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Docs dispensing drugs: System not without its benefits, says Khaw Print E-mail

The Straits Times Sep 21, 2007

HEALTH Minister Khaw Boon Wan is in favour of keeping the current system where doctors are also allowed to dispense medicines.
But he told MPs yesterday that he would work to enhance the system.

'The key is to give our patients the choice to fill the prescriptions wherever they wish, be it at the doctor's clinic, in a private pharmacy, or even across the Causeway,' he said during yesterday's debate on the Pharmacists Registration Bill.

Madam Halimah Yacob (Jurong GRC), who heads the Government Parliamentary Committee for Health, raised the idea of separating prescribing and dispensing of medicines - as is done in some countries.

She said such a system would have pharmacists acting as a check on doctors' prescriptions, which would improve patient safety.

And patient safety, she argued, was a 'greater overriding consideration' than the convenience of being able to consult a doctor and fill a prescription at one place.

Doctors in private practice here prescribe and dispense medication; in public hospitals and polyclinics, doctors usually prescribe the drugs, while pharmacists in the same institution dispense it.

But Mr Khaw was not in favour of leaving all dispensing of medicines only to pharmacists.

Saying that the current system was 'not without its benefits', he pointed to convenience and cost savings for patients who pick up their medicine at the same place they see the doctor.

However, he suggested that, as a start, doctors in private practice should follow the lead of public-sector clinics and hospitals and provide all patients with a clearly written or printed prescription as a matter of course. They should then leave it to the patient to pick up the medicine anywhere he wants to.

If they choose to do so at the doctor's clinic, the cost of the medication should be itemised on the bill, separate from the consultation fee.

With the passing of the Pharmacists Registration Bill yesterday, higher standards will now be demanded of the 1,468 pharmacists here.

Like doctors, they will have to clock 50 hours of continuing professional education to renew their practising certificates every two years.

And with a register to be set up to list pharmacists with training in areas such as cancer, more will be spurred to pursue further training.

Another change with the passing of the Bill: The Singapore Pharmacy Board, a department within the Health Ministry, will become a new statutory board.

The new Singapore Pharmacy Council will have more power to discipline errant pharmacists. It can, for example, suspend such pharmacists from practice even before investigations are completed.

Two new categories of registration - temporary and conditional - will enable more foreign pharmacists to work here.

Mr Khaw noted that despite the National University of Singapore tripling its intake of pharmacy students from 41 to 115 over the last 10 years, Singapore needs still more such professionals - 200 more a year for the next decade.

Madam Halimah, Dr Lam Pin Min (Ang Mo Kio GRC), Dr Fatimah Lateef (Marine Parade GRC) and Mr Seah Kian Peng (Marine Parade GRC) spoke in support of the changes yesterday, saying that they would improve the standards of what Madam Halimah called 'a neglected lot'.

But Dr Lam cautioned against taking in foreign pharmacists who were not up to par just to ease the shortage, while Mr Seah hoped that foreign pharmacists would be allowed to work in private retail pharmacies.

Article by Lee Hui Chieh

Comments (1)add comment
Web Admin: St forum response to Health Minister Khaw
Oct 1, 2007

Private clinics should give details of charges

I REFER to the report, 'Docs dispensing drugs: System not without its benefits, says Khaw' (ST, Sept 21).

I fully agree with Health Minister Khaw Boon Wan's view that the current system of allowing private doctors to prescribe and dispense drugs has its benefits. Doctors know what medicine they carry and are flexible to prescribe alternative medicine in the event they do not have a particular drug.

This arrangement allows patients to enjoy the convenience of a one-stop service. Otherwise, patients who are sick may have to make a separate trip to a pharmacy to buy the prescribed medicine. In the event that the pharmacy does not carry the medicine or runs out of it, the patient may have to make a reservation and collect it on another day.

Alternatively, he will have to go to another pharmacy.

Moreover, patients who consult doctors at night can buy their medicine from a pharmacy only the next day.

In addition, with the profit from dispensing drugs, doctors can lower their consultation fees. Otherwise, they will have to charge a higher consultation fee to cover their operating cost. This will result in a higher total cost to the patient.

However, currently, the costs of consultation, tests and medication are not transparent in private clinics. Patients are told verbally the total charges payable and so are at the mercy of the clinics and have no way to compare prices or detect any error of overcharging.

The Singapore Medical Council no longer provides guidelines on consultation fees. Doctors are free to charge their own consultation fees and are not obliged to tell their patients.

Therefore, it is timely that private clinics should provide a bill itemising the cost of consultation, tests and medication to their patients, as suggested by Mr Khaw.

With the IT available, doctors should be able to comply with this new requirement.


Goh Kian Huat

1

October 04, 2007

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