A protest at the Selayang Hospital today saw activists criticising the government's move to fully implement the Full Paying Patient (FPP) scheme in public hospitals as one that will punish the poor.

The scheme - aimed at retaining the services of specialists at public hospitals and clinics - was put in place at the Selayang Hospital and Putrajaya Hospital on Aug 1 as a six-month pilot programme.

While the treatment costs of ordinary patients are currently subsidised by the government, the FPP scheme will introduce the concept of fee-sharing between the hospitals and specialists treating paying patients.

Barely a month after the Health Ministry launched its pilot programme, 2008 Budget proposed that the FPP scheme will be implemented in all public hospitals and clinics from Jan 1 next year.

Coalition Against the Privatisation of Healthcare chairperson Dr Subramaniam Pillay, an exco member of social reform movement Aliran, was among the 120 people who protested against the FPP at the lobby of the Selayang Hospital this morning.

Leaders of opposition parties PAS and PKR were also present alongside members of grassroots rights organisations Jerit, the Women's Development Collective, and student group Dema.

Fifteen members of the coalition submitted a memorandum to Selayang Hospital deputy director Dr Zainab Ramli. She promised to forward it to the Health Ministry and Prime Minister Abdullah Ahmad Badawi.

Subramaniam pointed out that the government has yet to make public its assessment of the scheme in Selayang and Putrajaya - if carried out at all.

Based on the FPP programme put in place four years ago in two teaching hospitals - Universiti Malaya Medical Centre and Universiti Kebangsaan Malaysia Hospital - he said there is little credence to claims of its effectiveness or the desirability of it being replicated.

"From our experience and cases that we've looked at in countries such as India, there are a lot of problems (with the scheme)," he told reporters.

Among these is that medical specialists do not turn up for duty due to exhaustion, after spending hours treating or giving consultations to their private patients, he said.

Adverse implications

The Selayang Hospital, in a statement, has said that patients receiving government-subsidised treatment from specialists will not be adversely affected by the scheme.

It said they will continue to be attended to as usual because "patients under the FPP scheme will not affect the clinic appointments of ordinary patients".

Coalition member Dr Xavier Jayakumar remains unconvinced. He said the scheme looks good on paper but will, in reality, have negative repercussions for the quality of specialist treatment as well as medical facilities.

"Will doctors spend the needed time with government-subsidised patients when they can make more money with FPP patients?" asked Jayakumar, who is also deputy secretary-general of the opposition party PKR.

"Public hospitals and clinics are already packed with patients. How are you going to find time to treat FPP patients?"

Pro-tem Parti Sosialis Malaysia secretary-general S Arutchelvan compared the motivation for specialists to earn more money by attending to FPP patients to that of teachers who spend more time and effort giving tuition than on school work.

"We don't want hospitals to be just money-making machines. People will soon worry more about their medical bills than about falling sick," he said.

PAS leader Dr Siti Maria Mahmud warned that the FPP scheme is another step towards the full privatisation of healthcare.

"Since 1999, privatisation has (crept into) the laundry services in hospitals, preparation of food, engineering, and manufacture of drugs. Ten years from now, we will lose all the medical facilities that have been given to us at the time of Independence," she said.

Urging the government to put the scheme on hold, Jayakumar said there are other ways of retaining the services of medical specialists at public hospitals and clinics.

This includes the setting up of a Health Commission to look into improved remuneration of all medical professionals, he said.

"This FPP scheme is just another knee-jerk reaction," said Jayakumar.

Coalition secretary Dr D Jeyakumar said the FPP would widen inequality between the rich and the poor.

"It is the sacred duty of the government to provide (adequate healthcare) for all, rich or poor," he said.