Slower than snail speed!

26 May 2010 32 Comments

by Dr Hsu in competitiveness, Living, Malaysia

Remember Idi AMin? Younger people out there would not know who this man was. But those of us in the 50s and above would know about this person, the dictator in Uganda in the 70s, who did what a dictator in those days would do.

He fled to Saudi after an uprising , and died there in 2003.

Since those days of Idi Amin, we Malaysians have  always treated Uganda like a rogue state. Sub-Sahara Africa is supposed to be backward, and  we have always thought of Uganda as a disease-and-poverty-striken country, with children thin like skeletons and bellies big like pregnant ladies.

Now, do not look down on these countries anymore. Many of them have a broadband speed much faster than us, Yes , Malaysia — the country with the multimedia super corridor, the country that once boosted that it wanted to become a silicon valley of the East. We still wanted to become that, but we simply do not have the means to become that; just like an impotent old man, willing but not able to.

With broadband speed like snail, how are we going to compete with other countries?

What is the use of having all the modern buildings when we have a broadband speed placing of 104, according to speednet.com (below). The whole list can be viewed here. Uganda is ranked 95, Rwanda (yes Rwanda) 65, Ghana 44.

Even the country which exports maids to Malaysia, the Phillipines, is ranked 93. Your  maid  when she goes back to her home country, can assess info much faster than you. How about that!

Download Speed

1 South Korea 33.91 Mb/s
2 Latvia 24.07 Mb/s
3 Republic of Moldova 21.32 Mb/s
4 Japan 20.43 Mb/s
5 Sweden 19.83 Mb/s
6 Romania 18.69 Mb/s
7 Bulgaria 17.57 Mb/s
8 Netherlands 17.34 Mb/s
9 Andorra 17.06 Mb/s
10 Lithuania 17.04 Mb/s
11 Aland Islands 15.34 Mb/s
12 Portugal 14.71 Mb/s
13 Finland 14.17 Mb/s
14 Iceland 13.61 Mb/s
15 Switzerland 13.52 Mb/s
104 Malaysia 1.94 Mb/s

If you are in AUstralia, a movie can be downloaded in the time you go to ease yourself, take a drink and come back to your computer. here, you need your computer to stay on whole night to download the same .

How to be an innovative and knowledgeable country when we cannot access information as fast as others?

Chicken and Duck talk!

26 May 2010 8 Comments

by Dr Hsu in government, Malaysia, social economic

This is what the Sun says today:

TAN SRI Hasmy Agam, the executive chairman of the Institute of Diplomacy and Foreign Relations (IDFR), has done a great service to Malaysia by exposing the country’s “state secret” – that our government officials especially diplomats are often rendered tongue-tied and speechless when they come face to face with foreigners. They probably break into cold sweat when hailed by their foreign counterparts at an investment or security seminar or even at a cocktail reception or informal dinner. (for the full article , read here)

Malaysians used to play a very important role in international conferences, whether they were at government  or non-government levels. Many Malaysians were chosen to be part of international organisations as Malaysians were known to have  strong command of English.

Not any more. Those who are at the DG levels at their late 50s may still be able to hold their ground when speaking in english, but the lower ranking officers at pengarah level may not be as eloquent anymore. Worse still, the officers at lower levels could hardly string a sentence of english together. That is part of the reasons, I suspect, that many DGs got extension of their services, not because they are outstanding, but rather, there was no one who is dependable to take over their functions.

So the above news should not  come as a big surprise to us. Psychologically, a person who is not confident , like those mentioned in the news, would act in a pompous way to hide their insufficiencies. At the same time, they would try to avoid contact with foreigners because of the lack of confidence. So you get arrogant officers who cannot perform for the government.

Often such officers are sent overseas on trade missions and so on, and I wonder how they could help secure investments if they would cuddle themselves in one corner in international meets and fail to mix around.

In the same news article, it was reported that:

One complaint of Tun Dr Mahathir Mohamad when he was prime minister was that Malaysia failed to be properly informed because officials sent abroad often avoid attending cocktails, informal dinners or other functions where information, not available officially, can sometimes be obtained.

I would say this is what the proverb ” what goes round comes around’ means. It was his policy that saw the end of good English speaking officers, and because of that, officers sent overseas could not serve him effectively as required. He has only himself to blame.

No wonder the book “Malaysian Maverick” was such a hot sell.

………………………………..

Talking about the book,  I received an email from monk conveying this info about Barry Wain’s lecture:

Public Lecture

Malaysian Maverick:

Mahathir Mohamad in Turbulent Times

Speaker: Barry Wain

Discussants: Professor Edmund Terence Gomez,
Professor Wan Zawawi Ibrahim, Dr Ong Kian Ming

Date: 27 May 2010 (Thursday)

Time: 6.00-7.30pm

Venue: Lecture Theatre 3

Faculty of Economics & Administration

University of Malaya

Enquiries: Please call 603-7967-7800

What is there to invest in anymore?

22 May 2010 24 Comments

by Dr Hsu in business, Malaysia

It used to be when friends asked me what shares to buy, I would recommend a few solid blue-chips, like Perlis Plantations (PPB), Public Bank (PBB)and Sime Darby.

I have also told them to buy and keep these shares long term. In fact, I myself have gained quite a lot from the appreciation of these shares over the years. PPB and PBB are both selling  over double digits per share now. Over the years, they have given out  bonus issues as well as attractive dividends and people  who have bought them even 5 to 10 years back would have made a ton of money and those who have bought in the 80s much more.

Financial people used to say that if you want to know about Malaysian economy and its future prospect, just look at the conglomerate Sime Darby Bhd. It has wide ranging businesses, from retails, trading, plantations, industries, constructions, cars, real estates, healthcare, energy  and so on. Those who have bought Sime Darby’s shares before would have made quite a bit too.

Many of the management in Sime rose through the ranks over the years  and they  have inherited the  culture of being careful, conservative and  prudent, since many of the companies in Sime’s  stable like Dunlop Malaysia, Tractors , Guthrie, Golden Hope (formerly Harrison and Crosfield) and so on were formerly run by the British .

The British, despite the colonial power that it was , did many good things to Malaysia. Unfortunately,  many of these we have squandered in the name of nationalism. Of course, there were some not-too-good things left behind too; one of the most glaring being the racial divide that was a direct result of the British system of divide and rule. Despite that, we cannot deny that there were many good things that were left for us.

Among the good things left behind were  good roads and communication , fair and independent judicial system, good  healthcare , and a relatively good education system. Besides the  road system that still remains good, all the other systems have turned from good to mediocre, and from mediocre to bad.

One of the legacies left behind by the departing British was the civil service, which was fair, efficient and most importantly, it operated according to the rules and laws of the land. I would not want to use that to compare with the present civil service, since this is outside the topic I am discussing today, and I leave it to you to assess for yourself.

Another legacy was of course good business practices in many former British companies which had been  taken over by Malaysians since our independence.

For those who have worked in these companies and rose to managerial positions, they have inherited a sense of openness, fairness and most importantly accountability.

But over the years, as the political and economic landscape changes in Malaysia, we can see a slow but definite change in business practice too.

It is no longer how good a person run his  business that determines the success or failure of that company. It is who that person is and whom that person knows that determine the success of his businesses.

Those who have connections and  pull the right strings get all the lucrative projects, and not only that, slowly and surely a culture of cronyism and kickback started. To get business means that you must know the right people, but you must also be prepared to offer ‘commissions’ for these ‘right’ people to get the business you want.

Once the culture of cronyism sets in, the whole philosophy of how to do business in Malaysia changes. It  is no longer about who has the best to offer the country, but rather who has the best to offer the decision makers, both in public or private sectors.

We all know that once a culture has taken roots, it is a mammoth task to change that culture. In this case, the roots are so deep that even a tsunami may not uproot the whole culture of cronyism and ways of doing business.

Not too longer ago, in 2007, we had the Transmile debacle, in which accounting frauds covered up a multi-million loss and turned that loss into multi-million paper gain — to the tune of a whopping overstatement of hundreds of millions. The share price of that company dropped steeply after this was made known  and hundreds of minor shareholders, which could have been you and me, suffered losses because of the fraud.

Sime is no Transmile. It was a profitable company. It used to be very well run and most fund managers and many private investors would invest in it as a form of ‘fixed deposits’;  as a hedge against violent share price movement, since as a blue-chip, even during a bear market, its price would hold relatively well as compared to many other companies.

So the news of cost overrun and loss to the tune of a billion in this company- mind you, BILLION- is a shocking news. How could that have happened?

Dr Mahathir has written in his blog that the company knew about the losses 3 years ago, but why wasn’t the public told of these? As a public company, it has an obligation to reveal all these not only to its shareholders, but the public as well, since everyone of us could be a potential investor in that company.

What went wrong? Was it due to genuine mistakes, the bad business decisions? Was there any misappropriations? Was there any frauds?

These are the questions that need to be answer, and answer quickly,  since as a company that prides  itself as the cream of Malaysian economy,  a loss of confidence in that company by investors, whether local or foreign,  would have far reaching consequences.

If investors cannot even trust a blue chip company like Sime, what is there to invest in anymore?

This article is also posted in my column in  MalaysianInsider

The writing is already on the wall

20 May 2010 13 Comments

by Dr Hsu in Malaysia, politics

A foreign journalist called up and chatted with me about the Sibu by election and its impact. He also asked about whether UMNo would move more to the right and be more extreme in view of the fact that they have lost the Chinese votes, and UMNO leaders may strategise  that they have to be more extreme to win back even more  Malay voters to compensate for the loss of Chinese votes.

I said it would be foolish if they do that since to be more extreme , they would  alienate the CHinese more, and by extension, even Indian voters may be put off.

I said that the prevailing perception is that certain leaders in UMNO have outsourced their extremism to Perkasa, and the more Perkasa and the Old Horse behind make inflammatory racist remarks, the more BN would lose Chinese votes.

I also told him that even if UMNO decides to go more extreme , they have reached the limits of the Malays votes that they can get.

Looking at past elections, even at best of time, UMNO gets only about 60% or slightly more than 60% of Malay votes. Recent racist tones made by certain UMNO leaders have swung back Malay votes from 50 plus percent to slight over more than 60%, as seen in Ulu Selangor by election, and in my opinion, that is about the most they can get, even if they make more extreme remarks

I said that now the only way forward for UMNo is to really reform, to do away with racist tones and treat everyone fair and equal, to tackle the problem of bad governance, to return independence to judiciary, to enforce laws  on all law-breaking citizens irrespective of their background ( and not be seen as practising double standardS), and be more liberal in religious tolerance, i think they can swing back some Non Malays votes.

But is UMNO willing to take such ‘bitter’ steps? As for Gerakan,and MCA, there are no other ways except to push UMNO for taking such changes, and if changes fail to come, they have to leave immediately and not cling to the coat tail hoping for crumbs to fall into their hands.

Otherwise, the writing is on the wall that there is likely to be a change of government come the next election.

On another point, there is no point trying to ‘bribe’ the by election voters by showering development projects on their heads. As citizens of this country and as tax payers, the voters have every right to development and to think that their votes can be swayed by using this tactic is archaic and naive.

This last minute attempt at vote buying is futile to the more educated urban voters, and this tactic in fact alienates even more the people staying in towns and suburban areas.

There is really no other way!

17 May 2010 26 Comments

by Dr Hsu in Malaysia, politics

PR has reversed the trend of the last 2 by elections and won in the Sibu By election.

this is a very important by election because

1. the Sarawak state election is only months away

2. The last tsunami of 308 did not hit East Malaysia, and the sentiments of the Sarawak people after 308 can only be gauged through by election. Never in the history of Malaysia has the votes in East Malaysia  been so pivotal than now, since if more people in in East Malaysia vote in the next election the way the West Malaysians voted in the last GE, BN’s hold on Federal power will be shaky..

The result showed that there was a swing of 3000 over votes , resulting BN losing by 398 ( in the last election, BN won by more than 3000 votes).

Early indications showed that BN got the majority of the indigenous people’s votes while PR most of the CHinese votes.

This reinforces the results of HUlu Selagnor, and it is now clear that BN has lost most of the CHinese support.

Perkasa again attacked the CHinese saying that they are disloyal to BN.

I think that was very wrong to say. It is exactly the types of views as expounded by Perkasa and certain UMno leaders that have alienated most of the CHinese voters, while many others were disappointed with the poor governance and corruptions that is so pervasive in the country.

If BN is serious to gain back the CHinese votes, it has to do really hard soul-searching and not harping on racial and religious issues.

In the next election, the trend is clear. Most Chinese votes will go to the opposition, while UMNO will be trying to win more Malay votes and Indian votes. ANd to win more Malay votes, especially in the rural constituencies, we can expect more Perkasa-like rhetorics and this is dangerous , for this type of rhetoric is threatening to tear the country apart.

What it should do is to try to win back the hearts of the Chinese people by taking harsh actions against these sorts of extremist views which is seditious actually, correct the unequal playing fields, and make meritocracy the main driving force for the nation, and strictly  tackle all law breakers (irrespective of whether he is a top officials or top leaders) , including corruptions  and seditions, according to the provisions in the laws, and stop practicing double standard in treating the people.

There is really no other way.

A tale of 2 nations

14 May 2010 20 Comments

by Dr Hsu in Malaysia, The other side of the world

This is sent to me by not less than 3 persons via emails the past few days. The author has done a great job in listing the reasons for Greece’s predicaments.

Read through it and does it sound very familiar?

Are we going to go the Greek way?

This is it:

Subject: Why and how Greece collasped

I have just watched a documentary regarding Greece’s financial and am appalled ! These are the why’s and how’s that this historic and beautiful country came to grieve.

Bureaucracy: Greece’s bureaucracy is famous in the whole of Europe ! To open a cafe or pub there are 25 processes to go through !! This is a country of rules and regulations.

Bloated civil service: There are 1.05 milliion civil servants (excluding police and armed forces) . The population of Greece is only 10 million !! More than 10% are govt servants !! Salary increases every year and benefit for civil servants in Greece is one of the best in Europe !! More and more money is needed to upkeep this bloated civil servants . The retirement age is 62 yrs old.

Corruption: Greece is the most corrupted nation in the Eurozone. Citizens pay “under table ” money to:

# admit into a public hospital

# pass a driving licence

# to enter public service

# renovate your business premises or your home

# avoid income tax

Every govt project is awarded to political cronies and at hugely inflated prices ! Transparency International compared the prices of the construction costs of stadiums built for the Athens Olympics recently with similar structures in China –500% more expensive than the Chinese , compared to Los Angeles and Sydney — 50 % more expensive !!! All these with tax payers money ! and borrowings !!!

Tax evasion: Officially 80% of its citizens are supposed to pay tax but only 37% are doing so. Big businessmen and corporations have refined tax evasion to a fine art ( or have the tax men taken some coffee money ? )

No transparency in governance: The politicians and bureaucrats falsified economic data and painted a rosy and manageable picture while the economy was rotting away .

Unabated borrowings: Meanwhile, the politicians and bureaucrats continue to issue govt bonds to keep afloat, series after series. They were trying to cover up the financial mess they have created creating one big hole to cover up the previous !!

Lacking political will power to reform: To keep hold on to political power, politicians are prepared to lie, commit economic and political fraud. If reforms were taken some five years ago , the country need not go bankrupt and its citizens need not suffer so much. Political expediency and greed to political power over-rides everything and hence Greece is now a bankrupt country. Luckily, it is part of the European Union and its currency is EUROs, otherwise Greeks will have to eat grass to survive !!

Laid back attitude: Tourism is THE ONLY industry in Greece and over the years the Greeks have had an easy time. Many flocked to see the historical sites. enjoy summer vacation on the islands. But they forgot that not many tourists will return after visiting the sites –there are so many other tourists attractions in the world, maybe more exotic and perhaps cheaper !! So once tourism vanes and couple with higher costs of living –the Greeks could not and refused to adapt and transform –still partying and having a nice time — maybe the Greek Gods will bless them !!! Greece have no natural resources, no electronics industry , no R & D –no anything !! They were so laid back –cannot see what is coming and crashing down on them. Even now, the civil servants refused to take a pay cut — the world owes them a living !!

Poignant Conclusion:

The producer of the documentary had hired a taxi driver to go around while doing this documentary. The taxi driver had studied economics for 4 years in US and this was his parting words:

“My biggest mistake was returning 15 years ago, I should have stayed back in US. My nationalist instinct made me returned. The politicians screwed me. I loved my country but my country did not love me !!!!

Try the whole system too!

12 May 2010 17 Comments

by Dr Hsu in culture, government, Malaysia, social economic

A police corporal was charged for homicide of the 14 year old boy in Shah Alam.

If indeed he has fired the gun that killed the boy, he needs to answer to it, since this is how accountability works.

However, if he has done what was taught (or not taught) to him during his training as a policeman, especially as to when to discharge his gun, then he should not be made to shouldered the responsibility alone.

The whole system and the whole training program should be on trial too.

If there is a standard procedure for firing a gun, and then this was not taught to the ‘mata-mata’, then someone must be held responsible for the negligence.

Someone must be held responsible for the inadequate training of the force.

On the other hand, if the training was adequate, and yet this policeman still fires his gun, then the one who is in charge of discipline must be held responsible.

When taken into consideration the case in Negeri Sembilan when a Mat rempit was shot, perhaps a culture of arrogance has formed within the force. And this is dangerous.

An enforcement agency , or for that matter any armed units,which is arrogant will not have discipline, and when an enforcement unit does not have discipline, it will be disastrous.

So I think we should not put too much of the blame  on the corporal.  He has to face the music, that is correct. However, the whole system perhaps should be reviewed.

What is glaringly evident is that we need to have better monitoring and acoountability in the system. And nothing can be better than to have a commission (IPCMC) to monitor the police force, and by doing so, it may be the only way to bring back the glory as well as the respectability to the force.

(This post is also posted as a letter in Malaysiakini).

Let them compete fair and square !

11 May 2010 9 Comments

by Dr Hsu in Malaysia, social economic

One of the wealthiest men in the world is Warren Buffet. He did not make his money by digging oil well; he did not make his money by loan sharking; he did not make his money by dealing with drugs or through other illicit manners. He made his big pile of money by investing– by using his brain.

It is often said that if you want to be a successful investor, you have to follow your brain and not your heart. In other words, you have to be rational and not emotional. I think Warren Buffet did that- a feat easier said than done.

What differentiates him from other rich is that he donates most of his money to charity. He did not stay in a 24 million house in Shah Alam; rather, despite his riches, he has always stayed in the simple house in Omaha , Nebraka since his youth.

This is what is written in Wikipedia about his plan to donate most of his fortune away:

His children will not inherit a significant proportion of his wealth. These actions are consistent with statements he has made in the past indicating his opposition to the transfer of great fortunes from one generation to the next.[94] Buffett once commented, “I want to give my kids just enough so that they would feel that they could do anything, but not so much that they would feel like doing nothing”.[95]

In June 2006, he announced a plan to give away his fortune to charity, with 83% of it going to the Bill & Melinda Gates Foundation.[96] He pledged about the equivalent of 10 million Berkshire Hathaway Class B shares to the Bill & Melinda Gates Foundation (worth approximately US$30.7 billion as of 23 June 2006), making it the largest charitable donation in history, and Buffett one of the leaders in thephilanthrocapitalism revolution. The foundation will receive 5% of the total donation on an annualised basis each July, beginning in 2006. Buffett also will join the board of directors of the Gates Foundation, although he does not plan to be actively involved in the foundation’s investments

He is one who did not believe in giving lots and lots of fish to his children but rather he believes in giving fish to all those who have no fish to eat, while at the same time, he is satisfied with teaching his children how to fish.

There is an article today in Yahoo about one of his sons, Peter, thanking his father for making him a happy person rather than a spoilt brag (read here). Peter also mentioned that his father had said that those who are born with the silver spoons in their mouth can become victims of  ‘having silver daggers in their back”.

What this means is that we should allow our children to go through tough competition and hardship even if we have the means to give them a very comfortable life. We should allow them to compete fairly and squarely with other kids. We should not spoil them by making their lives too easy.

The same thing must be said of society. Everyone , regardless of colour or creed, must be given a fair and square chance to compete against each other in order to toughen them up and in order to make them useful persons rather than those who depends on handouts.

By not giving his fortune to his children and making his children realise the importance of building their own careers, Warren Buffet shows the greatest love a parent can have for his children.

Pay increase to achieve High income status?

10 May 2010 22 Comments

by Dr Hsu in economy, government, Malaysia

The Star carried a news report today that a Deputy minister said this:

A pay increase for over one million civil servants is one of the key ingredients in ensuring the success of the New Economic Model (NEM)….

He said this was to ensure that the NEM’s objective of transforming the country from a middle-income economy to that of a high-income would improve the public sector’s productivity, thus ensuring successful development.

“Singapore shifted to a high-income economy several years ago by setting high pay for civil servants, which has succeeded in improving its economic performance.

“So civil servants in this country cannot be ignored,” he said

I thought that was a very simplistic view of how to transform Malaysia from a middle income country to a high income country.

Increasing the pay of the civil servants without increasing the productivity and ensuring that there is a matching growth of the economy will only make the country incur more debts.

Say if there is an  increase of pay without increase in economic activity and growth, the operating budget of the government will increase , and this increase will either come at the expense of the smaller development budget or making the budget deficits bigger. If the budget deficits is bigger, then we need to borrow more to fund the deficits, and ultimately the country will be in a bad financial state. If the development budget is smaller, then we cannot fund projects to stimulate our economic expansion.

It is like a company suddenly raising the staff’s salary across the board without any increase in its revenue and profits. So whatever increase will be from either its reserve or borrowing. This will ultimately affect the balance sheets and the shareholders will suffer .

If the solution is so simple, then even Nigeria, Myanmar would be HIgh Income countries by just increasing the pay of its civils service and forcing its private sectors to increase pay for all Nigerians or Burmese.

We need to increase our economic activities and growth so that we enlarge our tax revenues, making the nation and the government richer in order to pay our workers higher salaries and thus move up the Economic ladder. There is no shortcut to this!

Singapore is a total different case altogether. They pay higher salary to their civil servants because they have the best in their civil service, and their economy was growing much faster at that time when they raised the civil service’s pay. The pay increase matched the productivity increase.

This cannot be said of our civil service where not everything , from recruitment to promotion, depends on meritocracy. In Malaysia, we still have the crutch syndrome and this is a direct opposite of meritocracy. Without meritocracy, ow are you going to attract the best brains into civil service? If the best brains are not in civil service , then how are you going to compete with private sector, no matter how high you raise your salary?

The whole idea ( to increase pay to make the country a high income country)is naive and does not make much sense to me. A high income country depends on innovation and knowledge, and i think we have not done very well in both these areas.

Another shooting of teen

08 May 2010 11 Comments

by Dr Hsu in Malaysia, social economic

This is the latest from Malaysiakini:

Yet another teenager has been shot at by the police but this time in a rare show of humility and compassion Negeri Sembilan’s top cop apologised for the action of the officerconcerned.

SAC1 Datuk Osman Salleh in doing so described the action as “unjustifiable considering the boy never posed any danger to the officer”.

He also said that the police officer responsible has since been suspended from his duties.

Imat rempitn the 3.30am incident at Seremban today, some policemen spotted about 20 Mat Rempit hanging around Kampung Ujong Pasir.

On spotting the police car, they scrambled away on their motorcycles, triggering a chase.

According to The Star online, some of the youths were taunting the policemen by swerving left and right in front of the pursuing police car.

One of the policemen then opened fire, hitting a 17-year-old boy in the hip.

However, Osman at a press conference this afternoon, stressed that those were meant to be warning shots.

He added that the boy is now in stable condition at the Tuanku Jaafar Hospital.

WHy must the police shoot in this case? It is obvious that they do not pose a threat to the police.

There must be a independent bogy overseeing the police force, and IPCMC which was recommneded by the Royal Commission on the enhancement of Police Force must be set up without delay.

The issue of the ‘machete’

06 May 2010 23 Comments

by Dr Hsu in Malaysia, social economic

In the case of the police shooting of the minor, most people are upset because they think the police are too trigger happy.

While this might be true, I think there are other issues involved here too. An  important point is to determine whether there was any ‘parang’ in the car when the child was shot dead. If there is no parang when the 2 kids drove the car to the mamak stall, and later , after the shooting , there was one found in the car, someone must have planted the parang. If this is the case, then there is an attempt to cover up.

In the States, a president was impeached in the 70s because of his attempt to cover up, or rather his failure to stop the cover-up,  a break-in– The watergate.

If there is an attempt to cover up, then a very grave wrong would  have been done on purpose. If this is so, there must be a full investigation to find out how high the cover up has gone..If any highers-up are involved, they must face the law too.

So it is very important for  the investigators to find out where the parang is from. It si also important to have independent investigators.

Looking at the face of the kids, I really doubt that they were ‘robbers’ or criminals, even though they had done a wrong in driving a car without a license

recommended reading:

What has Malaysian society become?

A doctor too many IV

06 May 2010 19 Comments

by Dr Hsu in Health, Malaysia, social economic

At the end of 2008, Malaysia has about 23000 doctors, almost half in private sector.

Our Ministry is trying to achieve a ratio of 1:400 as existed in most OECD countries.

In the haste to achieve this number game, they have forgone quality.

It does not mean the more the better. Look at some of the communist countries like Bulgaria. They have a ratio of 1:200 doctor:population ratio. That does not mean that they have a better healthcare than Britain which has a ratio of 1:450. Another example is Kazakhstan which has a ration of 1:280 , as compared to Australia which has a ratio of 1:400.  Does that means that Kazakhstan has better healthcare than Australia?

Our officials stress too much on achieving numbers. They stress too much on ‘form’ rather than substance.

If we have well trained doctor which are productive, a ratio of 1:1100, will mean that we are on par with those 1;400 countries with doctors which have low productivity.

Alas, we built 5 star hospitals with lobby bigger than Shangri La, but you dont need 5 star bed to treat diseases. You need clinical acumen , experience, and doctors who communicate with their patients.

As for the question asked by MKO in the last post (A doctor too many 3), it is still ok to get treatment from govt hospital NOW. In 5 to 10 years time, I am not sure. Unless they buck up, and set up a body to oversee the standard of doctors produced, I will not want to get treatment there in 10 years time.

I must stress that I am never against producing doctors. I am not in favour of producing too many INADEQUATELY TRAINED doctors. That would be like producing too many gun-carrying policemen without training them as to when to shoot and when not to shoot.

At the rate we are producing doctors, 4000 a year, we will soon be down to 1:100 ratio.

Let us assume that we have a population of 27 million. Let us assume that the population growth is 3%. So every year, we have an additional 800000 people. Divide 800000 by 400, you get 2000. That means once we achieve a ratio of 1:400, we need only to produce 2000 doctors a year to maintain the ratio found in most advanced country. But we will be producing 4000 local plus 1000 from overseas (India, Indonesia etc..many will be staying put in the place they study like my children). So there will be excess 3000 doctors a year… This will quickly bring our ratio down to perhaps 1:100, and you will find some of the hawkers and taxi drivers with MBBS degree hanging in their stalls or taxis.

Not joking…

And looking at the history of medicine at advanced countries, when their doctor:population ratio decreased, the charges went up, and so was the cost of medical treatment , even when taken into consideration of inflation. This is because those who are competent, will charge higher and do more investigations, to make up for the decrease in number of patients each doctor is seeing.

There will come a stage when we have too many doctors, too many lawyers(already happening since some junior lawyers have to pay the senior lawyers to do their chambering), too many nurses, too many hawkers, too many cars, too many motorcycles, too many politicians, too many parties, too many police, too many criminals and too many crooks….. I dread to think of such a day!

As for the suggestion by Stevent in the last post, yes, we can send them overseas to work and gain experience, but which country would take them in if their standard is low? I am sure there is a cutting point where even Singapore would not want to take them in, as is the case now.

So you can still send them, to tag with experience doctors. That would like starting their medical training again and you need to pay overseas doctors money to do that sort of things, and there is really no guarantee these people will come back, once they are competent enough to be able to find a working job overseas.

The whole system is rotten, and all the planners can think of is short term and they are all very short sighted… Ultimately they will  suffer too if there is a drop in medical standard. Because health hits everyone equally, it does not mean that if you are wealthy and powerful, you would not get cancer or immune disorders.. Ultimately, like facing the creator, everyone will have to face health problems, and they will then realise that what a monster they have created in their haste to achieve certain figures… Because a healthcare system without good doctors will be like a monster released ..

A doctor too many III

04 May 2010 20 Comments

by Dr Hsu in government, Health, Malaysia

This is the number of house officers as of end of April 2010 in HKL , the biggest hospital in our country:

Unit Number of housemen in the unit
Orthopaedic Department 52
O & G Unit 50
Medical Department 72
Surgical Department 57
Paediatric Department 62

Just as an illustration, the orthopedic unit mentioned in the table above has 182 beds. With 52 house officers, it amounts to 1 houseman to slightly more than 3 patients.. A ratio you would not be able to find anywhere else in the world, believe me! Not even in the most advanced country!

Gone were the days when we had only 2 or 3 house officers in a unit. I remember during my time, when I was doing housemanship in Penang GH, I was for 2 weeks the only houseman in the orthopedic unit. Now I heard they too had 60 housemen in the unit (Jan 2010 figure).

Just imagine, if you have 60 house officers following a consultant doing the ward round, how are those at the back going to learn? I do not think there are even enough standing room for all of them. How are they going to examine a textbook case ( a case with classical signs and symptoms), since to do so would have subjected the patient to examinations 60 times– if the patient does not die from his illness, he might die from too much handling from these housemen!!!

The figures I quoted are real figures. I am sure those of you reading now would agree with me that there are now simply too many doctors being produced, and since there are not enough hospitals to place them in, there is no choice but to place them in the same units…

No wonder i received emails after my last posts saying that many house officrs are seen spending most of their time in the canteens, since they just have nowhere to go…

And in no time, these same people will be treating you and me, including the politicians. Perhaps I should warn them here that Healthcare is different from education. In education, if our schools are no good, they can still send their children overseas to study. But when these politicians get a stroke or heart attack, it would be too late for them to fly out to even Singapore to seek treatment. They would be treated by the same local doctors that they help in mass production.

Our healthcare standard is going to deteriorate with this sort of training of our doctors..Just like almost everything else.

I am now in the process of writing a memorandum to be submitted to the Ministry on this problem and I hope my writings can bring some sense to this madness of  indiscriminate issuing of licenses to set up medical schools.

related articles:

A doctor too many II** (This article also published in Malaysian Insider and many blogsites). Someone has  translated this into Chinese and the Version is posted here.

A doctor too many I

Press freedom Day

03 May 2010 7 Comments

by Dr Hsu in Uncategorized

Today is World Press Freedom Day.

Press freedom is one of the most important requisites of a true democracy.

Without a free press, government tends to be suppressive and democracy is often hijacked to suit individual interest.

It is interesting to note that the more oil( petroleum) a country possesses, the worse is the record of press freedom.

Prehaps it is the curse of Oil as I have written before?

Design a site like this with WordPress.com
Get started