[ENGLISH VERSION VELOW] Kami yang bertandatangan di bawah, terdiri daripada 40 organisasi dan 43 individu, menggesa Perdana Menteri Anwar Ibrahim, untuk terus tegas menyokong pelaksanaan Perintah Kawalan Harga dan Anti-Pencatutan (Penandaan Harga bagi Ubat) 2025 oleh Kementerian Kesihatan dan Kementerian Perdagangan Dalam Negeri dan Kos Sara Hidup mulai 1 Mei.
Kami juga menggesa perdana menteri agar campur tangan dan menolak caj atau yuran baharu yang dikenakan oleh sesetengah pengamal perubatan am (GP) atas alasan pematuhan peraturan, pendaftaran, preskripsi ubat atau penggunaan kemudahan mereka, kerana caj-caj ini adalah tidak wajar, tidak munasabah, tidak berasas dan tidak adil serta akan menambah beban kewangan kepada banyak isi rumah.
Kami ingin menyuarakan bantahan keras serta rasa tidak bersetuju terhadap tindakan GP tersebut, yang kami anggap sebagai reaksi terhadap perintah paparan harga ubat yang baru diperkenalkan.
Keengganan GP untuk menyokong ketelusan harga dengan segera tidak memberi imej yang baik kepada mereka di mata masyarakat.
Tindakan mereka yang hanya mahu memaparkan harga ubat selepas pindaan dibuat terhadap Akta Kemudahan dan Perkhidmatan Penjagaan Kesihatan Swasta 1998 menunjukkan ketidakikhlasan dan seolah-olah dijadikan alasan untuk melengahkan pelaksanaan perintah tersebut.
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Akta Kawalan Harga dan Anti-Pencatutan 2011 adalah akta paling sesuai untuk mengawal selia pelabelan dan paparan harga barangan, dan ubat-ubatan tidak sepatutnya dikecualikan. Walaupun doktor memberikan preskripsi sebagai sebahagian daripada amalan profesional, penentuan harga ubat adalah keputusan perniagaan semata-mata. Ramai GP mengakui mereka bergantung kepada jualan ubat untuk menampung kos operasi klinik, dan ini membuktikan perkara tersebut.
GP sepatutnya memperoleh pendapatan utama melalui yuran profesional, seperti yuran rundingan, dan bukannya melalui jualan ubat. Kebergantungan klinik GP terhadap jualan ubat mewujudkan konflik kepentingan yang serius serta dorongan yang salah bagi sesetengah GP untuk memberikan preskripsi dan menjual ubat yang tidak diperlukan, sama ada untuk penggunaan “sekadar berjaga-jaga” atau dalam kuantiti yang lebih banyak daripada biasa.
Ada juga GP yang menyembunyikan nama ubat dan membungkus semula ubat dengan harapan pesakit akan kembali ke klinik mereka untuk mendapatkan ubat dan bukannya membeli dari farmasi komuniti. Tingkah laku ini boleh dianggap sebagai anti-persaingan dan merugikan kepentingan pesakit.
Seiring dengan perintah paparan harga ubat, kami juga menuntut agar semua kemudahan penjagaan kesihatan swasta menyediakan bil terperinci (itemised bill). Ini akan membolehkan pesakit atau pengguna mengetahui maklumat mengenai ubat yang dipreskripsi dan dibekalkan, termasuk harga seunit, supaya mereka tahu apa yang dibayar. Ketelusan dan pendedahan secara proaktif akan membolehkan pesakit membuat keputusan yang lebih bijak dan berinformasi.
Kami menyokong gesaan GP untuk menyemak semula jadual yuran dalam Akta Kemudahan dan Perkhidmatan Penjagaan Kesihatan Swasta bagi menaikkan yuran rundingan selaras dengan kadar inflasi umum sejak 1992.
Menurut Indeks Harga Pengguna (CPI), kadar inflasi bagi tempoh ini ialah 114%. Oleh itu, julat baharu bagi yuran rundingan GP sepatutnya adalah antara RM21.40 hingga RM75.
Ini boleh dijadikan rujukan munasabah untuk kenaikan yang adil; sebarang penetapan yang menyimpang terlalu jauh – contohnya, cadangan yuran minimum RM50 – adalah berlebihan dan tidak selari dengan realiti kewangan isi rumah.
Dalam menentukan julat yuran rundingan yang wajar, kami menggesa perdana menteri dan Kementerian Kesihatan untuk mengutamakan perlindungan kepentingan pengguna dan pesakit.
Kami turut bimbang terhadap pertambahan pesat klinik swasta di kawasan bandar Malaysia pasca era Covid. Dari 2021 hingga 2023, sebanyak 2,040 klinik baharu dibuka, dengan hampir dua klinik baharu setiap hari. Selangor dan Kuala Lumpur sahaja menyumbang 43% daripada keseluruhan klinik swasta, dan Selangor mencatat peningkatan sebanyak 32% dalam tempoh tiga tahun.
Jika GP menghadapi kesukaran menjana keuntungan, ia berkemungkinan besar disebabkan persaingan pasaran yang sengit, manakala permintaan mungkin menurun akibat inflasi perubatan yang meningkat dan kesempitan kewangan dalam kalangan isi rumah.
Adalah tidak wajar bagi GP menyelesaikan masalah persaingan ini dengan mengenakan lebih banyak yuran baharu ke atas pesakit.
Walaupun kerajaan tidak wajib menjamin keuntungan dan kelangsungan setiap klinik, kami menggesa kerajaan untuk mewujudkan lebih banyak jawatan dan peluang untuk GP meningkatkan kemahiran serta menjadi pakar, kerana terdapat kekurangan sebenar pakar dalam sektor penjagaan kesihatan. Langkah ini juga boleh mengurangkan persaingan keterlaluan antara GP sedia ada di kawasan bandar.
English version
Consumer, patient and civil society groups object to new charges by GPs
They call on the government to stay firm in enforcing the Drug Price Display Order
The undersigned 40 organisations and 43 individuals urge Prime Minister Anwar Ibrahim to stand firm in supporting the implementation of the Price Control and Anti-Profiteering (Price Marking for Drug) Order 2025 by the Ministry of Health and the Ministry of Domestic Trade and Cost of Living on 1 May.
We also urge the prime minister to intervene and reject the current new charges or fees imposed by some GPs for regulatory compliance, registration, drug prescription or use of their facilities because these charges are unwarranted, unreasonable, unjustified and unfair, and would place an additional financial burden on many households.
We wish to express our strong objection to and disapproval of these GPs’ actions, which we deem to be a reaction to the newly introduced drug price display order.
The GPs’ reluctance to support price transparency immediately does not reflect well on them in the eyes of the public. Their insistence on displaying drug prices only after amendments have been made to the Private Healthcare Facilities and Services Act 1998 exposes their insincerity and makes it seem like an excuse to delay the implementation of the order further.
The Price Control and Anti-Profiteering Act 2011 is the most appropriate act governing price labels and displays on goods, and medicines are not an exception.
While doctors may prescribe medicine as part of their standard professional practice, determining drug prices is a purely business decision. Many GPs admit that they rely on drug sales to cover the cost of running their clinics, which is a testament to this claim.
GPs should earn most of their income through professional fees, such as consultation fees, rather than through drug sales. A GP clinic’s reliance on drug sales creates a dangerous conflict of interest and a perverse incentive for some GPs to prescribe and sell unnecessary medicines for ‘just-in-case’ use or in larger quantities than normal. Some GPs also hide the names of medicines and repackage them in the hope that patients will return to them for the medicines they have prescribed rather than buying them from a local community pharmacy. This behaviour may be deemed anti-competitive and detrimental to patients’ interests.
Alongside the drug price display order, we demand that all private healthcare facilities provide itemised bills. This will allow patients or consumers to learn about the prescribed and dispensed medicines, including unit price information, so they know what they are paying for. Transparency and proactive disclosure will enable patients to make informed decisions.
We support the GPs’ call to revise the fee schedule in Private Healthcare Facilities and Services Act 1998 to increase the consultation fee in line with the general inflation rate since 1992.
According to the Consumer Price Index (CPI), the inflation rate for this period is 114%. Therefore, the new range for GP consultation fees should be RM21.40 to RM75. This would provide a good reference for a fair increase. A large deviation from this – for example, the proposal for a minimum fee of RM50 – would be excessive and out of touch with household financial realities.
When setting a fair consultation fee range, we urge the prime minister and the Ministry of Health to consider protection for consumer and patient interests first.
We are concerned about the rapid proliferation of private clinics in urban areas of Malaysia in the post-Covid era. From 2021 to 2023, Malaysia saw 2,040 more clinics open, with almost two new clinics opening every day. Selangor and Kuala Lumpur alone account for 43% of all private clinics, and Selangor has seen a 32% increase in the number of private clinics in the last three years.
If GPs are struggling to be profitable, this is most likely due to intense market competition, while demand could be falling due to rising medical inflation and financial difficulties among households. It would be misguided for GPs to try to solve their problem of fierce competition by charging patients more new fees.
While the government is under no obligation to ensure the profitability and survival of every clinic, we urge the government to create more positions and opportunities for GPs to upskill and become specialists, as there is a real shortage of experts in the healthcare sector. This could also alleviate the intense rivalry and cutthroat competition among current GPs in urban areas.
Endorsed by:
Organisations
1. Consumers’ Association of Penang (CAP)
2. Third World Network (TWN)
3. Agora Society Malaysia
4. Aliran
5. All Women’s Action Society (Awam)
6. Always for People
7. Association of Family Support and Welfare Selangor & KL (Family Frontiers)
8. Center for Independent Journalism (CIJ)
9. Citizens’ Health Initiative (CHI)
10. Coalition for Clean and Fair Elections (Bersih)
11. Dialektika Tv
12. Forum Kedaulatan Makanan Malaysia (FKMM)
13. Gabungan Bertindak Malaysia (GBM)
14. Health Equity Initiatives (HEI)
15. Johor Yellow Flame (JYF)
16. KLSCAH Youth
17. Labour Solidarity and Learning Resources Association (LLRC)
18. National Union of Seafarers Peninsular Malaysia
19. North South Initiative (NSI)
20. Organisation for International Development and Research in Sustainability (Idris)
21. Penang Forum
22. Penang Hills Watch
23. Pertubuhan Menangani Gejala Sosial Malaysia (Unggas Malaysia)
24. Persatuan Hokkien Selangor dan Kuala Lumpur
25. Persatuan Pendidikan dan Penyelidikan untuk Pengguna-Pengguna Pahang (Era Pahang)
26. Persatuan Sahabat Wanita Selangor (PSWS)
27. Persatuan Tarian Desa Selangor dan Wilayah Persekutuan
28. Persatuan Wanita Maju Selangor dan Kuala Lumpur
29. Pertubuhan Jaringan Kebajikan Komuniti (Jejaka)
30. Pertubuhan Rangkaian Pembangunan Kesinambungan Malaysia (Susden Malaysia)
31. Pusat Pembangunan Rakyat (Mandiri)
32. Reproductive Rights Advocacy Alliance Malaysia (RRAAM)
33. Sahabat Alam Malaysia (SAM)
34. Saya Anak Bangsa Malaysia (SABM)
35. Suara Anak Muda
36. Tanjung Bungah Residents’ Association (TBRA)
37. Together Against Cancer (TAC)
38. Treat Every Environment Special (TrEES)
39. Women’s Aid Organization (WAO)
40. Women’s Centre for Change (WCC)
Individuals
1. Adrian Pereira, executive director, North-South Initiative
2. Agnes James, deputy chair, Tanjung Bunga Residents’ Association
3. Alice Tan Pei Pei
4. Andrew Pang, social entrepreneur/co-founder
5. Annelies Allain
6. Atyrah Hanim Razali, founder, Feminomics Malaysia
7. Aw Swee Lim
8. Catherine Choon
9. Datuk Nizam Mahshar, chairman, IDRIS
10. Dr Geoffrey Williams
11. Dr Ho Meilu, retired professor
12. Dr Lim Chee Han, public health policy researcher and advocate
13. Dr Mazlan Che Soh, senior lecturer
14. Dr Sem Xiao Hui, global public health strategist
15. Dr Sharuna Verghis
16. Egha Elias, advocacy manager
17. Evelyn Teh
18. Gopalan-K Papachan
19. Harmit Singh, concerned citizen
20. Ho Yock Lin, president, Awam; gender equality advocate
21. Jasmine Sum
22. Jayanath Appudurai, retiree
23. Karina Yong, legal advisor, public health advocate
24. Kelvin Lee, chief, KLSCAH Youth
25. Kwan Shuk Yee
26. Leow E Ten, operations executive
27. Lim HuiYing, parliament researcher to MP
28. Lim Swee Swee
29. Margaret Chin, banker
30. Masjaliza Hamzah, project coordinator
31. Meenakshi Raman
32. Mohammad Shahrin Mohamad Ilmi
33. Ng Jee Kwan, president, Imperial College Alumni Association Malaysia
34. Patricia Nunis, director
35. Prof P T Thomas, executive dean
36. Roslizawati Md Ali, carer
37. Saiful Nizam Ab Wahab, aktivis rakyat, content creator
38. Sarajun Hoda Abdul Hassan, social activist
39. Suguna Papachan, teacher
40. Tiow Ee Hsiang
41. Wan Azuan Bin Wan Ali, community health worker
42. Wong Jia Woei
43. Yap Mei Shya
AGENDA RAKYAT - Lima perkara utama
- Tegakkan maruah serta kualiti kehidupan rakyat
- Galakkan pembangunan saksama, lestari serta tangani krisis alam sekitar
- Raikan kerencaman dan keterangkuman
- Selamatkan demokrasi dan angkatkan keluhuran undang-undang
- Lawan rasuah dan kronisme
