Author: Shiva Knight
Studying abroad on a summer programme offers a fantastic opportunity. I visited Malaysia, a culturally diverse country, which has thirty-six subethnicities with the main three races of Malay, Chinese and Indian. My time at Taylor’s University offered a clear depiction of the pharmacist’s role in the Malaysian healthcare system where the two-tier model of public and private sectors presents many challenges.
The public sector is heavily subsidised to be affordable while the private sector is funded by the patients to provide a faster service. This dichotomy has led to the merging of prescribing and supply with private sector general practitioners both prescribing and dispensing medicines. As a result, community pharmacists, who may receive less than ten prescriptions per month, rely on the sale of OTC medication business survival, which may lead to unethical practices. Potentially, this portrays the pharmacist as a shopkeeper without clinical skills and puts the patient and public at risk by allowing access to prescription-only medications (e.g. antibiotics) over the counter.
Another challenge arising from this split system is the migration of healthcare professionals to the private sector for better working conditions and higher salaries. This results in inequality in access to healthcare in rural areas where only public hospitals can be found.
This system has been deemed unsustainable for many years. The government introduced the ICare concept several years ago to resolve these issues, providing a single national healthcare system. Implementing the new system, however, has been a challenge for a number of reasons including the general practitioners’ reluctance to separate prescribing and dispensing. To deliver the vision, Malaysia will require the healthcare professionals to be united, working in inter-professional healthcare teams, focusing on patient safety and taking responsibility for their individual and collective practices.