THE HEALTH | NOVEMBER-DECEMBER , 2021

Datuk Dr Kuljit Singh

President , Association of Private Hospitals Malaysia

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