Labour promises more doctors in training by 2011

New Zealand Herald, Oct 27 2008

Labour is promising 100 extra places in medical schools by 2011, toughened regulation and public audits of aged care facilities.

Prime Minister Helen Clark and Health Minister David Cunliffe released Labour's election health policy today and said it underlined the party's commitment to a strong, safe, affordable and accessible public health system for every New Zealander.

"Labour will continue to invest in a world class public health strategy aimed at helping New Zealanders stay well.

"We will prioritise fighting the disease and disability caused by obesity, tobacco, and alcohol and by the preventable cancers."

Labour's promise to increase the number of doctors in training by 100 by 2011 follows National's pledge of an additional 200 places over five years - which would lead to 140 extra places by 2011.

Announcing the policy today, Helen Clark said Labour said was committed to new initiatives like the B4 school checks for four year-olds, bowel cancer screening and HPV vaccination against causes of cervical cancer.

She said Labour would also introduce free annual health checks for the intellectually disabled with high support needs.

Helen Clark said as soon as economic circumstances permitted it would work to lower the cost of doctor visits further, with priority being given to the 65 plus and six to seventeen year age groups.

Mr Cunliffe said Labour would work with DHBs to strengthen regional, clinical, and administrative networks.

Productivity could be lifted through joint purchasing and common approaches to workforce development and IT planning.

"Labour will also continue to prioritise shorter waiting times for treatment in the cardiac, cancer and orthopaedic services," he said.

"We will also strengthen work force development and regulation in the aged care sector, and ensure that the audits of facilities are publicly available."

- NZPA

The Parable of the Banquet

If little children aged from 9 months to 13 years old can't access surgical treatments for their hearts in their own homeland, then something must be very very wrong in the Malaysian health system.

It is a paradox where a country that boasts a RM9 billion health budget, the world's top five medical tourism destination with a RM200million industry, 361 public and private hospitals with 47376 beds, and the ever-famous National Heart Institute that houses 85 cardiac specialists under one roof, can barely afford to meet the needs of a mere 17 children.

It is a national shame that we should seek the cheapest option available to fly these children and their families to another country, when there is so much capacity within the private sector to treat our own kin. We prefer to treat the rich, the famous and the foreign but marginalise our own poor and needy. Anak di riba dibiarkan, kera di hutan disusui.

We aspire to be a developed nation with huge investment poured into the many medical schools and medical scholarships annually, yet we barely provide for the needs of the poor. In 2006, there are 13,335 public medical practitioners compared to 8602 private ones, accounting to a ratio of 3:2. This seems reasonable and alright.

But when the medical needs are actually compared, the inequality to access and providence of healthcare is rather shocking. While the MOH health stats do not reveal much information, a rough estimation of doctor:bed ratio, of public and private health sector (30,396 and 11637 beds respectively), is about 1 : 2.3 (1 doctor to 2.3 beds) for public hospitals and 1:1.4 (1 doctor to 1.4 beds). This does not include the amount of doctor : outpatient ratio.

This means that public doctors are actually serving almost double the amount of beds than private doctors. This also implies that the public of all strata of society do not receive comparable proportions of health resources, with the rich enjoying almost double the amount of health resources available, while the poor are grabbing whatever resources left.

Imagine a big banquet with a huge table with luxury food and abundance for the few rich and a small table with rationed soup for the to be shared among the throngs of beggars. After a while, the soup for the poor run out, the poor old beggar and the blind orphan who came late and was hungry was disappointed that the soup has ran out. They begged for the banquet host for more soup, perhaps some of the leftovers or droppings from the table of the rich. Instead, they were turned away, and were sent to go to the pig farm next door, which served leftover food for pigs.

When there isn't enough beds for the poor, when the poor is sent to somewhere else, instead of sharing some of the rich people's beds, when even just a bite from the rich people's table is not possible, then there is something very wrong with the banquet host.

The Only Hope for Monsters

The evils and crimes of the world is certainly no worse than the evil of our own. Perhaps PM-wannabes and crime enforcers should realise that. Read The Only Hope for Monsters

Alex Tang noted a few principles for doctors

Whoever takes up medicine should aeriously consider the following points: firstly, that he must one day render to the Supreme Judge an account of the lives of those sick men who have been entrusted to his care.

Secondly, that such skill and science as, by the blessing of Almighty God, he has attained, are to be specially directed toward the honour of his Maker, and the welfare of his fellow-creatures; since it is a base thing for the great gifts of Heaven to become the servants of avarice and ambition.

Thirdly, he must remember that it is no mean or ignoble animal that he deals with. He may ascertain the worth of the human race, since for its sake God’s Only-begotten Son became man, and thereby ennobled the nature that he took upon him.

Lastly, he must remember that he himself hath no exemption from the common lot, but that he is bound by the same laws of mortality, and liable to the same ailments and afflictions with his fellows. For these and like reasons let him strive to render aid to the distressed with the greater care, with the kindlier spirit, and with the stronger fellow-feeling..

Traditional and Complementary Medicine

The Ministry of Health has introduced traditional and complementary medicine in a few public hospitals in Malaysia lately. While it is undoubtedly popular among lay people, the efficacy of the treatment is still in much doubt, and yet to be supported by leading good quality evidence-based research around the world.

It is rather concerning that the Ministry of Health would make choices based on popularity without considering its efficacy and value-for-money especially in improving mortality and morbidity. What more, the precious tax-payers money invested in the health system which is certainly not adequate to provide for the increasing need for primary care nor tertiary medical services, is unnecessarily spent on TCM providers whom may not deal with real biomedical problems.

While I understand that patients have the choice to opt for contemporary or alternative ones, it is preposterous that public funds are used to finance services that are show little or no significant benefit in disease intervention, while there are thousands more who are dying on waiting list for surgeries or cancer treatment. There are many more hospitals and clinics that are underfunded and are lacking in adequate medical equipments, struggling with the RM8 billion budget for health.

This is indeed a contradiction to some of the strategic plan laid out Ministry of Health, namely to
prevent and reduce the burden of disease, enhance the healthcare delivery system and optimise resources (p.9) through health indicators like average life expectancy at birth, crude death rates and infant rates. I don't see how having urut or munching Lidah Jin, or taking jamu Tongkat Ali or Kacip Fatimah, nor the poking needles onto one's biceps could have any effects whatsoever to those indicators. More evidence must be justified by the Ministry to randomly start up things on whim and fancy, rather than succumbing to popular cultural sentiments.

Semerbak melur berkuntum satu,
Andai disisir terpikat hati,
Meski jauh selaksa batu,
Rindu genggam berpahat di hati.

Harapan jiwa ibu pertiwi,
Hiburan hati mukmin yang saleh,
Molek sekali rupawan syurgawi,
Cantik lagi hati yang saleh.

Prayer

Help with My Studies

O Lord, who is the fountain 
of all wisdom and learning, 
you have given me the years 
of my youth to learn 
the arts and skills necessary 
for an honest and holy life. 
Enlighten my mind, 
that I may acquire knowledge. 
Strengthen my memory 
that I may retain what 
I have learnt. 
Govern my heart, 
that I may always 
be eager and diligent in my studies. 
And let your Spirit of truth, 
judgment and prudence 
guide my understanding, 
that I may perceive how everything 
I learn fits into your holy plan 
for the world.

—John Calvin, French Reformer (1509-1564)

A Desire for True Knowledge

Good Lord, 
you have refreshed our souls 
with the streams of knowledge; 
lead us at last to yourself, 
the source and spring of knowledge.

—Alcuin of York early Christian scholar (735-804)

Your Faithfulness

Your Faithfulness
by Brian Doerksen

I don't know what this day will bring
Will it be disappointing, filled with longed-for things?
I don't know what tomorrow holds
Still I know I can trust Your faithfulness

I don't know if these clouds mean rain
If they do, will they pour down blessing or pain?
I don't know what the future holds
Still I know I can trust Your faithfulness

Certain as the rivers reach the sea
Certain as the sunrise in the east
I can rest in Your faithfulness
Surer than a mother's tender love
Surer than the stars still shine above
I can rest in Your faithfulness

I don't know how or when I'll die
Will it be a thief, or will I have a chance to say goodbye?
No, I don't know how much time is left
But in the end, I will know Your faithfulness

When darkness overwhelms my soul
When thoughts and storms of doubt
Still I trust You are always faithful, always faithful

Certain as the rivers reach the sea
Certain as the sunrise in the east
I can rest in Your faithfulness
Surer than a mother's tender love
Surer than the stars still shine above
I can rest in Your faithfulness

I don't know what this day will bring
Will it be disappointing, filled with longed-for things?
I don't know what tomorrow holds
Still I know I can trust Your faithfulness