Healthcare Liberalization of Clinics
With more local doctors leaving the SERVICE and of course, expat doctors no longer willing to work for the pittance that is called the NEW SCHEME. What should we do ? Management believes in a BIGGER AND STRONGER STICK. Tell me if you see a man wielding a large long stick, would you not run away faster ? There is a need for a new direction in the management of healthcare and healthcare staff, which the public desperately needs.
In this country, there are three types of health clinics:
1. The government health clinic
2. The government RURAL health clinic
3. Private clinics
Private clinics are clinics themselves which are treating our very own people, so we should utilize this as a resource instead of a competition to the government.
The challenges with government health clinics is that it is still like a factory, the whole idea of ‘Decentralization’ has not instilled the true and full changes it should have made.
Where is the continuity of care promised thru decentralization ?
What happened to patients seeing the same doctor ?
Do you really think that just because the previous doctor wrote in your medical notes, it will be the same continuity with another doctor whom you have not met before ? Seriously ?
Funny thing is that….
Management blames all of this shortfall on the shortage of doctors, BUT doctors (and also the Public) blame the Management for their poor creativity in retaining and inspiring our local doctors.
In the UK, health clinics are owned by private doctors, with contracts with the government or the NHS as well as incentives (financial) to achieve targets such as checking every patient’s blood pressure and managing it, ensuring women to have their PAPs Smears for example. There are many ways the NHS inspires their health clinics to perform additional services for example smoking cessation clinic. The clinics get rewarded and are funded for such initiatives.
On the other hand, our government health clinics try to setup additional services but as there is no reward or support for achieving these new services, the services always dwindle & disappear with time. It actually becomes a fashion trend of the current management. Most patients turn up to their clinic and it is like going to a workshop, fix what is the problem now, if can. Little initiative to do prevention.. isn’t prevention better than the cure ?
Micro-management by the administrators stifle growth and innovation !
How do we inspire our doctors, the vanguards of health in this country to provide better and comprehensive health care ?
Allow our local doctors to leave the Service and create a different kind of clinic, which is to become the standard for all clinics !
The setup of clinics within the country which is owned by local doctors and shareholders and contractually funded by the government.
Patients only have to pay their standard one dollar fee and the government is billed per patient seen and for medication.
These clinics can also provide additional services which is to be negotiated with the government on whether this would be funded by the government or patients have to pay for the services.
This arrangement would drive staff to perform better, find more patients and deliver better quality of care, and yet the government will have an ability to regulate this and set-out targets to be achieved like for example. patients to stop smoking or to be referred to be smoking cessation clinics, waiting times, continuity of care etc etc.
The government can also set penalties for not achieving targets such as waiting times. I am sure many of us would love to know that a clinic is being punished for making us wait long !
For each designated area/region, there should be more than one clinic serving the same area so as to stimulate competition.
Local doctors would stay as they decide how much their pay is and it is directly performance based. Hiring and firing new staff would be so much easier without government red tape and not to mention procurement of equipment would be almost hassle-free.
This is what we call Autonomy.
Of course, to pacify the nay-sayers and control freaks, each clinic would be subject to yearly or regular audit and submit reports of their performances & the government will have a say in the direction and objectives of each clinic.
However, in rural areas, government health clinics would have to remain within complete government control, which would also serve as excellent training centres for our local doctors.
Private clinics would of course have to change, to either follow to register as a clinic that has a contract with the government or remain completely private to satisfy whatever niche healthcare markets.
This would definitely in line with His Majesty’s Government to persuade for civil servants to work in the private sector.
Welcome to the a new world, this is the next step: the Healthcare Liberalization of Our Clinics !
Disclaimer: All of the above is solely the author’s personal opinion and does not reflect any professional or institutions’ standings.
