RM20 medical fees for e-hailing drivers can compromise quality

LETTER | The Malaysian Medical Association (MMA) views with great concern the fees as low as RM20 being offered to conduct the mandatory medical examination for the application and renewal of E-hailing driver’s public service vehicle (PSV) licence as reported on Star Online on Sept 27.

It is impossible for general practitioners (GPs) to conduct a proper medical examination for commercial vehicle drivers at RM20, and we are curious to know what kind of medical examination is being offered at such a low price.

Such practices of price undercutting under the guise of corporate social responsibility (CSR) is shameful, an utter disgrace to the medical fraternity and may compromise duty and quality of care.

We wish to remind all concerned that medical examinations are mandatory for the safety of drivers, their passengers and all road users.

We also urge the Health Ministry to investigate the standard of medical examination services provided at RM20 that was claimed to have been offered to E-hailing drivers. This is a form of block discounts that may amount to fee splitting, which is unethical, whereby the clinic and practitioner can be charged under the Private Healthcare Facilities and Services Act 1998.

The mandatory medical examinations for the application and renewal of PSV licence consists of the following: consultation, physical examination, vision, hearing, obstructive sleep apnea, neurology/musculoskeletal, cardio vascular system, respiratory system and diabetes questions.

Heavy responsibility

As we know, many persons are walking around not knowing that they suffer from high blood pressure, diabetes mellitus or high cholesterol (or some combination of these three). GPs shoulder a heavy responsibility in certifying a person medically fit and there are legal implications if there are errors made by a GP in the medical examination process.

Commercial vehicle drivers spend more time on the road than other drivers normally do. Certain medical conditions such as diabetes can cause drowsiness and affect concentration behind the wheel.

In certain countries, patients with medical conditions such as sleep apnea will not be allowed to drive. Try to imagine what will happen if a driver with severe colour blindness is passed as fit. What about someone with severe lung disease due to smoking, or someone with reduced vision due to cataracts? All these can easily be missed if a hurried or incomplete examination is done.

There have been cases of heavy vehicle drivers causing accidents when they develop stroke. If hypertension, diabetes and high cholesterol are missed because a thorough history was not taken and physical examination was cursory, are we not increasing the likelihood of such incidents occurring? This is how serious we should be taking the mandatory medical examinations for the application and renewal of PSV licences for all commercial vehicle drivers.

The rate of RM80 set by the Road Transport Department (RTD) for doing this examination was not pulled out of thin air. In the news report, the president of the Malaysian E-Hailing Drivers Association himself states that the examination, done properly, will take half an hour. MMA had initially proposed a fee of RM120 to RTD for the mandatory medical examination but it was lowered to RM80 after taking into consideration the financial status of E-hailing drivers.

From Oct 1, a new format of a more detailed examination proposed by the RTD requires doctors to spend longer time for each driver to be examined.

The health of all commercial vehicle drivers must be taken seriously with a detailed medical examination carried out to ensure all drivers are medically fit to provide their services as the lives of passengers are put in their hands the minute a passenger steps into their vehicle.

A proper detailed medical examination must be insisted upon by the authorities with no compromise on the standard and quality of healthcare services provided by GPs who conduct these medical check-ups.

Dr N Ganabaskaran is president of the Malaysian Medical Association

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.