KUALA LUMPUR, Aug 23 — The Health Ministry said it has managed to cut waiting times to see doctors at public hospitals, and patients can expect to be served by medical staff within 90 minutes.
When asked about a Malay Mail Online survey that showed 40 per cent of respondents saying they waited about four hours to see a doctor at public clinics or hospitals, Health deputy director-general Datuk Dr S. Jeyaindran said patients at specialist clinics sometimes had to undergo tests and screenings first.
“If it’s an 11am doctor appointment, we ask the patient to come at 9am to do various tests before seeing the doctor,” Dr Jeyaindran told Malay Mail Online.
He noted that at eye clinics for example, the total contact time to see a doctor may be up to three hours.
“In many places, the waiting time has come down a lot,” he said, adding that patients sometimes come to the hospital at 8am to find parking if they have a 10.30am appointment.
In Malay Mail Online’s online survey from August 16 to 18 and which received 358 responses, slightly more than a quarter cited excessive waits as the reason they stopped seeking medical treatment at public clinics or hospitals in the last 12 months. About 20 per cent said they do not seek medical treatment at all or rely on alternative medicine.
The poll revealed that patients were not just switching from private to public hospitals amid high medical fees — with the Association of Private Hospitals of Malaysia (APHM) reporting a 30 per cent drop in the number of patients at private hospitals — but that some people were dropping out of the healthcare system entirely. However, it is unclear just how pervasive the problem is in the country.
Dr Jeyaindran said MOH has piloted lean management, a management concept that cuts waste, for chemotherapy at Hospital Sultan Ismail (HSI) in Johor Baru and for the emergency department at the Hospital Tengku Ampuan Rahimah (HTAR) in Klang.
The LEAN Healthcare project was piloted at HSI in October 2013 for its orthopaedic specialist clinic and oncology treatment centre, while it was launched at HTAR in early 2014.
Datin Dr Nur Akma Yusuf, deputy director of the hospital management services unit under the Health Ministry’s medical development division, told news portal Gov Insider last August that wait times for cancer treatment went from four months to one. The waiting time at HSI’s orthopaedic specialist clinic was reduced by half from 115 minutes to 62 minutes.
Waiting time hasn’t changed since 2014
Selangor State Health Department director Datuk Dr Hajah Zailan Adnan said the waiting time — calculated as the period between taking a queue number and getting the first contact of service from hospital staff, which could include taking a blood test or an X-ray — at public hospitals in the state have averaged 90 or 93 minutes since 2014.
“Our waiting time hasn’t changed much,” Dr Zailan told Malay Mail Online in an interview at her office in Shah Alam.
When asked about the discrepancy between the ministry’s figures and patients’ claims of taking four hours to see a doctor, she suggested that some patients included the time they take to find parking as part of their “waiting time”.
“They have to understand what is waiting time,” she said.
When asked if Selangor government hospitals were facing patient overloads, Dr Zailan said it depended on how “overload” was perceived, noting that the bed occupancy rate is more than 90 per cent at all times.
“If that’s considered ‘overload’, it’s overload. If you consider it optimisation of the hospital, then it is optimisation,” she said.
No significant patient increase at Selangor, KL public hospitals
Despite the APHM reporting a 30 per cent drop in patient numbers at private hospitals, statistics on the busiest public hospitals in Kuala Lumpur and Selangor — Hospital Kuala Lumpur (HKL), HTAR, Hospital Sungai Buloh and Hospital Ampang — do not show a marked rise in patient admissions.
HKL’s figures provided to Malay Mail Online showed 1,266,250 admissions in 2012, increasing by just 1.9 per cent to 1,289,895 admissions last year. Admissions at the public hospital’s specialist clinics, however, rose about 16 per cent from 511,816 to 595,296 in the same period.
The number of patients at HKL’s outpatient department decreased substantially by 20 per cent from 304,675 in 2012 to 244,435 in 2016.
According to Dr Zailan, patient admissions at HTAR decreased by 17 per cent from 101,253 in 2014 to 84,197 in 2016. Hospital Sungai Buloh recorded a slight dip from 50,407 to 48,951 patient admissions in the same period, while Hospital Ampang went from 43,890 to 42,487.
“So when the private hospitals say less 30 per cent, it doesn’t mean an increase on our side,” said Dr Zailan.
She theorised that the decreased patient admissions at the three Selangor government hospitals could be due to fewer foreigners following the rise in fees for non-citizens since January 2015, while the drop in patients at private facilities may be attributed to cost-cutting by employers or people self-medicating.
“It’s dangerous to self-medicate,” she said. “Even cuts can be dangerous.”
Malaysian Medical Association (MMA) president Dr Ravindran R. Naidu said HKL’s decrease in the number of patients at its outpatient department was due to the hospital referring patients to Klinik Kesihatan and 1Malaysia clinics.
“So the reason for this drop is because of these other clinics… even MOH have claimed, in our discussion with the DG, they claimed there’s a 30 per cent increase in patients on the government side. Patients are diverted to clinics. There’s no way the numbers dropped down,” Dr Ravindran told Malay Mail Online.
Dr Ravindran also said MMA has been informed by doctors working at public hospitals that certain disposable items used for procedures were being recycled.
“Of course they’re sterilised and all that, but they’re supposed to be disposable. That’s the worrying part,” he said.
Health Ministry’s Dr Jeyaindran, however, denied that it was ministry policy to divert patients to clinics.
“Any patient registered at a healthcare facility will be seen. The only time patients are diverted to another clinic is if the patient comes after the registration counter is closed and if it’s not a medical emergency,” he told Malay Mail Online.
He also denied MMA’s claim that public hospitals were reusing disposable items, saying: “The only thing that’s being reused is artificial kidneys, and even that we’ve stopped now.”