Healthcare: Patients' interest first, not shareholders'

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I refer to the Malaysiakini report Cabinet hits pause button on IJN sale .

I read with great interest the plans to privatise the National Heart Institute announced recently. As a former heart patient who had surgery performed at the Penang Hospital Heart Centre, another government facility offering cardiac services, I would like to clarify a few points regarding this issue.

Firstly, the main reason IJN has been successful is the fact that it has managed to attract and keep a group of dedicated cardiologists and surgeons who continued to develop the services and subsequently contribute to the success story it actually is today.

This is possible because IJN has managed to escape the long bureaucratic arms and clutches of the civil service which more often than not becomes a hindrance and certainly a push factor for doctors leaving for the more lucrative private sector.

By being a semi-private entity, decisions for advancement of services, introduction of new treatments etc, training and even better remuneration for staff are more readily made, unlike the usual delays and difficulties encountered within the ministry of health framework .

Secondly, it has to be pointed out that services in IJN for civil servants and their families are borne by the government. Therefore, IJN is actually not providing any free healthcare but instead charges the government normal market rates for decent cardiac care.

Although mechanisms for some subsidisation does exist, it is reasonable to conclude that the average Joe Public, like me, who is not in the civil service and without any company guarantee letter will be asked to pay for treatment, and more often than not will be referred to government cardiac centres in Serdang, Penang, Johor Bharu and Kuching, Sarawak if he is unable to afford it.

Treatment will be subsidised, however, if a government hospital refers the patient to IJN for some specialised treatment not available within the health ministry hospitals. In conclusion, the taxpayer's money is still funding IJN in a huge way .

In the last 10 years , the ministry of health, to its credit, has invested heavily in terms of finance and manpower in setting up its own heart centres, notably in Penang , Serdang and Johor Baru where patients are finally able to undergo almost free open heart surgery. I am personally very thankful to the cardiac surgeons at the Penang Hospital who demonstrated fantastic dedication and extreme professionalism in rendering their services.

But centres such as these, although blessed with great infrastructure, huge allocations and training facilities fail to match the success of IJN due to perennial problems of staff shortage with senior surgeons and cardiologists leaving for the private sector due to slow promotions and low salaries.

They, however, have huge potential to match IJN provided they manage to keep their senior doctors with better perks and remuneration similar to those provided for the IJN specialists. I am puzzled on why nobody from the ministry of health, including the DG and his deputy, does not respond to this issue by clarifying that the ministry already has its own heart centres which are up and running.

Instead the minister, albeit in supporting the IJN privatisation, choses to remain silent to the fact that hospitals such as Penang GH do have established heart centres and have been around for more then 10 years .

I, therefore, fail to understand the reasons stated by the government in privatising IJN especially with taxpayers most likely continuing to fund treatment. Privatisation is not always a better option for patients.

Sime Darby on the contrary will benefit from the guaranteed number of civil servants seeking cardiac care, especially with ministry of health heart centres still having severe manpower shortage.

Like all privatised projects, profits are still the main objective and contracts are usually discovered to be astonishingly lopsided, years after they have been signed.

The government should instead maintain IJN as it is, and even learn from the IJN success formula and use it to further develop and consolidate the existing government hospital heart centres into regional centres of excellence similar to IJN but closer to the public.

As always, the patient's interest and not the shareholder's interest should come first in every deal involving public healthcare .

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