SMA’s response to ST articles

Dear Sir


There has recently been debate in the ST about the benefits of separating prescription by doctors, from dispensing of medicine from their clinics. Doctors in Singapore have heard two differing accounts of the intention of MOH on this matter - one reported in the ST and another from circulated MOH minutes of the meeting - and most have no doubt as to which of these is accurate. We had hoped that there would be no need to speak further on this matter publicly, especially as the Director of Medical Services, Prof. Satku, had written to the ST Forum (published on 7 Jan) to say that: "The [1 Jan, ST] article did not communicate my vision accurately and in the right context. During the interview, I had stated that the separation of drug prescribing and dispensing will not happen soon in Singapore."

However, the Sunday Times published a one -page article on the topic only two days later (Docs not swallowing bitter pill, ST Jan 9). This included generalizations and comments that SMA members, and indeed some of our patients, have found offensive. Therefore, for the sake of clarity, the Singapore Medical Association wishes to state the following:

The opening paragraphs of the article speak of local patients not getting better until at least the second visit to the doctor and then goes on to quote a study carried out in Zimbabwe that found that "dispensing doctors were 2.5 times more likely to prescribe sub -curative dosages of medicine that was not strong enough to treat the problem." Because the first paragraphs were written to the reader ("You see a see him get better") we can only conclude that your Health Correspondent is alleging that readers with similar experiences in Singapore have also suffered from sub -curative dosages prescribed by doctors, deliberately and for profit. This is a very serious allegation of misconduct against a profession. May we request your correspondent to provide us, or the statutory authority, adequate details for further verification. Doing so will prevent a misunderstanding that this allegation about widespread professional misconduct in Singapore has a factual basis.

The article also states that the idea of separating prescription from dispensing is unlikely to happen, because "the strong doctor lobby here looks set to kill the move even before the idea can be fleshed out". The SMA would like to state categorically that we have not lobbied the MOH on this matter. We have also verified yesterday that the MOH has not been lobbied by any other group of doctors on this issue. On the contrary, all patients in Singapore have always been able to ask their doctor for a prescription that allows them to get their medicine from an independent pharmacy - the precise thing that your Health Correspondent is asking for. They have always been able to, and many of our patients actually do. On both those counts, therefore, we believe your Health Correspondent is factually wrong.

Finally, your Health Correspondent concludes that "it would be a pity if the ministry knuckles under the demands from self-serving doctors and drops the idea altogether". By "self-serving doctors" we can only assume that she is referring to the "strong doctor lobby here", which she has earlier characterized as "3000 doctors in private practice". As stated above, the SMA has neither lobbied nor presented demands to the Ministry on this matter, nor is it or MOH aware of any other group of doctors who has done so. Because there is no basis for the adjective she has chosen, we hope your readers will understand why the SMA finds that her tarring all doctors with the same brush as "self-serving" is extremely offensive.

Yours sincerely

Singapore Medical Association

Cc: Mr Cheong Yip Seng
Editor -in -Chief English & Malay Newspaper Division
Singapore Press Holdings
News Centre, 1000 Toa Payoh North, Singapore 318994
Email: cheong yip
Fax: 67320131

Cc: Dr Christopher Chia
Chief Executive Officer
Media Development Authority
140 Hill Street 04-01 MICA Building Singapore 179369