Dispensary Separation: MMA has no plans to sue anyone and will continue negotiations

The Malaysian Medical Association (MMA) would like to reiterate our stand against the separation of dispensing and prescribing. However, we regret for any offense caused to any party if it is construed that the MMA has refused to discuss, negotiate or continue to engage with the Ministry of Health or any other related party where we strive to continue to improve the conditions for doctors and our patients. This would cover areas of separation of dispensing and prescription as well as the GST.

At no time did the MMA plan to sue anybody but did bring to light that there may be parties out there who are keen to do so due to the confusion created by certain parties. We will continue to negotiate with the Ministry of Health and all other ministries and hope that we can find a win-win solution to all the problems that are being placed on the practice of medicine in this country. Our stand made in the previous statement stands as below:-

We contacted the Honorable Minister of Health and with his help had a meeting with the Pharmacy division and other divisions of Ministry of Health on 24th February 2015. Here we were given a presentation and have been told that the Pharmacy Act is still very far from being tabled in the parliament. Next the essence of the Act is to merge several of the older Acts together to streamline it with current needs and to cover areas that are not covered in the current Acts.

We were also shown that there will be no separation of dispensing and prescription in this Act. Doctors in the private practice will still be allowed to prescribe and dispense from their registered place of practice. There will be no restriction to the types of medications these doctors can prescribe. We would like to note that there will be certain class of medications that may be dispensed by pharmacists to patients on filling up the prescriptions provided by doctors.

The Pharmacy division will be calling for meetings in the near future involving other associations and stakeholders to explain about the Pharmacy Act. This is to ensure that the misinformation that is spreading around will be rectified.

The Malaysian Medical Association (MMA) would strongly object to the separation of the prescribing and dispensing of medications at this time. There are many reasons to our objection. The main reasons for our objection are that the country and the ‘Rakyat’ are not ready for it. These include:-

1. There is insufficient number of pharmacists and pharmacies distributed in the country.
2. The distribution of the pharmacies is mainly in the urban area. They are not freely available in the outskirts of towns, rural and interiors of the country. It would burden the population in these areas to travel to towns to obtain their medication when currently they would be able to obtain it from the General Practitioner (GP) who is practicing in these areas.
3. There are currently many GP clinics that run 24 hours a day but there are hardly any pharmacies that are running 24 hour pharmacies.
4. There will be an increase cost to the public to pay for 2 different professionals when the current system permits the doctor to combine both at a lower cost.
5. There will be an inconvenience to travel to look for a pharmacist after seeing the doctor.
6. The pharmacist may not stock the medication prescribed by the doctor.
7. The pharmacist may dispense an alternative medication without really understanding why the doctor had prescribed the initial drug that may be specifically determined to the patient based on the patient’s medical condition.

We acknowledge and support the statements by the Minister of Health and the Director General of Health that DS should only take place after a comprehensive health Care Restructuring. This would ensure that there would be adequate facilities to serve the public at all locations at any time so that it would serve as an improvement to the current system.

We will also object to the implementation as a sample, study group, in phases or having dual systems for different places based on geography or any other separation. If and when the country is ready for it, the government must discuss with all stakeholders including the doctors and the consumer groups for feedback before its implementation. There must also be a time frame for all parties to be educated on its implementation, the pros and cons as well as avenue for it to be objected against. Putting up in an internet for feedback without first discussing and informing all stakeholders would not be constituted as being informed. It would be best to get the informed consent of all stakeholders before its implementation.

By Dr. H. Krishna Kumar, President, Malaysian Medical Association

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