It’s August, the month that marks the independence day of our beloved Malaysia. Well, I am relieved to share that I just regained my independence as well… from the clutches of a complicated bout of illness that featured not our new imported acquaintance Covid-19, but old backyard buddies named dengue and tick-borne rickettsial pox.
It’s often said that cooks rarely eat the food they cook. If you ask your mum (which I did), on the days they cook large amounts of food such as during Hari Raya, they rarely eat the food they cook. This is quite similar with healthcare professionals. While we work at providing healthcare for others, we rarely use the system i.e. eat the food we cook.
Thus, it’s actually quite interesting when a healthcare practitioner falls ill. It’s only then that we really get to ‘enjoy’ the health system we work in. If you are not severely ill, you might want to take this opportunity to audit the health system and see if it works, and if it works well.
As I fell ill during this pandemic, I had the unique opportunity to use the healthcare system, and not as a Covid-19 patient. Why is this distinction important? At a time when resources are being channeled (rightly so) to managing Covid-19, it’s critical to gauge how the health system is managing other diseases or conditions.
This is because Covid-19 has not brought an end to all other illnesses. Diabetes, heart conditions, cancer and a whole lot of other infectious diseases such as dengue (as I can personally attest to) are still ongoing.
Well, let me share with you some of my personal insights from this experience. On one side, the private clinic I visited in my neighbourhood was deserted. The highly able physician and his staff were really busy ‘shooing flies’. On the other, during a follow-up blood test, I went to a government health clinic. Things here were in an uproar. Many, many patients were queuing up, sometimes in the hot sun (due to social distancing measures), with many of my public sector colleagues looking hot and tired in protection gear trying their best to calmly settle the patients and their needs. This was at the primary care level.
At the secondary level when my illness worsened, I sought care in a public tertiary centre. Here, similar problems occurred as many healthcare resources were being focused towards managing Covid-19 situations if and when they arose; but this meant elsewhere, there were shortages. I did not opt for private tertiary care but my colleagues working within that sector told me how underutilised private healthcare institutions were.
Covid-19 looks like it has snuggled in and is about to stay for an indeterminate time in Malaysia. Thus, the health system needs to slowly transition from being on an emergency war footing to a more normal health delivery, while keeping Covid-19 preparedness at an optimum level.
Going back to the earlier analogy, your mom (wife, sister, aunts and pretty much every other female relative) will be willing to slog their hearts out and cook a feast for Hari Raya, since it comes once a year. They will churn out dish after dish for hundreds of guests willingly. But ask them to do this every day, and you will have a full-blown riot on your hands, and if you’re not lucky, maybe even a divorce notice. (Please take note that there is no gender-biased slant in this analogy so please don’t take offense.)
This is the conundrum the health system is facing. Transitioning from dealing with an acute emergency situation to a chronic semi-emergency while also dealing with day-to-day healthcare. How do we do it? At the risk of sounding blasé’, perhaps now may be the best time for us to stop thinking about it and to get things into motion. Gain independence from the shackles.
In an earlier piece, I had written at length about rationing healthcare and how there can never be a situation where unlimited healthcare can be provided for everyone.
However, as we start wading through the swamp of Covid-19, another facet of healthcare delivery strategies needs to be looked at: rationalisation of healthcare. Rationalisation looks at increasing the efficiency of healthcare delivery in order to ensure the same effects are being provided at a population or system-wide level, especially when resources are limited.
At a time when our public health resources may be overburdened by trying to cope with both the lingering effects of the pandemic as well as with our ‘normal’ health needs, a serious rationalisation exercise may be needed to free our national healthcare system and let it evolve into something better.
Rationalisation of our healthcare system requires us to take the genuine step of integrating the public and private sectors, something we have continued to struggle with for more than three decades if not longer. This calamity may have provided us with the socio-political springboard to enable this transformation, that is if we will it.
The views expressed are those of the author and do not necessarily reflect those of FMT.
CLICK HERE FOR THE LATEST DATA ON THE COVID-19 SITUATION IN MALAYSIA
from Free Malaysia Today https://ift.tt/30XyAS5
via IFTTT
No comments:
Post a Comment