Sultanah Aminah Hospital (HSA) in Johor Bahru has temporarily stopped accepting referrals from surrounding government clinics to perform various tests at its Pathology Department, citing "shortage of funds".

An Oct 17 internal memo from its Pathology Department sighted by Malaysiakini said shortage was at a national level.

According to the memo received by HSA director Dr Rooshaimi Mexican Abdul Rahim Merican on Oct 25, the pathology department had identified its available stock of reagent is at a "very critical" level, estimated to finish in less than a month.

"Due to shortage of funds to obtain reagents and consumables at a national level, the Pathology Lab for Hospital Sultanah Aminah, Johor Bahru has identified tests where reagent stocks to conduct such tests are at critical level (less than one month's supply)," the memo read.

Priority would be given for HSA's patients as well as paediatric patients, it read.

Reagents are chemical substances used in machines that perform various tests, including on a person's blood sample, urine, tissue or other bodily fluids.

"Without funds to purchase more reagents, the tests cannot be performed," a source, who wanted to remain anonymous as he is not authorised to speak to the media, told Malaysiakini.

Among tests which would be temporarily halted were for renal function and liver function.

Waiting for budget

Another Health Ministry source told Malaysiakini that the funding could only be obtained after the 2017 Supply Bill was passed in Parliament.

"The state health departments would distribute the funds to the district health departments which would in turn allocate funds for the government hospitals and clinics," the source explained.

In this case, Sultanah Aminah Hospital is under the jurisdiction of the Johor Bahru district health department.

According to the Health Ministry's directory, there are also 35 government clinics and two other hospitals - Sultan Ismail Hospital and Permai Hospital - in areas around Johor Bahru.

Under Budget 2017, prime minister Najib Abdul Razak had announced RM4 billion in allocations for supply of medicines, consumables and reagents at all government health facilities nationwide.

This is part of the Health Ministry's RM25 billion proposed total allocations for next year.

The Supply Bill was passed at the policy stage on Monday and debates are now ongoing at the committee stage.

Johor Bahru district health director Dr Badrul Hisham Abdul Samad has yet to respond to Malaysiakini's requests for comment.

Health director-general Dr Noor Hisham Abdullah in a statement to Malaysiakini said the ministry had taken up the challenge to restructure and reprioritise its finances, including to halt several non-critical laboratory tests.

"Out of the 14 states in Malaysia, (only) Selangor and Johor are primarily affected.

"Hospitals in Kelantan, Terengganu, Pahang, Perlis, Penang and Kedah are only minimally affected," he said in confirming the temporary suspension of non-critical lab services.

The remaining hospitals in Malacca, Perak, Sabah and Sarawak remained unaffected, he added.

Asked whether there are any contingency plans in place, Noor Hisham reiterated that the halted tests did not interfere with ongoing management of patients.

"However, should such tests be warranted during the clinical course of patients management in an affected hospital, such tests would be performed in the neighbouring hospital," he stressed.

Noor Hisham also said the ministry would continue to strive to provide high quality service at an affordable cost to the people.

Issues surrounding limited services at HSA followed the recent fire at its Intensive Care Unit, currently under investigation by a multi-agency taskforce.

Last month, Klang's Tengku Ampuan Rahimah Hospital's Pathological Department imposed a temporary halt on blood tests for instructional purposes, due to funding shortage.

Selangor Health Department director Dr Zailan Adnan said the ministry allocated additional funding for the hospital so it could restock required supply to last until the end of the year.