This news appeared in the Star 2 days ago: http://thestar.com.my/news/story.asp?file=/2012/4/17/nation/11116137&sec=nation. A MOU was signed to allow some private and public university lecturers to run specialist services in district hospitals. Few people asked for my opinion on this issue and whether it is a prelude for something else that is coming. I would say that there are pros and cons to this arrangement. One of the main reason why many do not want to join the private or public universities is because majority would not be able to do clinical practise. Even though all these medical schools are attached to a MOH hospital, the politics that goes inside these hospital prevents the academics from running any service for the hospital. I had written about this in March 2007 in Berita MMA https://pagalavan.com/my-mma-articles/march-2007academicians-vs-service-providers-clash-of-the-titans/. Allowing these specialist to run services in district hospitals will allow them to keep the clinical skills intact and at the same time teach the students.
However, we must understand that majority of the academics in most of our private and some public medical schools are expats. That is the reality. In fact, there is even a joke that some universities can be known as Burmese universities as almost all their lecturers are Burmese. I have seen good ones and bad ones. Some of these academics have not done clinical work for many years. Thus, they may be good in theoretical knowledge but not clinical acumen. Secondly, how many of this district hospitals have enough facilities to run specialist service? For example, do Tapah hospital have ultrasound facilities, CT scans, operating theatres etc? The OT is mainly for minor cases and not for major cases. Most of these hospitals do not even have enough A class medications. Even LSCS cannot be done in their OT. Most of the hospitals mentioned below are in this category. So, having a specialist in this hospital may not add any benefit. It may be useful for Internal medicine services but not surgical services. I am also not sure whether MOH is paying for these services, as previously they don’t.
The government prevented medical schools from building their own teaching hospitals since the late 1990s, after HUKM. Unfortunately, this rule was removed when our PM launched Perdana University!! Now, every medical school is racing ahead to set up their own teaching hospital. UCSI is setting up in PD, IMU is buying over Pantai Ampang, Melaka Manipal is setting up Manipal Hospital and I heard even Allianz Medical college is building a private hospital too!! So, here comes another madness after 36 medical schools. It is a way for the private uni to make more money. Frankly speaking, private hospital are not suitable to be made a teaching hospital at this moment. How many private hospitals have all the specialities and manage complicated and chronic cases? WE do not have a National healthcare scheme yet to subsidise patients in private hospitals. Almost 80-90% of the patients in private hospitals now are insurance paid. The cost is just too high for any cash paying patients. Most of these patients wants privacy and personalised care by a consultant. Any new private hospitals will take 5-7 years to be fully occupied by patients. It does not mean that when these hospitals open, patients will be rushing in like a shopping complex! There will not be enough pool of patients for training purposes.
Private hospitals do not hire medical officers or housemen. The only medical officers they hire is for the emergency department. Consultants are NOT employed or paid a salary by these hospitals. Will this scenario change? There are still few questions that are unanswered . Are these hospitals only meant for their lecturers ? Will the specialist be paid a fixed salary by the university unlike the normal private hospitals? Will this private hospitals start to hire MOs and HOs? Economically, it is not viable. That’s the reason why Monash decided to put their plan on hold. Private hospitals will take at least 5-7 years to start to make profit for the investment made. Thus, it is very unlikely they can employ MOs and HOs as financially they will not be able to cope. Furthermore, under the Medical Act, housemanship can only be done in public hospitals. And, will the consultants/lecturers have enough time to teach the students when they are busy with their patients in the ward/clinic?
I was informed that some private hospitals which belongs to big corporate giants are proposing to use their hospitals for postgraduate training. Well, it may be useful for certain subspeciality training in big private hospitals but not for basic speciality training. Again, there will be a lot of issues to settle. Will MOH pay the trainees to be trained in these hospitals? How much will MOH pay to these hospitals to run this “training” scheme? How much will the consultants be paid by MOH or will MOH pay the hospitals only? Will the consultant really train these trainees or merely use them as their free coolie?
Whatever it is , I smell something fishy in all this. For sure, there will be a lot of money involved and changing hands, from right pocket to left pocket! The standard of healthcare will definitely go down the drain due to poor training etc. I wonder whether there will come a time where the rakyat will lose faith in our doctors and go elsewhere for medical treatment? Our politicians are already doing it! Will we become like the Indonesians who rush to Malaysia and Singapore to seek treatment??? Only time will tell……………….
Varsity lecturers to help out at 22 hospitals
By ROSHIDI ABU SAMAH roshidi@thestar.com.my
TAPAH: The Health Ministry has identified 22 public and private universities which will provide specialist medical services in 22 district hospitals nationwide.
Minister Datuk Seri Liow Tiong Lai said the universities were among 33 public and private universities in the country that offer medical courses.
He described it as a smart partnership as the hospitals would provide all the necessary facilities while the universities would send their lecturers who are also medical experts with various specialisations.
He said the collaboration would result in more patients receiving specialist treatment with a shorter waiting period.
“It is a win-win solution for the ministry, universities and the public,” he said after witnessing the signing of the smart partnership between the ministry and nine universities at the Tapah Hospital yesterday.
The ministry was represented by its secretary-general Datuk Kamarul Zaman Md Isa while the nine universities were represented by their vice-chancellors or top officials.
The nine universities that inked the partnership agreement were Universiti Tunku Abdul Rahman that would provide specialist medical service at the Tapah Hospital, Management and Science University (Kuala Kubu Baru Hospital), Perdana University (Bentong Hospital), Universiti Malaysia Sarawak (Serian Hospital), UCSI University (Dungun Hospital), Lincoln University College (Lahad Datu Hospital), Allianze University College of Medical Sciences (Kepala Batas Hospital), Melaka Manipal Medical College (Jasin Hospital) and Mahsa University College (Tanjung Karang Hospital).
Liow said the signing ceremony with the remaining 13 universities would be held later.
“The partnership will help ease congestion at main hospitals and increase the bed occupancy rate at district hospitals,” he said, adding that priority areas include internal medicine, general surgery, paediatrics, obstetrics and gynaecology, orthopedic and anaesthesiology.
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The answer is simple. With most of the senior doctors (MO or Specialist) left government service, there are not many experience senior doctor available. The university brain maybe is the last resort of the ‘experience’ available. I think the down side is university brain will no longer have time to do research. It is not a good idea. Perdana University is destined to be failed.
think this could be part of the larger restructuring plans for 1care. basically… Hospital IMU (pantai ampang) will serve as the tertiary hospital for 1care referrals. So in a way, its a ‘private hospital’ but patients will be seen by students
I AGRE THIS IS FISHY PLUS MADNESS.. 1 CARE IS CRAP..
I think it is a step in the right direction for medical Unis to hv their own hospitals. I understand that in India it is a must. Patients have more choices too and I am certain that their services would be a lot better & more efficient & cheaper than what the government hospitals provide.
Take Dental Unis for example, PIDC and Mahsa have their own clinics. I can tell you from my own experiences. Their charges are comparable with government dental clinics (and about 25% of what u pay at private dental clinics). And they are way better in terms of services. You need to make appointments too but not months like the govt clinics. And they r definitely far more efficient. The govt clinics working hours is from 8am, but they start attending to their first patient only at 10…and their appointments are every hourly…they drag their feet. The PIDC clinic starts at 9am and appointments every half hour. The final year dental students are always supervised by their lecturers majority of whom are specialists themselves..and in many cases the specialists do the jobs themsleves.
So if Medical Unis set up their own hospitals we can only expect better & cheaper services and a good competition to the existing private hospitals whose charges are unaffordable to the lay men.
Yes, it is good for medical schools to have their own teaching hospitals. I have always supported this. BUT, the situation in Malaysia is different. You can’t compare running a dental clinic to running a private hospital. Running a private hospital involves huge amount of money unlike dental clinics. I am in a private hospital which started 2 years ago and till today, it is yet to make a profit and we are not even talking about return of investment yet!So, it is VERY UNLIKELY they can offer cheaper services than the current private hospital.
Most of the fees that a student pays is just enough to pay the lecturers salary and running the medical course. When Monash thought of starting a Monash Medical Centre in Sunway, the suggestion was to make it cheaper than Sunway medical centre thus to make it attractive and to make the patients receptive to students running around. BUT when they looked at it from the economical point of view, it did not turn up well and thus they put the plan on hold!
The cost of running a hospital is huge!! Most of the charges are for the consumables and medications. Most private hospitals will mark up 20-30% to make profit from the consumables, labs and medications. This is how the hospital makes money. So, the higher the medication price, the more it will cost the patient. We are not talking about service like the dental service above. Most consultant’s charges is no where near 20% of the total bill. So, even if these private uni hospitals remove this consultant charges ( since they are being paid a salary), it will only reduce the amount by 10-20%!
So, we just have to wait and see!