FHLS

DIPLOMA IN MEDICAL ASSISTANT (INTAKE: 7TH INTAKE)

NURSING SCIENCE 1 (SNSO154)

STUDENT NAME STUDENT ID LECTURER NAME BATCH/INTAKE DATE OF SUBMISSION

: : : : :

Shamsul Kamal Bin Shamsuddin 012010051577 Madam Nurhayati Hussain 201005 (05) DMA-F-2014 29th April 2011

PRIMARY, SECONDARY AND TERTIARY HEALTHCARE in MALAYSIA

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No 1 2 3 4

Topics/Titles Objective Primary Healthcare Secondary Healthcare Tertiary Healthcare

Page Number 3 4-5 5 6

Private Sector

6,7-8

Conclusions

7 8

Appendixes References

8,9-10 10

Ministry of Healths Vision for Health in which Malaysia is to be a nation of healthy individuals, families, and communities, through a health system that is equitable, affordable efficient, technologically appropriate, environmentally adaptable and consumer-friendly, with emphasis on quality, innovation health promotion and respect for human dignity, and which promotes individual responsibility and community participation towards an enhanced quality of life.

Objective
The objective of the health services in Malaysia is to raise and continuously improve the health status of individuals, families and communities. This includes health promotion, disease prevention as well as curative and rehabilitative services.

The healthcare system in Malaysia involves many different agencies and organizations that may be directly, or indirectly, related to health. The Ministry of Health (MOH) acts as the primary provider, planner and organizer of medical, and health services for the nation and is thus the governments lead agency for health.

Malaysia generally has an efficient and widespread system of health care, operating a two-tier health care system consisting of both a government-run universal healthcare system and a co-existing private healthcare system. Two-tier health is a situation that arises when there is a basic health care system financed by government providing medically necessary but perhaps quite basic health care services, and a secondary tier of care for those with access to more funds who can purchase additional health care not covered by the publicly financed system or which permits better quality or faster access.

Healthcare in Malaysia is divided into private and public sectors. The main bulk of Public Sector is under the MOH, which provides care at three levels primary, secondary and tertiary.
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Primary Healthcare
Primary health care is the thrust of the Malaysian healthcare system and the country is a signatory to the Alma Ata Declaration of 1978. There is government acknowledgement that equity in health is not the purview of the health sector alone. Government policies for the poor have included targeting healthcare delivery to the economically disadvantaged and to rural populations. The concept and philosophy of health in Malaysia is embodied in the following tenets:

Health is a fundamental right of every Malaysian and every individual has the right to develop and lead a healthy life. With this right, there must also be a balanced individual responsibility to maintain his or her owned health and the realization that health is an asset, which must be actively acquired.

Health is a shared responsibility of the government, the profession and the community. The government continues to advocate health as a social responsibility. Health is a public service to be made available to everyone, with equity of access, both in geographical and cost terms.

There must be continued creation of equal opportunities for health, and efforts must be concentrated to bringing health differentials down to the lowest possible level. Primary care is the term for the health services that play a central role in the local community. It refers to the work of health care professionals who act as a first point of consultation for all patients. Such a professional would usually be a general practitioner or family physician, depending on locality. They may then refer to secondary care.

Primary care involves the widest scope of health care, including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health, and patients with all manner of acute and chronic physical, mental and social health issues, including multiple chronic diseases. Comprehensive healthcare services are provided covering antenatal, postnatal, child health, adolescent, school health, wellness, elderly, mental health, nutrition and dietetics, home care nursing, rehabilitation, occupational health and health surveillance.
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Consequently, a primary care practitioner must possess a wide breadth of knowledge in many areas. Continuity is a key desirable characteristic of primary care, as patients usually prefer to consult the same primary care doctor for routine check-ups, and every time they require an initial consultation about a new complaint. Collaboration among providers is a desirable characteristic of primary care.

Common chronic illnesses, usually treated in primary care, include Hypertension, heart failure, and angina, Diabetes, Asthma and COPD, Depression and anxiety, Back pain, Arthritis and Thyroid dysfunction.

Secondary Healthcare
Secondary health care is the service provided by medical specialists who generally do not have first contact with patients, for example, cardiologists, urologists and dermatologists. A physician might voluntarily limit his or her practice to secondary care by refusing patients who have not seen a primary care provider first, or a physician may be required, usually by various payment agreements, to limit the practice this way. Consequently, secondary care physicians will only see patients referred by a primary care physician or another specialist. Allied health professionals, such as occupational therapists, speech therapists, and dietitians, also generally only work in secondary care. These professionals do not receive patient self-referrals; they work with physicians to co-manage the aspects of a patients health related to their area of expertise. Some allied health professions, such as physiotherapy, may be accessed through patient self-referral or through physician referral.

Examples of Secondary Health Care are Hospital Sg Petani(Kedah), Hospital Temerloh (Pahang), Hospital Slim River(Perak), Hospital Keningau(Sabah), Hospital Lahad Datu(Sabah), Hospital Bintulu(Sarawak) and Hospital Putrajaya.

Tertiary Healthcare
Tertiary health care is specialized consultative care, usually on referral from primary or secondary medical care personnel, by specialists working in a center that has personnel and facilities for special investigation and treatment. For medical and surgical emergencies, these are adequately provided for, with a government-managed fleet of ambulances, including airlift capacities for more interior remote sites. Tertiary Care Hospitals have recently made its presence felt in the Malaysian public healthcare sector, beginning in the 1980s, with the expansion and privatisation of the University of Malaya Specialist Centre (Petaling Jaya), and the building of the Universiti Kebangsaan Malaysia Medical Centre (Bandar Tun Razak, Kuala Lumpur), and the renowned National Heart Institute (Institut Jantung Negara, IJN), along Jalan Tun Razak. These have provided excellent specialist care for several highly specialized medical disciplines such as cardiology, cardiothoracic surgery, nephrology, cancer care, neurology and some infectious diseases. These however cater predominantly to our Malaysian civil servants, pensioners and their dependents (including many of our VVIPs), but due to facility constraints, long waiting times are now the norm.

In comparison, secondary medical care is the medical care provided by a physician who acts as a consultant at the request of the primary physician.

Private Sector
The Private Sector on the other hand, has always attracted both general and family physicians who had opted out by opening individual clinics or by joining more established group practices; while specialists join the better-paying more personalized care practices in urban private medical centres. Private clinics cater to most of the fee-for-service self-paying public, which include: private sector employees through panel doctor contract/insurance arrangement; thus relieving the already overloaded Ministry of Healths public clinics. In general, the choice for such private clinic consultations and treatment is due to easier access,
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simpler registration and appointment, and shorter waiting times. There is also possibly greater continuity of care with better personal attention from ones own family physician or general practitioner

Redistributing public sector patients who sometimes have to wait several hours, to a panel of urban or suburban private clinics nearer their home, can be a real option for better patient care and attention.

Besides that, for more serious illness and injuries, hospital care through wellequipped emergency departments (EDs) is now the expected practice. These medical emergencies are previously offered only at larger public sector general or district hospitals. These days however, most private medical centres boast of state-of-the-art emergency care at more luxurious settings and costs. Personal and more attentive specialist care are now demanded and offered at many of these private EDs, where many orthopaedic surgeons and neurosurgeons now practice privately.

However, private medical centres are not simply for emergency and/or trauma care. Most are now developed as competitive consumer-driven full-fledged healthcare facilities to cater for the more discerning public who would pay more to obtain perhaps better (perceptibly), more personalised, faster (less or no waiting time) and possibly more comfortable and/or luxurious medical care.

Health insurance or maintenance organisations have also bought into this system to offer more premium benefits to their clients, particularly those of the corporate world, where risk-averse and delay-averse market-driven results are expected. Executives and staff are offered contracted quicker and direct access to possibly more expert specialised care, with faster turnaround times and earlier return to work expectations. Healthcare industry players such as the state-owned KPJ group (Johor State Development Board), Parkway Holdings (Singapore-based, American-invested), and latterly Khazanah National Berhad (a Ministry of Finance Malaysian GLC) have greatly influenced the direction and expansion of these private services, while at the same time
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inflating the cost of private health care services by offering more sophisticated amenities and newer technology-driven expert care.

Conclusions
As the conclusion both government and private sectors were meeting our objective of a better healthcare provider. This is proved by the emerging of the new and up to date hospitals either for the government or private sector.

Appendixes

Figure 1: Government Hospital

Figure 2: Signage and Label in Government Hospital

Figure 3: Private Hospital

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Figure 4: Private Hospital Signage

References
1) http://hsudarren.files.wordpress.com/2006/10/malaysian-healthcare-a-critical-look.pdf 2) http://blogmoh.moh.gov.my/?p=562 3) http://www.whocollab.od.mah.se/wpro/malaysia/data/oral_healthcare_in_malaysi a_05.pdf 4) http://cpds.fep.um.edu.my/events/2009/workshop/29042009/PPT%20&%20full% 20paper/session%203/The%20Malaysian%20Health%20Care%20System1presentation-dr%20david%20quek.pdf

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