Vintage Salma Khalik

Another year. Another year of Salma Khalik. And her style of journalism.

On 26 March 2018, she wrote in The Sunday Times, “Drilling down, the MOH concluded that much of the higher claims was the result of overcharging and overtreatment by doctors in the private sector”. (“Diagnosing the cause of rising costs”).

On 29 March 2018, in another lengthy opinion piece in The Straits Times “Prescriptions to rein in healthcare costs”, she claimed that the “The Competition Act” had outlawed the “price guide set by the Singapore Medical Council”

These two claims of Salma Khalik have resulted in The Straits Times clarifying that they are incorrect (30 March 2018, Page 2). With regard to the claim of 26 March 2018, it stated that “This is incorrect, the Ministry of Health did not draw such a conclusion” (that much of the higher claims was the result of overcharging and overtreatment by doctors in the private sector).

Interestingly, the online version does not have this erroneous sentence anymore. Presumably, it has been removed. Instead, there is this label:

 Correction note: This story has been edited for clarity.

In this hobbit’s humble opinion, the correction note is euphemistic.

Salma Khalik was not being unclear originally and hence there is no need to edit for clarity. She was very clear in what she meant, but, she was just wrong. Factually wrong.

The correction note should really read:

This story has been edited for factual inaccuracy.

C’mon. Call a spade a spade.

And had she succeeded in making that claim that has now been “clarified”, a wedge would have been created between MOH and the medical profession, especially the private sectors doctors. Because the medical profession would have been pretty upset and wondered how on earth did MOH come to such a conclusion when in reality, many factors contributed to the rise in healthcare costs.

The second mistake is obvious to everyone who is even remotely interested in this subject. The price guide (i.e. Guidelines of Fees) was set by the SMA, not SMC.

This hobbit is baffled. If you go to the The Straits Times website, there is this is the description of Salma Khalik (http://www.straitstimes.com/authors/salma-khalik):

“With more than three decades in journalism, Salma Khalik has been in the thick of things, from covering the stock market to general elections. In the 15 years on the health beat, Salma has gone into Sars wards as that deadly bug put fear into Singaporeans, and uncovered “unhealthy” practices such as patients being given overdoses of chemotherapy drugs. With her grasp of the healthcare system, Salma has also helped to explain the impact of policy changes, supporting some and pointing out failings in others. Her over-riding goal is to push for a better healthcare system for all”.

If the memory of this hobbit serves him correctly, Salma Khalik has been writing about healthcare matters since the last century/millennium, not just 15 years. It’s a great write-up for an experienced journalist. If so, how can she mistake the SMA for the SMC?

This hobbit has no idea. Maybe like the old coot that this hobbit is, she is also getting on in age and the effects of ageing are showing. After all, Salma Khalik has been around for ages. Nowadays, many reporters and journalists do not stay for more than 10 years in one job before they move on, or even five years; either they get promoted to management, or leave for other opportunities in the media or press industry, or leave the sector altogether. In journalist-lifespan terms, she can proudly claim to be an example of an object of antiquity, like the Pyramids of Egypt or the Great Wall of China.

She is a walking piece of history herself. Let this hobbit illustrate as this hobbit remembers only too well. Because there is a style to Salma Khalik’s journalism, best  explained by the fact that she has an “over-riding goal” to push for a better healthcare system.

I do not know much about journalism, but if I were a journalist, my “over-riding goal”  would be to be a honest, competent journalist committed to reporting the truth and avoiding factual inaccuracies. But that’s just me.

Let’s take the example of dispensing rights of doctors. In January of 2005, she wrote two opinion pieces in The Straits Times to push for it. In the process, she completely misrepresented what the then DMS (Prof K Satku) meant. The reporting was so pernicious in nature that it warranted the DMS to clarify with the whole medical profession by circulating the minutes of the meeting between DMS and Salma Khalik (which took place on 1 Dec 2004). The minutes reported “On the separation of drug dispensing form the practitioner as in developing countries, DMS said that it would not happen anytime soon”.

From this statement, Salma Khalik made the quantum leap in logic to conclude that separation of prescription and dispensing will certainly come. DMS said in the cover-note to the circulated minutes that “I will strive to mend any damage done to our trust so that we can work together to serve our patients better”.

We can safely conclude from this sentence that trust between MOH and the medical profession was likely to have been damaged by Salma Khalik’s writing in 2005, since DMS is the most senior and preeminent medical officer of MOH, if not the whole of government and hence the office of DMS is well-placed to represent MOH, especially in the area of professional matters.

In the history of Singapore, no MOH official or MOH political office holder has ever saw the need to circulate the minutes of a meeting between MOH and a reporter to the whole medical profession. Salma Khalik holds this singular honour.

To bolster her case that separation of dispensing and prescription was the right thing to do, she then gave the example of Zimbabwe and recommended we should learn from them in this matter. Yes, Zimbabwe. I am not making this up. Maybe that is why Robert Mugabe came not infrequently after that to Singapore, rumoured to be for medical treatment; maybe it is because Singapore was asked by Salma Khalik to learn from Zimbabwe.

That was in 2005, it is now in 2018. Nothing much has changed. The relationship of trust enjoyed between MOH and the medical profession is put under strain due to the inadvertent efforts of Salma Khalik. In 2005, it was about dispensing rights. In 2018, it is about private doctors overcharging and overtreatment leading to higher insurance claims.

In any case, after 13 years, we still do not have separation of dispensing and prescription rights, despite what Salma Khalik claimed in the January of 2005. Maybe she should just humbly apologise for what she wrote in 2005. After 13 years, we can certainly conclude Salma Khalik was wrong in 2005.

An interesting note to the correction by The Straits Times on 30 March 2018 – did the ST themselves realise Salma Khalik made the two factual errors or it had been notified by someone else, such as MOH? If The Straits Times was informed by an external party of these inaccuracies, shouldn’t the correction come in the form of a published letter in the ST Forum rather than some itsy-bitsy column on Page 2?

One more luminary example of Salma Khalik’s style of journalism: She now laments that it was wrong for the Competition Act to outlaw the Guidelines of Fees (GOF) in the aforesaid opinion piece of 29 March 2018. She then asked who is to be blamed for the current situation? Her answer to her own question included a list of blameworthy folks:

• The Government
• Insurers
• Doctors
• Patients
• The Competition Act (for outlawing the GOF)

Let us go back to April 2007. The SMA reluctantly withdrew the GOF in early April of 2007, after its AGM. On 12 April 2007, she wrote an opinion piece titled “Scrapping an obsolete practice” and therein, she opined, “Without a fee guideline, doctors can be more open and competitive. They may post their rates prominently, or even advertise, since that is now allowed”. She also gave “kudos to the Competition Commission” (for outlawing the SMA GOF). She further remarked, “As the world changes, so too must the medical profession. The days when no one questions their diagnoses or their charges are gone”.

Obviously, her 2018 position differs remarkably from what she advocated in 2007.

In retrospect, obviously, three things happened in 2007:

• She explained wrongly the impact of the policy change of outlawing the GOF
• She wrongly pointed out “the failings” in the policy of keeping or having the GOF, and
• She wrongly “supported” the policy of outlawing GOF (versus her 2018 position)

Going by the above three points, in the interests of intellectual honesty, shouldn’t she blame herself too, since she supported and advocated for the outlawing of the GOF in 2007?

But she hasn’t blamed herself. We can only surmise she is either blameless or not  blameworthy.

Let us now revisit her write-up on the ST website

“With her grasp of the healthcare system, Salma has also helped to explain the impact of policy changes, supporting some and pointing out failings in others. Her over-riding goal is to push for a better healthcare system for all”.

Her goal as a senior healthcare correspondent of The Straits Times may be acceptable, but going from the above three examples, obviously her grasp of the healthcare system has been inadequate and inaccurate on more than one occasion.

There are many examples to Salma Khalik’s style of journalism, but let us take a break for now.

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*Note: For more commentary on the 2005 saga involving Salma Khalik and DMS, readers can check out this link:

https://www.sma.org.sg/sma_news/3701/hobbit.pdf