Datuk Dr Kuljit Singh
President, Association of Private Hospitals Malaysia
THE PANDEMIC has undeniably placed the nation’s healthcare systems under immense pressure, and public healthcare services were stretched beyond their capacity.
When the pandemic cases were at their peak, there were not enough hospitals beds available in public hospitals. The government roped in private hospitals, but, even then, there was a shortage of other facilities.
“Some amount of concentration in terms of budgeting needs to be put into public healthcare to ensure preparedness for future health crises,” stressed Dr Kuljit Singh, President of the Association of Private Hospitals Malaysia (APHM).
“There is a need to create more space in public hospitals. We are not entirely out of the pandemic. There can be another wave at any time.
“So, we need to have a budget to create space, which can be converted into ICUs, whenever there is a pandemic or when we need beds.”
Expand space and services
He added some amount of budget needed to be used to expand the services in public health care. “We must make sure public healthcare is robust and beneficial for the public.
“That means the public will be able to get treatment from the general hospitals quickly. There are areas where the government can do smart partnerships with the private sector.
“If public hospitals cannot treat patients quickly for reasons such as shortage of infrastructure, manpower or services, then they can buy services from private hospitals. It’s a win-win situation for all parties.”
Consolidating resources and responsibilities
The 12th Malaysia Plan states resources and responsibilities will be consolidated, and healthcare services will be redesigned through collaboration between public and private sectors to manage future outbreaks and health crises better.
The private sector, said Dr Kuljit, was willing to help and support public hospitals when their capacity and resources are overwhelmed during a pandemic outbreak or a non-pandemic crisis.
However, he stressed the government must come up with a reasonable reimbursement for private services.
“You cannot expect private hospitals to treat at a meagre cost or a very high discounted rate because that will not be sustainable for the private sector.
“We will give a discount but in a sustainable manner. We run a business, it is private, and we don’t get any support from anywhere.
“So, we are willing to help but at least reimburse us in a manner that we can carry on with the collaboration.”
He highlighted the government could buy services from private hospitals at any time, which is much cheaper than building more hospitals and healthcare facilities, finding human resources, and purchasing equipment.
“There are 220 private hospitals in Malaysia, and some of their resources are not being fully utilised.
“At any time when public hospitals find their system is getting very tight and the capacity is full, they should not make patients wait because the waiting list is long.”
He said if the government did not have the space or capacity to treat, then they should transfer the patients to the private sector, just like what they did with the Covid-19 patients and backlog cases.
Private hospital’s role in Covid-19 responses
Dr Kuljit shared some of the aid and support provided by the private sector.
“We did many things. Last year, the situation was not very bad as there were few patients. All Covid-19 patients were required to receive Covid-19 treatment in government hospitals only, no matter whether they could or could not afford private healthcare services. Therefore, we did not treat Covid-19 patients in 2020.
“However, the government was worried that they might not have enough ventilators. So, we gave the government free ventilators, about 75 ventilators on loan.”
From 2021 onwards, the private sector started looking after some Covid-19 patients who could afford private healthcare services.
“That eased some of the burdens of the government hospital. People who can afford it could come to private, thus making space in government hospitals for patients who can’t afford private healthcare services.”
Next, he said, private hospitals took over some of the non-Covid-19 cases from the public hospitals, and the government paid for the private sector’s services.
“These are the collaborations we have done, and it has helped to ease the load of Covid-19 patients in public hospitals and the non-Covid-19 backlog cases.
“Lastly, we also participated in the National Covid-19 Immunisation Programme (NIP), whereby some of the vaccinations were in our private hospitals, and we also sent our staff to some of the mega vaccinations centres (PPV) to vaccinate the people.”
Low profits
Healthcare is expensive, and it will keep rising, said Dr Kuljit.
“A lot of our medical products and medications are all bought from overseas. When the government purchases a CT scan or an MRI machine from Germany or the US, and with our exchange rate, it will cost the same for both public and private sectors.
“The difference between the public and private sector is that the public does not see the cost in government hospitals because there is no price tag there, and patients are only required to pay a nominal fee.
“In private, of course, when we buy and upgrade services and equipment, it is all chargeable, and there is a price tag.”
Private entities run privately, and the profits they make is very low, he explained.
“Most of them only make about six or seven per cent profit at the end of the day, and the cost to maintain and ensure the hospital is safe for patients is expensive.
“We have to embrace the fact that healthcare will become more expensive. The only way is, we need to focus and help the group of people who cannot afford healthcare.”
While it may seem that digitalisation and technological advancement would make healthcare cheaper, Dr Kuljit reminded technology itself was not affordable.
“There is no mechanism to reduce the cost. Every government in the world has tried, thinking there will be a magic formula to reduce it.
“So what is more important to the people to know is to keep themselves healthy. When you keep yourself healthy by practising a good healthy lifestyle, you will have fewer chances to get sick and avoid going to hospitals.”
The Covid-19 pandemic is a good example, he said.
“If you prevent yourself from getting Covid-19, you will not get infected, and you don’t need to see a doctor, and you don’t have to pay bills. But if you don’t follow the SOP and don’t get vaccinated, be ready for the bill.”
Private hospitals, he explained, were based entirely on ‘willing buyer willing seller’. And while it may be costly to the man in the street, patients who can afford it and want the comfort and the frills the private sector provides are willing to pay for it.
“We saw during the pandemic 80 to 90 per cent of the patients had no issue with the payment, and most of them wanted a bed in private even though they already had a bed in a government hospital.”
Ready for medical tourism
He noted that Malaysia had the best healthcare system with the best prices in Southeast Asia.
“Comparatively between Thailand and Singapore, we give excellent healthcare treatment at excellent costs. And medical tourists are coming to Malaysia because of that reason.
“In 2019, we got RM1 billion revenue for the government because many medical tourists came to Malaysia as they found it very cost-effective. So if you look at it, we are not expensive.”
As travel restrictions are relaxing and border and tourism are opening up, Dr Kuljit shared that the private hospitals involved in medical tourism before the pandemic are ready to accept and serve medical tourists.
He, however, noted that it must be at a slow and steady pace.
“We have to be careful and follow the SOPs and the guidelines given by the government. And I think it would not be a problem when it is between green travel bubbles, whereby the endemic level and type of virus between the countries is the same.
“We need to take small steps because we do not want a situation where we try to get a lot of medical tourists and end up bringing in Covid-19 variants. But otherwise, we are ready to start even today.” KHIRTINI K KUMARAN — The Health
