What drives Malaysians to slag off our own healthcare?

SEPTEMBER 10 — Controversial Singaporean blogger Xiaxue’s defamatory tweets about Malaysia’s healthcare system early this month provide an insight into how the middle-class ethnic Chinese status quo there sees their neighbour.

Xiaxue, who is immensely popular despite her history of provocative posts, showed that she chose her incendiary remarks as they appeal to her readers who already believe in that kind of populist drivel.

And in this case her tweet against the Malaysian ambulance driver, hospital and doctors — after several of her countrymen alleged they were to be blamed for their friend’s death after a hit-and-run accident — seems to be that our healthcare is rubbish when compared to Singapore’s.

In her subsequent tweets, Xiaxue claims that the incompetence, laziness and ineptitude of the Malaysian healthcare system had killed someone — despite the clear fact that Justinian Tan, 25, was critically injured when a car crashed into him and his friends in the wee hours of the morning. The driver has since been arrested and released on bail, pending an investigation.

“A reminder for Singaporeans to be grateful the difference a causeway can make,” Xiaxue said, claiming that the “not my job” attitude plagues Malaysia and her doctors.

But her tweet can also provide an insight into how one consumes news, and inevitably spread fallacies and untruths, despite being internet and social media savvy.

In her first tweet, Xiaxue chose to share a secondary report from Must Share News, one of the several news aggregator portals that have proliferated in the republic, partly due to the small and controlled media landscape there.

The initial report by Independent SG itself was already dubious. Quoting the victim’s friends, the report claimed that there was a slow response time for the ambulance from Sultanah Aminah Hospital (HSA) in Johor Baru — nearly half an hour.

Public healthcare in Malaysia may be overburdened but the care given is not any more inferior than that in other countries. — Picture by AFP
Public healthcare in Malaysia may be overburdened but the care given is not any more inferior than that in other countries. — Picture by AFP

It also alleged that HSA demanded a cash deposit from the victim’s family before treating the patient.

The Health Ministry should be praised for its speedy response. Several facts were provided with proof:

1. The ambulance left promptly, two minutes after the call and arrived on the scene 12 minutes later, and left with the patient five minutes after that. The victim was admitted to the Red Zone upon arrival at the Emergency Department.

Joshua De Rozario, one of Tan’s five friends later said he merely “felt” like the wait was long and “thought” it was 30 minutes.

2. There was no payment demanded, as per a ministry circular on foreign patients.

De Rozario admitted that “it could have been a miscommunication”, claiming that the staff was speaking Malay while he spoke English. Which was still questionable considering Malaysians learn English for at least 12 years in school.

3. Tan had died in Singapore, not Johor Baru.

The reason? Tan’s family members opted to discharge him and arranged for admission to a Singaporean hospital instead, even after being fully informed of the risk. Even after he was initially referred to the neurosurgery team for urgent surgery in HSA.

Independent SG nearly sparked a diplomatic incident, not to mention perpetuating stereotypes, which could have been avoided simply if they had not made the rookie mistake of quoting one side of the story without verifying the matter with Malaysia’s Health Ministry.

Facing the possibility of legal action from the ministry, the report was quietly replaced with a “We’re Sorry!” mention.

The ministry decided to not pursue the matter, regardless of the reputation damage it has sustained — especially among Malaysia’s own citizens.

The motive to defame Malaysia’s healthcare system is clear when you are seeking publicity and clicks from across the Causeway, but what drove Malaysians themselves to swallow the initial report and use it as ammo to shoot down their own?

The dissatisfaction with the system seems to be driven by the perception of poor service and frustrating waiting times which has overshadowed the excellent track record of the professionals in the public service.

Most of the time, it is due to a mismatch of expectations from the patients, especially those accustomed to private service — either through their own experience, or that of others.

Some patients complain of waiting time, yet they go straight to hospitals — a secondary or tertiary care centre, or worst yet straight to emergency departments -- when their first point of contact should be the Klinik Kesihatan primary care.

When they have a referral or appointment, they do not come at their time slot, but way earlier due to kiasu, thus clogging up the time slots reserved for others.

Some expect prioritised treatment you only get in private hospitals, but choose instead the public system because they cannot afford the alternative, or can now no longer afford it.

Some want extra time from the doctors, but complain when others do it and deprive them of their time.

Many wish for doctors to work longer hours, not knowing that as it is doctors already have little time for rest in between patients, what more lunch. For many doctors, leaving at punch-out time is a distant reality, with additional paperwork waiting.

Many want the best medicines that exist, yet fail to comply with those supplied and waste them.

In medicine there is the concept of triage, where you treat the most urgent and dying patients first. In many ways, our healthcare system runs triage on its entire operation every day.

The system is severely underfunded, with doctors stretched and overburdened with trivial and redundant tasks thanks to misallocation of resources and political aspirations of some at the top; all they want is to be allowed to save lives and treat others, no matter how bad things are in their daily lives.

There are so many things that should be fixed and improved with the system but in blaming hospitals and doctors, we miss the depressing tragedy that they are working with what little they have.