Question time: Dzulkefly speaking on the amendments being made to the Medical Act 1971 (act 50) and the Infectious Disease Prevention and Control act 1988 (Act 342) in Parliament. — Bernama
KUALA LUMPUR: Following significant contention from the medical community, the Health Ministry has tabled amendments to the Medical Act (Act 50) for the first reading in the Dewan Rakyat.
The Medical (Amendment) Bill 2024, tabled by Health Minister Datuk Seri Dr Dzulkefly Ahmad yesterday, aims to resolve the issues related to the parallel pathway specialist training programme.
The Bill is set for its second reading in the current Dewan Rakyat meeting, slated to conclude on Thursday.
The proposed amendments arose after the Malaysian Medical Council (MMC) refused to recognise certain cardiothoracic training programmes, despite a shortage of specialists, leaving graduates in the lurch.
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The Bill seeks to improve provisions related to the registration of specialists as well as the recognition of qualifications and specialised training.
It also proposes changes in the composition of MMC members.
One of the significant amendments to Section 14 (Medical Act) involves the registration of specialists. The proposed change replaces “recognised training programme in any recognised training institution” with “training programmes in any institution determined by the MMC”.
To become a specialist under Section 14 of the Act, a doctor must be fully registered as a medical practitioner, hold a qualification listed as registrable for specialists and have completed specialised training.
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The doctor must also have undergone supervised work experience determined by the MMC and demonstrated acceptable work experience to the council. Additionally, the medical practitioner must prove competency and possess good character.
“Notwithstanding paragraph (1)(b) or (c), any person may be entitled to be registered as a specialist under Section 14c where the minister, upon the recommendation of the council, is satisfied that he has any other comparable qualification or comparable specialised training as the case may be, which is of special value to this country, subject to such restrictions and conditions as the minister thinks fit,” the Bill reads.
The specialised training programmes under the Act include those approved by the MMC as listed in the Fourth Schedule, such as qualifications provided by the Health Ministry, local higher educational institutions, or other approved institutions within Malaysia.
Additionally, the MMC accepts training provided outside Malaysia related to specified specialities or sub-specialities listed in the Fourth and Fifth Schedules.
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Upon consulting the MMC, the minister can, from time to time, add, delete or amend the Fourth or Fifth Schedule by issuing an order in the Gazette.
Under Section 14C(1), the MMC can require an applicant to furnish further information or documents to support their application, and their name will be included in the Malaysian Medical Register if approved.
A new Subsection 14D has also been proposed, related to sub-specialities.
The composition of MMC council members will also be altered through a proposed amendment to Section 3A.
The number of registered medical practitioners representing local universities and university colleges in the MMC will be reduced to five from nine, through a proposed amendment to Subsection 3A(1).
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The number of representatives in the council who are from the public service will be increased from three to seven – they will be nominated by the director-general and appointed by the minister.
At yesterday’s press conference, Dzulkefly said Act 50 is being amended to “harmonise” the regulations for the two specialist training programmes – the Master’s and the parallel pathway programme.
Dzulkefly said despite the perception that the ministry favours overseas fellowships, the allocation of funds shows equal importance given to Masters and the parallel pathway programme.
Between 2019 and 2023, the Health Ministry allocated RM365.4mil to specialist training for medical officers. Of this, approximately RM352.3mil (96%) funded the Master’s programme at public universities, and RM13mil was designated for the parallel pathway programme.
Regarding the change in MMC representation from universities and public service, Datuk Dr Mohd Azman Yacob, director of the ministry’s Medical Development Division, said the proposed ratio was deemed “appropriate.”
He added that over 60% of registered doctors in government service are from the Health Ministry, with the remainder from teaching hospitals.
His deputy Dr Hirman Ismail justified the proposed changes, citing the ministry’s status as the largest provider of public healthcare, overseeing 159 hospitals.
In contrast, the Higher Education Ministry manages only nine teaching hospitals.
The Star reported that the Health Ministry might gain greater authority to oversee and recognise specialist training programmes, addressing the parallel pathway issue through amendments.
The shortage of cardiothoracic surgeons has left around 1,500 heart and lung disease patients in government hospitals in dire straits.