KUALA LUMPUR - THE business of fake medical chits (MCs) involves an intricate web that would put multilevel scams to shame.
So lucrative is the illicit medical certificate trade that many involved in it have given up their honest income to service their fast growing clientele.
When they can reap up to RM45,000 a month of non-taxable income from this business, it's easy to understand why.
The network that greases their operations include in their list runners serving most corners of the country, round-the-clock personnel to attend to desperate requests for fake MCs on various blogs and websites as well as insiders, allegedly those right at the source of where the MCs are printed.
The New Straits Times' probes team, in its week-long probe into the intricacies of the business, however discovered that the MC booklets were not systematically traded illegally, but were smuggled out in bulk.
This was fuelled by the soaring demand for MCs from government hospitals and clinics as many "clients" have attested that employers would almost never question those they issued.
While the problem of suspect issuance of MCs had always been associated with private clinics, with employers already making it a standard operating procedure to verify MCs they give out, errant employees were increasingly seeking the services of MC syndicates that can provide them with foolproof chits.
Those running the business said they sell no less than 25 MCs a day, at RM60 a piece.
In the course of its probe, the team also met scores of runners with MC booklets tucked in their briefcases.
We were spoilt for choice as the MCs up for grabs were those belonging to almost all of the government health facilities in the Klang Valley.
Malaysian Medical Association president Datuk Dr N.K.S Tharmaseelan, when told about the goings-on, found it hard to believe.
"The MMA is not aware of this racket you have highlighted. It may not be as rampant as you are suggesting. Otherwise, the Health Ministry would have known about this.
"Unless you have evidence, I cannot say much for now. If you can give us the evidence, the MMA will certainly push for action to be taken immediately," he said over the phone.
Congress of Unions of Employees in the Public and Civil Services (Cuepacs) president Azih Muda was also unaware that members had been resorting to MC syndicates to get them off the hook for failing to turn up for work.
"It is impossible to get MCs issued by government hospitals and clinics unless you are genuinely unfit for work that day," he said.
A video evidence, the kind MMA and Cuepacs expect to see, is also available on www.nst.com.my.
The association may have to rethink its position as the problem is far from just a scratch on the surface.
After taking the fake MCs, supposedly issued by government hospitals and clinics, reporters in the probe team "submitted" their MCs to NST news editor, Farrah Naz Karim.
The more than 10 MCs, including the "6-plus-1" package were blank, except that they came with each clinic's and hospital's stamp.
The team was free to fill in the dates they had been "absent from work" and, if we liked, we could mark off the next appointment dates. We were also "free" to forge the signature of the doctor who had supposedly certified us unfit for work that day.
One runner told us of several "commandments" that had to be observed so as not to be caught.
"Use only ball pens with black ink, avoid marking out more than two straight days, and never for the weekend," he said.
Their clients were not limited to employees in the private sector.
Civil servants, who would be expected to furnish MCs from public health facilities when they call in sick, were among their regulars.
"The human resources department will only seek to verify your MC if they had reasons to be suspicious. Avoid submitting your MC from the same hospital twice. You sell them to you friends instead," he told us as RM120 for two MCs changed hands.
The NST "took the advice".
Dr Tharmaseelan said on May 18 that employers "should question MCs and refuse to accept them if they genuinely believed they are unwarranted" and that the document is "just a recommendation from the doctor that the employee be allowed sick leave".
Farrah called up several of the clinics and hospitals. Two put her on hold until the line was cut off.
The response from Pusat Perubatan Universiti Kebangsaan Malaysia was an indication that our concern was indeed valid.
After introducing herself and her intention to verify an MC that had been "issued" by the hospital's emergency department on May 12, Farrah read out the MC's serial number, which began with the number three.
The person on the other end said the emergency department's MC records had, for a while, begun with "9".
Farrah asked for the attending doctor who had supposedly stamped her name on the MC.
This was the personnel's response: "The doctor has been transferred to the Health Ministry for some time now. She could not have issued the MC on May 12".
The personnel answered in the affirmative when asked if the MC could be presumed to be fake.
Apparently, this hospital identifies at least four fake MCs a week when employers call in to check.
The doctor may not know that her name was being used. But the ministry had apparently been made aware of this abuse.
Two more calls, each to Hospital Serdang and Klinik Kesihatan Putrajaya Precinct 9, confirmed our suspicions.
While the first told Farrah to make a formal request to the hospital's director, attaching with it a copy of the MC in question, the hospital personnel said there had been a lot of requests from employers lately from both the public and private sectors, asking for verifications of the document.
She said many of these employers' suspicions were confirmed.
The public health clinic said it knew nothing of MCs with serial numbers starting with "W", like the one in Farrah's hand. She said the clinic's began with "Z".
"Yes, you can safely assume it is fake because this clinic has never issued a booklet with the serial number starting with "W" this month," she said, adding that the first MC issued in May had Z838351 as its serial number.
She said there was no doctor of the name that was stamped on the MC in the house.
The MMA had said that in 2012, the cost of absenteeism to employers was about RM100,000 per day and the additional costs of replacing absent workers and the total loss due to sick leave stood at RM9 billion or one per cent of Malaysia's gross domestic product of RM850 billion. -NST