MALAY SIAN MEDICAL ASSOCIATION &

SOCIETY OF PRIVATE MEDICAL PRACTITIONERS SARAWAK

21st December 2008

2.00 pm – 6.00 pm

MMA Life membership Promotion MMA Life membership Promotion ends 31ends 31stst Dec 2008 Dec 2008

Society of Private Medical Practitioners SarawakSociety of Private Medical Practitioners SarawakAcknowledgements Acknowledgements

Dr Mohd KamilDr Mohd KamilDr AsmahDr Asmah

Dr ManalanDr ManalanSN Lee Geok NioSN Lee Geok Nio

Ms ChaiMs ChaiEastern OxygenEastern OxygenBorneo CyntexBorneo Cyntex

3A3ADorothy Tan, Amanda LiewDorothy Tan, Amanda Liew

Committee MembersCommittee Members

MMA(Sarawak) SPMPSMMA(Sarawak) SPMPSPost Registration Inspection and Dispensing Post Registration Inspection and Dispensing

WorkshopWorkshopProgrammeProgramme 2.00 pm - Welcome by Organising Chairman, Dr Tan Lean Sim2.00 pm - Welcome by Organising Chairman, Dr Tan Lean Sim 2.10 pm - Introduction by SPMPS President, Dr John Chew2.10 pm - Introduction by SPMPS President, Dr John Chew - Short Address by Sarawak State Health Director, - Short Address by Sarawak State Health Director, Dr Mohd Kamil HassanDr Mohd Kamil Hassan 2.30 pm - Post Registration Inspection Check List2.30 pm - Post Registration Inspection Check List By Dr Asmah Nazahiyah Bte SaidBy Dr Asmah Nazahiyah Bte Said Asst Director, (Medical), Private Medical Practice Control UnitAsst Director, (Medical), Private Medical Practice Control Unit 3.00 pm - Meeting The Requirements of the Post-Registration Check-List3.00 pm - Meeting The Requirements of the Post-Registration Check-List By Dr S R Manalan, National Chairman, MMA PPSBy Dr S R Manalan, National Chairman, MMA PPS 3.20 pm - Q & A3.20 pm - Q & A 3.30 pm - Refreshment3.30 pm - Refreshment 4.00 pm - Cold Chain Maintenance4.00 pm - Cold Chain Maintenance By Ms Lee Geok Noi, Staff Nurse, Private Medical Practice Control By Ms Lee Geok Noi, Staff Nurse, Private Medical Practice Control

UnitUnit 4.10 pm - Dispensing Medicine4.10 pm - Dispensing Medicine By Ms Chai, Enforcement Officer, Pharmacy Department, SGHBy Ms Chai, Enforcement Officer, Pharmacy Department, SGH 4.25 pm - Sharing by Dr Lim Meng Lang and Dr Kiu Chiong Chin4.25 pm - Sharing by Dr Lim Meng Lang and Dr Kiu Chiong Chin 4.45 pm - Rights, Responsibilities & Reasons To Be 4.45 pm - Rights, Responsibilities & Reasons To Be A Private Medical PractitionerA Private Medical Practitioner by Dr Mohd Hirman Ritom, Commissioner Human Rights of by Dr Mohd Hirman Ritom, Commissioner Human Rights of

Malaysia Malaysia 5.00 pm - Discussion & Conclusion5.00 pm - Discussion & Conclusion Briefing by Encik Faizal, Eastern OxygenBriefing by Encik Faizal, Eastern Oxygen

MMA(Sarawak) SPMPSMMA(Sarawak) SPMPSPost Registration Inspection and Dispensing Post Registration Inspection and Dispensing

WorkshopWorkshop

4.00 pm - Cold Chain Maintenance4.00 pm - Cold Chain Maintenance By Ms Lee Geok Noi, Staff Nurse, By Ms Lee Geok Noi, Staff Nurse, Private Medical Practice Control UnitPrivate Medical Practice Control Unit 4.10 pm - Dispensing Medicine4.10 pm - Dispensing Medicine By Ms Chai, Enforcement Officer, By Ms Chai, Enforcement Officer, Pharmacy Department, SGHPharmacy Department, SGH 4.25 pm - Sharing by Dr Lim Meng Lang and Dr Kiu 4.25 pm - Sharing by Dr Lim Meng Lang and Dr Kiu

Chiong ChinChiong Chin 4.45 pm - Rights, Responsibilities & Reasons To Be 4.45 pm - Rights, Responsibilities & Reasons To Be A Private Medical PractitionerA Private Medical Practitioner by Dr Mohd Hirman Ritom,by Dr Mohd Hirman Ritom, Commissioner Human Rights of Commissioner Human Rights of

Malaysia Malaysia 5.00 pm - Discussion & Conclusion5.00 pm - Discussion & Conclusion

WorkshopWorkshopWhat we hope to achieve?What we hope to achieve?

1.1. Support network for the single Support network for the single practitioner. practitioner.

2.2. Building Bridges between the Building Bridges between the Government Department and the Government Department and the DoctorsDoctors

3.3. Bulk purchase of equipment and Bulk purchase of equipment and drugs.drugs.

4.4. Sharing Expertise and ResourcesSharing Expertise and Resources

Private Doctors

Government DepartmentMOH Regulators

PHFS Act 1998 PHFS Act 1998 and Regulations and Regulations

20062006APPLICATION FEE RM500APPLICATION FEE RM500

APPROVAL FEE RM1000APPROVAL FEE RM1000

HOUSESBANKSCARSJOBS

HOUSESBANKSCARSJOBSPOLITICIANS

HOUSESBANKSCARSJOBSPOLITICIANS

Western Digital to cease Western Digital to cease operations in Sarawak, 1,500 to operations in Sarawak, 1,500 to be laid-offbe laid-off

By JACK WONGBy JACK WONG

Published: Saturday December 20, Published: Saturday December 20, 2008 MYT 3:06:00 PM2008 MYT 3:06:00 PM

ASIAN TSUNAMI 26th ASIAN TSUNAMI 26th DEC 2004 DEC 2004

"Great minds discuss ideas; Average "Great minds discuss ideas; Average minds discuss events; Small minds minds discuss events; Small minds discuss people" discuss people"

Eleanor Roosevelt - US diplomat & Eleanor Roosevelt - US diplomat & reformer (1884 - 1962) reformer (1884 - 1962)

CHANGE WE CAN CHANGE WE CAN BELIEVE INBELIEVE IN

TWO WARSTWO WARS

PLANET IN PERILPLANET IN PERIL

FINANCIAL FINANCIAL DISASTERDISASTER

PHFS Act and RegulationsPHFS Act and Regulationsto improve the delivery of to improve the delivery of

healthcarehealthcareDr Basmullah’s conviction RM Dr Basmullah’s conviction RM

120,000 fine; three months jail in 120,000 fine; three months jail in default default

Released March 2008Released March 2008

Dr Rahdakrishan’s RM15,000 fine Dr Rahdakrishan’s RM15,000 fine 10/09/2008 10/09/2008

MMA Workshop on PHFS MMA Workshop on PHFS Act and Regulations Act and Regulations

20th April 200820th April 20089.00 am Current Challenges for the Private Practitioners 9.00 am Current Challenges for the Private Practitioners

SectorSector

Dr S R Manalan, ChairmanDr S R Manalan, Chairman, PPSMMA, PPSMMA

9.30 am Challenges in the Enforcement of the PHFSA9.30 am Challenges in the Enforcement of the PHFSA

Dr Mohd Khairi Bin YakubDr Mohd Khairi Bin Yakub, Director of Medical , Director of Medical Practice Division, MOHPractice Division, MOH

11.00 am Private Health Care in a Developed Malaysia 202011.00 am Private Health Care in a Developed Malaysia 2020

Ybhg Tan Sri Datuk Dr Hj Mohd Ismail MericanYbhg Tan Sri Datuk Dr Hj Mohd Ismail Merican, , Director General of Health, MOHDirector General of Health, MOH

Malaysian Medical Malaysian Medical ResourcesResources- youtube, facebook- youtube, facebook

www.medicine.com.mywww.fpmpam.org

www.mma.org.mywww.mma.org.my

Post Registration Post Registration InspectionInspection

DR ONG HEIN TEIK PenangDR ONG HEIN TEIK Penang “ “Made to feel like a criminal" -- Made to feel like a criminal" --

NST, Sept 17 NST, Sept 17 An official reply:An official reply:NST Online » Letters (2008/09/24)NST Online » Letters (2008/09/24)

HEALTH MINISTRY INSPECTION: Thanks HEALTH MINISTRY INSPECTION: Thanks for the feedback for the feedback By : By : DR NOORAINI BABADR NOORAINI BABA, Director Medical , Director Medical Practice Division , Ministry of Health Practice Division , Ministry of Health MalaysiaMalaysia. .

HEALTH MINISTRY INSPECTION: Thanks for HEALTH MINISTRY INSPECTION: Thanks for the feedback the feedback

By : By : DR NOORAINI BABADR NOORAINI BABA, Director Medical , Director Medical Practice Division , Ministry of Health MalaysiaPractice Division , Ministry of Health Malaysia

1.1. checks on physical structures, basic checks on physical structures, basic emergency equipmentemergency equipment

2.2. inspection of documents on the inspection of documents on the organizational set-up policies, procedures organizational set-up policies, procedures and registers of private clinics.and registers of private clinics.

3.3. These inspections are designed to educate These inspections are designed to educate and to promote compliance by private and to promote compliance by private registered medical practitioners to ensure registered medical practitioners to ensure patients' safety and quality healthcare, patients' safety and quality healthcare, and is and is not meant to be punitivenot meant to be punitive. .

DR NOORAINI BABA, Director Medical DR NOORAINI BABA, Director Medical Practice Division , Ministry of Health Practice Division , Ministry of Health

Malaysia (2)Malaysia (2)4. This practice is consistent with the 4. This practice is consistent with the

requirements of the requirements of the Poison (Psychotropic Poison (Psychotropic Substance) Regulations 1989Substance) Regulations 1989 that psychotropic that psychotropic drugs must be supplied by a registered medical drugs must be supplied by a registered medical practitioner for medical treatment.practitioner for medical treatment.

5. Under 5. Under Paragraph 88(2)(e) of the ActParagraph 88(2)(e) of the Act, an , an inspector is also allowed to inspect and take inspector is also allowed to inspect and take extracts from any book, document or record extracts from any book, document or record relating to any private clinic which the relating to any private clinic which the inspector considers necessary to assist him or inspector considers necessary to assist him or her in the checks. her in the checks. (Including fees charged)(Including fees charged)

6. His (Dr Ong’s) feedback will serve to improve 6. His (Dr Ong’s) feedback will serve to improve the manner we conduct our post-registration the manner we conduct our post-registration checks in the future. checks in the future.

GUIDELINES ON GUIDELINES ON

EMERGENCY MEDICAL SERVICES EMERGENCY MEDICAL SERVICES

FOR FOR

PRIVATE HOSPITALS AND CLINICSPRIVATE HOSPITALS AND CLINICS

Emergency Care in Emergency Care in ClinicsClinics

Rare eventsRare events Maintenance of SkillsMaintenance of Skills Short expiratory of drugsShort expiratory of drugs Expensive equipmentsExpensive equipments Chains of SurvivalChains of Survival

3.1 Level / Category 1 of the Service 3.1 Level / Category 1 of the Service ( Single practice General Practitioner(GP), Primary care etc)( Single practice General Practitioner(GP), Primary care etc)

3.2 Level / Category 2 of the Service 3.2 Level / Category 2 of the Service ( Group Family Medicine Practice/ GP with or without( Group Family Medicine Practice/ GP with or withoutFamily Medicine Specialist or equivalent)Family Medicine Specialist or equivalent)

3.3 Level / Category 3 of the service 3.3 Level / Category 3 of the service ( Ambulatory Care Centre, Nursing Homes, Old Folks Home etc)( Ambulatory Care Centre, Nursing Homes, Old Folks Home etc)

3.4 Level / Category 4 of the service 3.4 Level / Category 4 of the service ( Private Hospitals with Basic, Single Discipline, Specialist Practice)( Private Hospitals with Basic, Single Discipline, Specialist Practice)

3.5 Level / Category 5 of the service 3.5 Level / Category 5 of the service ( Private Hospitals with multidisciplinary Specialist Practise ( Private Hospitals with multidisciplinary Specialist Practise with or without Subspecialty Unit or Department. with or without Subspecialty Unit or Department.

REQUIREMENT / REQUIREMENT / GUIDELINES FOR THE GUIDELINES FOR THE

LEVEL 1 SERVICELEVEL 1 SERVICE1)1) Structure :Structure :

Resuscitation and treatment roomResuscitation and treatment room i) Patient trolley/ Bed with privacy i) Patient trolley/ Bed with privacy

( curtain)( curtain)ii) Adequate lightingii) Adequate lightingiii) Adequate space approximately 28 x iii) Adequate space approximately 28 x

10 ft / 853 x 305 cm per room10 ft / 853 x 305 cm per room

The GP examination room with privacy The GP examination room with privacy is acceptableis acceptable

2)2) Equipment and Equipment and consumablesconsumables

Airway managementAirway management 1) Oropharyngeal airway (various sizes)1) Oropharyngeal airway (various sizes)

2) Bag-Valve and Mask2) Bag-Valve and Mask3) ETT Tube 3) ETT Tube Breathing and Ventilatory SupportBreathing and Ventilatory Support

1)Oxygen Supply or Oxygen Tank with 1)Oxygen Supply or Oxygen Tank with oxygen regulatoroxygen regulator2) High Flow Mask2) High Flow Mask3) Nebuliser mask3) Nebuliser mask4) Suction Outlet or Portable Suction 4) Suction Outlet or Portable Suction MachineMachine

2)2) Equipment and Equipment and consumables consumables

Circulation and Haemorrhage ControlCirculation and Haemorrhage Control 1) Automated External Defibrillator (AED)1) Automated External Defibrillator (AED)

2) Intravenous cannulae2) Intravenous cannulae3) Intravenous fluid for resuscitation3) Intravenous fluid for resuscitation4) Haemorrhage control bandages4) Haemorrhage control bandages

Skeletal ImmobilisationSkeletal Immobilisation 1) Cervical collar 1) Cervical collar 2) Universal Skeletal Immobilization Kit2) Universal Skeletal Immobilization Kit Eg: upper limb , lower limb, bandagesEg: upper limb , lower limb, bandages

Emergency medicationsEmergency medications( Medication for resuscitation procedure )( Medication for resuscitation procedure )

1) Adrenaline1) Adrenaline2) Atropine 2) Atropine

From: From: Mohd Anis Bin Haron (Dr)Mohd Anis Bin Haron (Dr) < <mohdanis@moh.gov.my>>Date: Thu, Dec 18, 2008 at 5:04 PMDate: Thu, Dec 18, 2008 at 5:04 PMSubject: PHFS Act 1998 and Regulations 2006 - Reply from Dr. Asmah.Subject: PHFS Act 1998 and Regulations 2006 - Reply from Dr. Asmah.To: "Sr. Mary Cardosa" <To: "Sr. Mary Cardosa" <mary.cardosa@gmail.com>>Cc: "Dr. Ahmad Razid Salleh" <Cc: "Dr. Ahmad Razid Salleh" <razid@moh.gov.my>, "Dr. Afidah Ali" <>, "Dr. Afidah Ali" <afidah@moh.gov.my>, drnooraini_b <>, drnooraini_b <drnooraini_b@moh.gov.my>, "Dr. Asmah" <>, "Dr. Asmah" <asmahn@moh.gov.my>>

Dear Dr Mary,Dear Dr Mary,

I am terribly sorry. Her reply was at the bottom of her email.I am terribly sorry. Her reply was at the bottom of her email.

The following is the extract from her reply in RED i.e.:The following is the extract from her reply in RED i.e.:

"Assalamualaikum."Assalamualaikum.Apart from what being mentioned in the Act, we did not ask for other things. We asked the PIC to Apart from what being mentioned in the Act, we did not ask for other things. We asked the PIC to get defibrillator for Haemodialysis Centres not clinic. get defibrillator for Haemodialysis Centres not clinic. 

If I'm not mistaken, during the earlier part of the post registration inspection, we asked for If I'm not mistaken, during the earlier part of the post registration inspection, we asked for everything in theeverything in the checklist checklist and the GP did well.They even keep ET and Laryngoscope (that was not and the GP did well.They even keep ET and Laryngoscope (that was not listed in our checklist). After sometime we noticed a lot of  GPs did not comply with the basic listed in our checklist). After sometime we noticed a lot of  GPs did not comply with the basic emergency equipment, so we asked them to refer to emergency equipment, so we asked them to refer to FIFTH SCHEDULEFIFTH SCHEDULE of the Act because we did of the Act because we did not supply them with the checklist(not much difference with our list). Some of the GP clinics do not not supply them with the checklist(not much difference with our list). Some of the GP clinics do not have OXYGEN TANK, INDWELLING URINARY CATHETER, IV SUPPLIES and EMERGENCY DRUGS have OXYGEN TANK, INDWELLING URINARY CATHETER, IV SUPPLIES and EMERGENCY DRUGS  too. too.

They were saying that they were waiting for the news from They were saying that they were waiting for the news from MMA SarawakMMA Sarawak to notify them on the to notify them on the latest list of the emergency equipments (MMA having discussion with KKM to exclude certain latest list of the emergency equipments (MMA having discussion with KKM to exclude certain things including Oxygen). What we do now is we ask what they have and jot down .If not complete things including Oxygen). What we do now is we ask what they have and jot down .If not complete ask them to refer to Fifth Schedule . Various response from the GPs, some have everything listed in ask them to refer to Fifth Schedule . Various response from the GPs, some have everything listed in the FIFTH SCHEDULE and one GP even refused to keep any basic emergency equipment and said the FIFTH SCHEDULE and one GP even refused to keep any basic emergency equipment and said he only have to drive the patient to the hospital just in case patient collapses in his clinic (maybe he only have to drive the patient to the hospital just in case patient collapses in his clinic (maybe not MMA member )I'm myself also not clear about the final decision. not MMA member )I'm myself also not clear about the final decision. Due to the mixed response by the GPs, we refer to both checklist and FIFTH SCHEDULE until the Due to the mixed response by the GPs, we refer to both checklist and FIFTH SCHEDULE until the final say. Anyway after last week 's meeting, we conclude that only ET is EXCLUDED and that is final say. Anyway after last week 's meeting, we conclude that only ET is EXCLUDED and that is what I'm going to inform them during our briefing. Thank you."what I'm going to inform them during our briefing. Thank you."

With regard to the 5th Schedule, there has been With regard to the 5th Schedule, there has been different opinionsdifferent opinions from various agencies including our from various agencies including our National Advisor for Traumatology i.e Datuk Abu Hassan who insist that the lists should be retained. We have National Advisor for Traumatology i.e Datuk Abu Hassan who insist that the lists should be retained. We have yet to make arrangement to discuss further this matter.yet to make arrangement to discuss further this matter.

Thanks.Thanks.

ANISANIS

Emergency careEmergency care

ChecklistChecklist Fifth ScheduleFifth Schedule Both Checklist and Fifth ScheduleBoth Checklist and Fifth Schedule MMA ListMMA List MMC ListMMC List ??? Final List??? Final List

ChecklistChecklist Emergency call systemEmergency call system OxygenOxygen Airways and manual breathing bagAirways and manual breathing bag IV suppliesIV supplies Suction equipmentSuction equipment In-dwelling urinary cathethersIn-dwelling urinary cathethers Drugs and other emergency medical Drugs and other emergency medical

equipment/supplies deemed necessaryequipment/supplies deemed necessary

Fifth ScheduleFifth Scheduleboth adult and paediatricsboth adult and paediatrics

Emergency call systemEmergency call system OxygenOxygen Ventilation assistance equipment, including Ventilation assistance equipment, including

airway and manual breathing bagairway and manual breathing bag Intravenous therapyIntravenous therapy ElectrocardiogramElectrocardiogram Laryngoscope and endotracheal tubes, if possible;Laryngoscope and endotracheal tubes, if possible; Suction equipment Suction equipment In dwelling urinary cathetersIn dwelling urinary catheters Drugs and other emergency medical equipment Drugs and other emergency medical equipment

and supplies, necessary for the level of services and supplies, necessary for the level of services to stabilize the patient as specified by the person to stabilize the patient as specified by the person in charge.in charge.

Emergency CareEmergency Care

NHSNHS: No Statutory Requirement: No Statutory Requirement

Designated Emergency CentresDesignated Emergency Centres Victoria, AustraliaVictoria, Australia: Drugs provided: Drugs provided

Mobile ICUMobile ICU SingaporeSingapore: Ambu Bag: Ambu Bag

Emergency drugs:- Adrenaline, Emergency drugs:- Adrenaline,

Atropine, Antihistamines, Atropine, Antihistamines, Hydrocortisone.Hydrocortisone.

Emergency CareEmergency Care

I.V. Adrenaline 50-100mcg over 5 minutesI.V. Adrenaline 50-100mcg over 5 minutes I.M. Adrenaline 0.3-0.5mg repeated after 5-I.M. Adrenaline 0.3-0.5mg repeated after 5-

10 minutes10 minutes I.V. Promethazine 0.2mg/kgI.V. Promethazine 0.2mg/kg I.V. Hydrocortisone 100-200mg.I.V. Hydrocortisone 100-200mg. I.V. Dextrose 50%I.V. Dextrose 50% I.V. Diazepam 5-10mg.I.V. Diazepam 5-10mg.

NegligenceNegligence Duty of Care – failing to attend ( Lowns v Duty of Care – failing to attend ( Lowns v

Woods 1996)Woods 1996) Breach of the duty of care – ineffective Breach of the duty of care – ineffective

treatment is not negligence.treatment is not negligence. Objective standardObjective standard Bolam principleBolam principle Rogers v Whitaker 1992Rogers v Whitaker 1992 Soo v Foo 2002Soo v Foo 2002 Good Samaritan clauseGood Samaritan clause

Medical Manslaughter on Medical Manslaughter on the Risethe Rise

……. Changes in the way that doctors . Changes in the way that doctors are held accountable for their are held accountable for their mistakes, and the rise in charges of mistakes, and the rise in charges of medical manslaughter.medical manslaughter.

Dato Dr NKS TharmaseelanDato Dr NKS Tharmaseelan

MPS ConsultantMPS Consultant

RISK RISK MANAGEMENTMANAGEMENT

Fire extinguisher and hope never Fire extinguisher and hope never to have fireto have fire

BURNING ISSUESBURNING ISSUES1. Clinical Waste Disposal1. Clinical Waste Disposal

2. Clinical Practice Guidelines2. Clinical Practice Guidelines

3. Documentations for Insurance3. Documentations for Insurance

4. Pharmacy Enforcement4. Pharmacy Enforcement

5. EPF, SOSCO, Labour laws , tax5. EPF, SOSCO, Labour laws , tax

6. FOMEMA, e- Kesihatan6. FOMEMA, e- Kesihatan

7. ASEAN COMMON MARKET by 20137. ASEAN COMMON MARKET by 2013

8. Over supply of doctors.8. Over supply of doctors.

9. Revisions to the MEDICAL ACT 19719. Revisions to the MEDICAL ACT 1971

10. Impaired doctors10. Impaired doctors

12. Health Financing, Medical Devices, TCM12. Health Financing, Medical Devices, TCM

Malaysian Medical CouncilMalaysian Medical Council20082008

22,00022,000 doctors registered doctors registered2,3002,300 Housemen registered per year Housemen registered per year(3,000 per year in 2010)(3,000 per year in 2010)

15,00015,000 medical students in 21 Medical Schools medical students in 21 Medical Schools1,0001,000 per year sent overseas by Government. per year sent overseas by Government.1,0001,000 per year sent overseas by FAM per year sent overseas by FAM

scholarshipscholarship

1:600 ratio achieved between 2013 and 2018 1:600 ratio achieved between 2013 and 2018 ((Prof Prof Sim K H)Sim K H)

Registered Medical Registered Medical PractitionersPractitioners

2001 2001 20072007

Sarawak Sarawak

Public 205 276Public 205 276

Private 276 357Private 276 357

Total 481 828Total 481 828

MalaysiaMalaysia

Public 5219 8868Public 5219 8868

Private 7209 Private 7209 94169416

Total 12,428 Total 12,428 18,28418,284

Pharmacy Board of Pharmacy Board of MalaysiaMalaysia

2001 2001 20072007SarawakSarawakPublic 20Public 20Private 126Private 126Total 146Total 146MalaysiaMalaysia Pharmacist Pharmacist

=4420=4420Public 460 Public 460 Private 2108 Private 2108 Corporate = 414Corporate = 414

Total 2665Total 2665

ASEAN COMMON ASEAN COMMON MARKET 2013MARKET 2013

Your employerYour employer

SINGAPORESINGAPORE

Your competitorYour competitor

PHILLIPINESPHILLIPINES

CHEW CHEE-MING, JOHNCHEW CHEE-MING, JOHN

Full Registration No: 25208Full Registration No: 25208

11stst January 2009 January 2009

Medical Act 1971Medical Act 1971

We We survivedsurvived because we were because we were strongerstronger than we thought. than we thought.

We We sufferedsuffered because we were because we were weaker weaker than we should have been.than we should have been.

Bill Young Bill Young

Former POWFormer POW

BLTC, KuchingBLTC, Kuching

Borneo Post 21Borneo Post 21stst Dec 2008 Dec 2008

THANK YOUTHANK YOU

MMA Life membership Promotion MMA Life membership Promotion ends 31ends 31stst Dec 2008 Dec 2008

Society of Private Medical Practitioners SarawakSociety of Private Medical Practitioners SarawakAcknowledgements Acknowledgements

Dr Mohd KamilDr Mohd KamilDr AsmahDr Asmah

Dr ManalanDr ManalanSN Lee Geok NioSN Lee Geok Nio

Ms ChaiMs ChaiEastern OxygenEastern OxygenBorneo CyntexBorneo Cyntex

3A3ADorothy Tan, Amanda LiewDorothy Tan, Amanda Liew

Committee MembersCommittee Members