This keynote address was read by the Director General of Health Malaysia, Datuk Dr Noor Hisham Abdullah during the launching of National Pain Free Hospital and National Seminar 2014, 3rd September 2014. Auditorium Parcel E, Putrajaya
YBhg. Dato’ Dr Azman Abu Bakar
Director of Medical Development Division
YBhg. Dr Wan Mazlan B. Wan Mohd Woojdy
Deputy Director of Quality in Medical Care Section
Dr Mary Suma Cardosa
Chairperson of National Pain Free Committee
Dato-Dato, Datin-Datin, Ladies and Gentlemen
Assalamualaikum wm. wb, Salam Sihat 1 Malaysia and a Very Good afternoon to everyone.
First of all, I would like to thank the organizing committee for inviting me today to deliver the keynote address. It is an honour for me to stand in front all of you in this historical day.
Pain is a common symptom experienced by hospitalized patients, whether it is due to cancer, surgery, trauma, childbirth or medical conditions. Pain causes a lot of suffering and unfortunately many patients in hospitals all over the world still experience unrelieved pain, despite the availability of many analgesic medications as well as advanced surgical and anesthetic techniques.
We, in the Ministry of Health are very aware of the importance of good pain management in our hospitals and we are committed to provide excellent services in this area. Specific programs targeting this, include the establishment of :
• Acute Pain Services (APS) in our hospitals (since 1993),
• Training of pain specialists (since 1997) and
• Setting up of pain clinics and specialist pain services in our hospitals (since 2000).
Other initiatives include the promotion of minimally invasive surgery and ambulatory surgery and the setting up of Traditional and Complementary Medicine units in our hospitals, with pain as one of the target symptoms for treatment using T/CM.
More recently, since 2008, we also implemented “Pain as the 5th Vital Sign” and now we have moved on to introduce the concept of Pain Free Hospitals. This concept promotes holistic pain management using a multidisciplinary team approach incorporating improvements in surgical and anesthetic techniques, and utilizing pharmacological and non-pharmacological methods including traditional and complementary medicine for the relief of pain. A recent survey conducted last month among patients in Selayang Hospital found that 68% of patients in all wards had pain on admission, with 30% having severe pain (pain score 7 or more). The good news is that after adequate pain management, only 3% of patients had severe pain and 72% of patients had either no pain or mild pain (pain score 3 or less). This simple survey showed us two important points – firstly, that pain is actually more prevalent than most of us think, and only by asking patients about pain will we be able to relieve their pain; and secondly that in the majority of patients, we are able to relieve that pain using simple means.
As many of you may know, the Pain Free Hospital Initiative in the Ministry of Health is a project that I have been personally involved with from the start. At the International Summit on Pain in Montreal in 2010, I had the opportunity to showcase the work that we in Malaysia had done to improve pain management as well as to listen to similar initiatives from all around the world. The Summit ended with the Declaration of Montreal, that “Access to pain management is a basic human right” and I felt inspired to be more pro-active in this area. At the Summit, I noted that there was a lot of interest in what we had done to integrate traditional and complementary medicine practices into mainstream medicine and pain management, and you will also know about my keen interest in day surgery and minimally invasive surgery; in conceptualizing the Pain Free Hospital program for the MOH, I was able to bring all these together for the benefit of our patients.
I am very pleased that my idea has been translated into reality and that today, the three pilot hospitals – Hospital Ipoh, Hospital Putrajaya and Hospital Selayang – have achieved their “Pain Free” status, having achieved the standards set by the National Pain Free Hospital Committee. I wish to congratulate all the staff of these three hospitals for their hard work and dedication in implementing the concept of Pain Free Hospital. I have been informed that there are already another 5 hospitals which have started working towards achieving a similar “Pain free” status since last year.
Based on the positive response to this initiative and the interest expressed by other hospitals, we felt that it is time for all MOH hospitals with specialists to come on board and participate in this exciting program, and this national seminar is the kick-off for the whole nation’s participation – so I hope that as many hospitals as possible will strive to implement the programs and policies to achieve your Pain Free certification within the next few years. The mission of the Ministry is to provide services beyond the expectation of our clients – our patients – and I believe that the Pain Free Hospital initiative will contribute significantly to this.
Although we have used the term “Pain Free” hospitals, we acknowledge that it is not possible to achieve a completely pain free state in many cases. Our pledge to patients – outlined in our Pain Free Hospital Patient Charter – “our healthcare professionals will enquire about your pain and care about your comfort throughout your hospital stay”. I am sure that any patient would be very happy to hear these words, as suffering in pain is one of the biggest fears of patients going to hospital for surgery or for treatment of any condition. Apart from patient comfort, we also aim to enable patients to have a faster recovery from their surgery or procedure and return to normal activities as soon as possible.
The Pain Free Hospital initiative, like all new projects in the Ministry, has to have a budget for training programs, promotional and educational materials as well as equipment and drugs. I am pleased to inform you that the Ministry of Health has been supporting the training programs and educational materials and we are working hard to secure the funds for purchase of necessary equipment and drugs as well. However, I am very happy that all the committed individuals from the Quality in Medical Care Section, Medical Development Division MOH; The National Pain Free Committee as well as the hospitals involved have already been contributing their time and efforts and I am very impressed by the great progress that has been made in the last three years despite the budget constraints. If the three hospitals can do it, so can all the rest. We do not need funds to show patients we care about them – just a simple word or touch can make the patient feel better, and all of us are able to do this.
Today, we will also launch the Pain Free Hospital Manual. This Manual will be an important resource for hospitals aspiring to be certified as “Pain Free Hospitals”. The Manual gives clear guidelines on the concept and principles of PFH and the role of the healthcare providers. It will complement the Guideline on Pain as the 5th Vital Sign which was published in 2008 and was recently updated.
Once again, I would like to congratulate the 3 hospitals, which are Hospital Ipoh, Hospital Putrajaya and Hospital Selayang for achieving the Pain Free Hospital certification, and I hope that all hospitals will come on board so that we can have a Pain Free Ministry of Health! . Last but not least, I would like to congratulate the Quality in Medical Care Division, the National Pain Free Hospital Committee and all individuals who are involved in organizing this event.
With lafaz Bismillahirahmanirahi I hereby, officially launch the “National Pain Free Seminar and National Launching of Pain Free Hospital.”