COMMENT We refer to the proposed 'doctor diagnose, pharmacist dispense' debate which has resurfaced for consideration.

Close to a decade ago, this proposal was initially mooted by the government but received vehement objection from medical practitioners, consumer associations and the general public.

The plan which was once shelved is seen to re-emerge in the mainstream media as attempts are being made to reintroduce this proposal.

There is speculation the proposal has been finalised, pending execution later this year. If true, why the intense level of secrecy and elimination of a public consultation period?

It is worrying to note that objections raised previously would potentially be ignored. Is it rightful for governmental authorities to succumb to industry pressure at the rakyat's expense, by outweighing voices of protest.

In Malaysia, doctors are entrusted to diagnose and prescribe medicines, while, pharmacists only dispense drugs as instructed.

Seemingly, this adequate and time tested system is being subjected to scrutiny whereby interested parties are recommending changes which the Malaysia Consumers Movement (MCM) believes would put individuals at a disadvantage.

The looming question is if dispensing separation is part of a larger scheme which would be disclosed after the first phase is implemented?

If implemented, the MCM believes that:

1.Cost of medical consultation will increase. Under the current system, doctors offset consultation cost by generating profits from sales of medication. Soon medical practitioners would be lobbying to increase consultation fee if this function be separated.

Subsequently, consumers will be left in a lurch to pay twice – first, for consultation and second, for medicine. The incidental price of traveling to a pharmacy would in itself be an additional cost element, not to forget time required.

2.Pharmacist may step out of the line by diagnosing illnesses and the cost of inaccurate prognosis may lead to greater health complexities. This risk is real as the authority of dispensing medication would reside solely in the hands of pharmacists. Is this disaster in the making as big pharmacies start to monopolise and proliferate much to the detriment of consumers?

3.Imposes inconvenience for consumers as the current practice provides a one stop mechanism for patients. If the new proposal is adopted, consumers will require increased resources, from time to money and logistic, merely for heading over to a pharmacy which may be a distance away. How would it be convenient for the underprivileged or senior citizens?

4.Patients may opt for cheaper medication or given the haste, ignore the purchase of medication to reduce cost or in the name of convenience at the expense of one's health. In some cases, patients may even self prescribe medication. Collectively, this puts the life of a patient at risk. Is it viable to take on such a risk?

5.Allowing some individuals to manipulate the system by making it easy to obtain prohibited drugs such as sleeping medicines. The pharmacists may not necessarily be held liable as the new system does not necessitate the need for a prescription by medical officers prior to the purchase of controlled medication. Would the new system become a tool for some to harm their own lives?

Needless to say, this new system has little good to offer, especially to consumers. Doctors would likely increase consultancy fees to make up for their losses, while pharmacists would have more options to maximise business growth.

The present state of uncertainties amid a volatile economy landscape calls for Governmental authorities to explore ideas so rakyat is truly 'didahulukan'. In this case, to ensure consumer welfare remains top on its agenda.

The act of merely discussing or allowing rampant dialogue on this proposal makes it appear that Governmental authorities are compromising on their responsibility in upholding the nation's well-being.

Let us not be overzealous in our quest of attaining high income nations to the extent of neglecting consumer welfare.

The MCM therefore urges a holistic consultation with all stakeholders before a decision is made on this critical proposal which will impact the people by putting individuals at stake for profits.


DARSHAN SINGH DHILLON is president of the Malaysia Consumers Movement (MCM).