PETALING JAYA: There is an urgent need for a full review of protection for patients and not just the protection of doctors as called for by the Malaysian Medical Association (MMA), says an economist.
"This is because the basis of trust breaks down when patients are not protected in law against negligence or malpractice," said Prof Dr Geoffrey Williams of the Malaysia University of Science Technology.
"Then the whole system will be at risk as the breakdown in trust and an absence of legal protection will cause significant economic harm to this sector."
Prof Williams said Malaysians and healthcare tourists will lose faith in the system if patients are not protected, particularly in the private sector, and thus there is a need to address the impact on private healthcare and Malaysia as an international healthcare centre.
"The idea that the courts should not compensate people for negligence otherwise doctors will refuse to treat them is both unethical and wrong in economic terms.
"From an economic perspective, patients need to trust that they will be protected if something goes wrong, otherwise they will refuse treatment.
“Doctors also face a moral hazard if they are completely protected – then they will be more likely to push patients for risky procedures, especially if they get paid for it in the private sector,” he said, adding that doctors will also be less careful if they are immune from accountability when things go wrong.
"If doctors know that they will be held liable, they will improve their service and those with a bad track record will face higher professional indemnity insurance and will not take unnecessary risks," he said, adding that those with good track records will have lower costs.
On the reforms proposed by the doctors such as mediation, Prof Williams said any mandatory mediation must include independent non-medical experts as this is a question of professional standards and patient trust.
"Medical professionals quite naturally see it from their own perspective and not the perspective of the patients.
"Expert opinions from doctors do not always help because there is a history of doctors protecting each other. Often the doctors are close colleagues.
"There must be a full review of the entire system of patient protection and the role of the Malaysian Medical Council (MMC).
"Ultimately, the regulation of the health system cannot be solely in the hands of the MMC or the Health Ministry because this is a conflict of interest.
"They become judges in their own cases, which is a breach of natural justice. An independent review is necessary," he said.
Prof Williams added that the government should appoint an independent panel of professionals to look into the economic issues, the moral hazard issues, costs and benefits, and possible solutions, in a wider context.
"Ultimately, this is a question of economics not a question for medical practitioners who are not qualified to deal with these issues.
"Their expertise is in medicine and while their input is important, it must be taken as part of a wider discussion of economics, management and governance as well as ethics,” he said.
