre (SMC) Consultant Neurologist Dr. Raymond Tan, based in Kuala Lumpur, Malaysia, has said that migraines are as incapacitating neurological disorder, and comes with a wide range of symptoms including blurred vision, nausea, and vomiting.

People who suffer from migraines may be sensitive to lights, noises, and scents, and — for some, experience aura or focal neurologic symptoms; episodes as such can last between 4 to 72 hours in duration.

According to the Office on Women’s Health, migraine is three times more common in women than in men, and is the fourth leading cause of disability in women.

Dr. Sharmina Kamal, SMC Consultant Obstetrician and Gynaecologist, revealed that this is largely due to specific changes in the hormone oestrogen: “Oestrogen helps regulate the female reproductive system and controls chemicals in the brain that impact the sensation of pain. Therefore, a drop in oestrogen levels can contribute to the development of chronic headaches or migraines.”

Still, migraines can affect both men and women, from all walks of life.

In childhood, migraines are more prevalent in males but cedes once the influence of oestrogen begins – that is when the prevalence starts to rise in females, contributing to more common, longer-lasting migraines in women between the ages of 20 and 45. Besides hormonal changes, factors such as stress, lack of or too much sleep, skipped meals, weather changes, alcohol, and caffeine can also trigger migraines.

Fortunately, migraines are a modifiable disorder and there is hope for relief through very simple methods.

“The best thing to do at the start of a migraine is to stop your activity and get some rest, preferably in a quiet and dim lit room or area. Taking a simple analgesic like paracetamol at the start of the migraine often helps to limit the severity. Application of topical menthol may also lessen the intensity of acute migraines, although this is best avoided in women who are pregnant or breastfeeding,” suggested Dr. Raymond.

Combining therapy or medication with behavioural measures and a lifestyle that promotes overall good health is also a proven way to handle migraine attacks. For example, maintaining a healthy lifestyle includes consuming nutritious foods, as well as ensuring adequate hydration, frequent exercise, and proper sleep.

You can also speak to your physician about daily vitamins or supplements, such as vitamin B or magnesium.

Migraines are a real source of pain, but most of the time, they are not signs that one has a serious medical problem. However, it is worth speaking to your doctor when you have symptoms that are more severe than normal, including:

  • Uncontrollable vomiting
  • Loss of consciousness
  • Seizures or convulsions
  • Blurred vision or other vision changes
  • Loss of balance or coordination

“Occasionally, the migraine attacks persist for more than 72 hours and become debilitating and resistant to conventional treatment. And in cases associated with persistent vomiting, this could lead to potential dehydration and its associated problems, which could require hospitalisation with intravenous fluids and medications,” Dr Raymond said.

Young women, in particular, who experience migraines with aura, especially those who smoke or use oral contraceptives, have an increased incidence of strokes and seizures. It is advisable for women at risk to avoid smoking and choose other forms of contraception, if possible.

As a close, you should know and avoid your triggers, treat symptoms early, and find medications or therapies that work best to relieve your migraine pain. When it comes to treating migraines, timing is everything – waiting too long to address your migraine symptoms or take preventive steps can increase how often and severely a migraine strikes.


Only 42.3% of children in Malaysia fully vaccinated against Covid-19

A total of 1.76 million or 49.8% of children aged between five and 11 in the country have received at least one dose of the Covid-19 vaccine as of Tuesday (Aug 2), said Deputy Health Minister Datuk Dr Noor Azmi Ghazali.

He said of the total, 1.5 million or 42.3% of the population have completed the vaccination while 1,030 children in the moderate to severe immunocompromised category within the same age range have received the third dose.

However, Dr Noor Azmi said the percentage is still low compared to the number of vaccination facilities provided for that group.

“It’s been almost six months since we launched the Covid-19 vaccine programme for children, the staff are doing a good job, the response and cooperation from state governments are also good, the response from private clinics is also encouraging.

“But the arms are not there,” he said when replying to a question from Wong Chen (PH-Subang) in the Dewan Rakyat on Wednesday.

Dr Noor Azmi said the Health Ministry (MOH) is still continuing its efforts to encourage parents to get their children vaccinated including through electronic and social media.

To date, he said there are still 926 private premises that provide vaccination facilities and 14 off-site vaccination centres.

Meanwhile, for children who missed their second dose of the vaccine, he said parents can contact the nearest health clinic to make an appointment for the second dose. – The Edge Markets


Prevention and early detection of scoliosis in children and adolescents

Scoliosis: the hereditary spinal condition in which the spine curves to one side, taking after the shape of an “S” or “C,” is often misbelieved to be the result of bad posture, and, in children, caused by carrying heavy bags – neither are true.

Although most cases of scoliosis have no known cause (idiopathic scoliosis), early detection is recommended to prevent it from causing serious detriment to a person’s health, according to Dr. Wong Chung Chek, Consultant Orthopaedic and Spine Surgeon at ALTY Hospital (ALTY) in Kuala Lumpur.

Scoliosis is said to affect about 2-3% of the population in Malaysia. It is most often detected during adolescence, but can also affect adults and the elderly, albeit at a lower rate.

As scoliosis can worsen very quickly during childhood growth spurts and adolescence, parents should make it a point to examine their children on a regular basis. Scoliosis progresses very rapidly during these growth spurts and only slows down or stops once the child reaches bone maturity.

Signs of scoliosis become more noticeable as a child grows in age or as the curve progresses, but that doesn’t mean that scoliosis is impossible to notice early.

Parents can look out for any imbalances in the height or position of shoulders, shoulder blades, or hips — for example, one shoulder appears to be consistently drooping below the other. Parents should also watch for protruding shoulder blades, unevenness in gait, or misalignment of the head with the rest of the body, as these are all common symptoms of scoliosis.

In addition to home surveyance by parents, it is recommended to have posture screening for children in schools, together with regular health screenings. This will help to identify any symptoms earlier, especially since most children are developing rapidly at this time, which is typically when scoliosis begins to occur; and raise awareness about the condition, at the same time.

Recently, ALTY organised a Community Scoliosis Screening campaign – with pharmaceutical business, Viatris – around Klang Valley which resulted in over 250 walk-ins. From the screening sessions, it was discovered that a majority of parents and guardians were unsure of what signs to look for in their children, especially concerning scoliosis.

Most were also unaware that posture screening is available at most health clinics that can highlight growth or development related issues in children.

Dr. Wong said that one away to ensure early detection of scoliosis in children is to make early screening accessible in schools. School authorities and government collaborations can be considered in the future to ensure that posture screening is included as part of regular health assessments for Malaysian children.

However, if you are still unsure, it is best to consult an orthopaedic specialist as soon as possible. An orthopaedist who specialises in paediatric conditions will be able to examine spinal curvatures in children or recommend preventive measures as necessary.

While scoliosis is not a preventable condition, measures can be taken for early detection that can slow down the worsening of the condition, thus avoiding surgery. Even in situations where surgery is still needed, early detection would translate to shorter segments and safer surgeries.


Postpone generational smoking ban by 3 years, says PSC

The parliamentary select committee (PSC) on health has urged Putrajaya to postpone by three years the implementation of the generational ban on smoking and the possession of tobacco products.

Committee chairman Dr Kelvin Yii maintained that it supported the Tobacco and Smoking Control Bill, which has been dubbed a generational endgame (GEG) policy.

However, he said the policy’s implementation should be postponed by three years to give the government more time to prepare and ensure that the GEG was executed effectively.

Yii, the Bandar Kuching MP, also said this was necessary to assess the need for separate legislation for combustible and non-combustible tobacco products, as well as vapes, in line with emerging science and data.

In a statement, he said the law should only be implemented after the assessment was completed and debated in Parliament.

“We acknowledge the different concerns raised by stakeholders and see the importance of addressing certain implementation gaps and to set a mandatory review and monitoring framework to ensure the Act achieves its intended target,” he said.

Health minister Khairy Jamaluddin tabled the Tobacco and Smoking Control Bill yesterday. It seeks to prohibit the sale of cigarettes, tobacco, and vape products to anyone born after 2007.

Yii also called for the bill to include a “mandatory evaluation clause” for the PSC to compile an assessment report on the eventual Act, which would then be brought to Parliament.

He said this evaluation should be held 10 years after the Act was enforced, to assess compliance levels and effectiveness.

He also opposed calls for juveniles breaching the Act to be faced with criminal punishment and imprisonment, adding that their offences should not be recorded in a system.

Instead, he suggested that youths caught possessing tobacco products carry out community service, undergo counselling, and be meted a “reasonable” fine for first-time offenders.

“The committee recommends that nicotine replacement therapy (NRT) be openly marketed over the counter and made easily available, and for increased allocations for the mQuit programme.

“At least 10% of taxes collected from the vape industry must be allocated to the mQuit programme,” he said.

MQuit is a collaborative programme that provides customised plans to quit smoking, resources and advice on quitting the habit.


Malaysia launches clinical practise guidelines on menopause management

Malaysia is now one of the pioneers in the management of menopause guidelines in South-east Asia with the launch of Clinical Practice Guidelines (CPG) of Management of Menopause in Malaysia today.

Health Minister Khairy Jamaluddin said the launch marked a historical achievement in Malaysian healthcare milestone and the ministry will support such an initiative by efforts to increase awareness surrounding menopause.

“A woman’s health during her post-menopausal years carries an enormous weight towards the health and economic productivity of our nation,” he said in a pre-recorded video shown to the participants during the launch of the CPG here today.

According to Khairy, the average life span of a Malaysian woman in 2021 is 78.3 years compared to 73.2 years for a Malaysian man.

“Half of our ladies will live their lives beyond the age of 78 years. So, it is hoped that this CPG would be the first step in educating Malaysian healthcare workers to be proactive in managing menopausal health,” he said.

Meanwhile, Chair of the CPG committee and consultant obstetrician and gynaecologist Dr Premitha Damodaran said the guideline covers various information on menopausal symptoms, clinical assessment and investigations, various treatments and their effects as well as religious perspectives on menopause.

She said the CPG will be made available on various platforms including the Ministry of Health, the Academy of Medicine Malaysia, the Obstetrical and Gynaecological Society of Malaysia, and the Malaysian Menopause Society.

“For a start, the CPG will be available for the health workers before it can be available for the general public in four languages — Malay, English, Mandarin and Tamil,” Premitha told reporters after the launch.

The CPG which is a collaborative initiative by the Obstetrical & Gynaecological Society of Malaysia; Malaysian Menopause Society and College of Obstetrics and Gynaecology under the Academy of Medicine of Malaysia will also be made accessible via Android and iOS under Malaysian Health Technology Assessment Section or MyMAHTAS. – Bernama


No doctor shortage crisis at HK

The health ministry has sought to allay fears of a shortage of doctors in Hospital Kuala Lumpur (HKL) and Hospital Tunku Azizah (HTA), with the upcoming exit of medical officers in the hospitals.

This follows an internal memo from HKL’s top management on a looming medical officer shortage “crisis” in the hospitals, following the exit of junior doctors from July 18. HTA is HKL’s women’s and children’s facility.

In a statement, the health ministry said the memo issued by HKL’s management was purely for “internal coordination” to ensure the delivery of its health services would continue smoothly, especially at HTA’s emergency department.

According to the ministry, it already planned for new medical officers from other states to be transferred to HKL and HTA on the same date that junior doctors currently attached to the hospitals are transferred out.

It said these transfers were a normal procedure.

“Therefore, there is no such thing as a medical officer shortage crisis in HKL and HTA,” it said.

In the internal memo dated June 30, HKL’s deputy director (medical) Dr Marina Abdullah Sani invited all medical officers to attend a meeting today over the purported shortage of doctors.

She stated that the meeting scheduled to be held in HKL’s main auditorium was to discuss a solution to the shortage. FMT