On healthcare, don’t forget cost of hardware

To say that the mood in the meeting room was tense would be an understatement. It was more confrontational and combative than beneficial and inspiring. There was the former secretary-general of the International Trade and Industry Ministry, Rebecca Santa Maria, a team of officials, former deputy director-general of health Dr Jeyaindran Sinnadurai, who also doubled up as personal physician for former premier Najib Razak.

The crux of the discussion was the supply of patient monitors, defibrillator monitors, and anaesthetic machines to government hospitals. All these equipment were being supplied by a company which was part-owned by yet another former deputy DG.

The company claimed it had a “Made in Malaysia” certification, which was being disputed on the grounds that the manufacture of such equipment would require a much conducive place – not a shady lot among a row of unoccupied shop houses in Shah Alam.

Going through the literature from manufacturers, it was noted that it would be impossible to assemble the "sensitive" and critical care equipment without precision tools and hi-tech equipment. Government hospitals are using critical life-saving equipment that have not met essential requirements like registration under the Medical Devices Act (MDA).

In a strongly-worded letter to the then Health Ministry's secretary-general, Farida Mohd Ali, signed by representatives of more than 70 companies, it was charged that the quality of medical devices claimed to be manufactured by the company is "seriously questionable". The letter noted that the company has not met the "Good Distribution Practice for Medical Devices” and therefore in violation of the MDA.

This was in October 2014. Nothing changed thereafter. The company continued, and still continues, to supply medical equipment to the government. No one cared or conveniently chose to turn a blind eye to the place of manufacture.

There were rumours that the ministry was merely acting on the directive from a certain woman in Putrajaya but this could not be independently confirmed. Political and other patronage continue to dominate medical supplies to the government. Directors of government hospitals are still being compelled to accept equipment – sometimes second-rate – ordered by the Health Ministry without competitive tenders.

Since May 9, the voices of discontent over the price and quality of medical equipment and pharmaceutical products are getting louder. Despite this disquiet, one company was awarded the contract to supply 100 ultra-scan machines from China and the more established brands from Europe and the United States.

Massive leaks

While there has been an outcry over the cost of drugs, the uneasiness and disquiet on multi-billion ringgit equipment has been hardly audible. A 30-year contract to supply equipment to government hospitals is also in limbo as key personnel have absconded.

There is a clamour for cheaper drugs but the high cost of equipment which adds to healthcare costs has been expediently forgotten or ignored.

Whatever happened to the multi-million ringgit project to build “women and children” clinics throughout the country? A handful has been completed and yet again the complaint is sub-standard equipment.

What about the unfinished hospital projects? An example is the RM494 million Petra Jaya Hospital in Kuching, which was initially scheduled for completion by the end of this month. But all kinds of issues caused to completion date to be set back for a year. The Tanjong Karang Hospital project, which has been delayed for a decade, will finally be fully completed by November 2020.

But what about its cost? This 150-bed hospital costs RM277.2 million, which is equivalent to RM1.848 million a bed. The Tanjong Karang Hospital is a “minor specialist service hospital” with a medical and ward block and two operating theatres.

The 300-bed Shah Alam Hospital was completed after much delay at a total cost of RM550 million. This worked out to RM1.83 million a bed. The hospital is a secondary referral centre.

By comparison, the 300-bed KPJ Kuching Specialist Hospital has all the latest modern medical facilities including orthopaedic and traumatology, cardiology and heart surgery, chemotherapy and radiation oncology as well as plastic surgery facilities. Phase one of KPJ Kuching has 150 beds and only cost RM130 million to build. The cost per bed is only RM866,666.

Everyone is debating the cost of the software while ignoring the fact that there are massive leaks in the hardware.

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R NADESWARAN supports calls for affordable healthcare and the first step is to get rid of middlemen, rent-seekers and commission agents. Comments: citizen.nades22@gmail.com. -Mkini

✍ Sumber Pautan : ☕ Malaysians Must Know the TRUTH

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