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MALAYSIA: Creation of Commercial Hospital Wings a Mistake -Critics

Baradan Kuppusamy

KUALA LUMPUR, Mar 14 2010 (IPS) - A Malaysian government scheme to create commercial ‘private wings’ in major government hospitals has come under fire from critics, who say it will add to the burden of people who need public healthcare the most.

S Arulchelvam (right) at a protest against privatisation of health services at a government hospital in Kuala Lumpur. Credit: Baradan Kuppusamy/IPS

S Arulchelvam (right) at a protest against privatisation of health services at a government hospital in Kuala Lumpur. Credit: Baradan Kuppusamy/IPS

Already, campaigners have been opposing the privatisation of health care services in this South-east Asian country, a trend that involves the introduction of more ‘efficient’ market forces in a sector that has traditionally seen a larger public and state role.

The government is determined to fully implement the Full Paying Patients (FPP) programme in all major general hospitals within the year, saying that the pilot phase it carried out in two big hospitals over the past six months has been successful.

But “it is a clever way of privatising health care,” said Nasir Hashim, leader of a protest movement against the scheme and president of the Socialist Party of Malaysia. “The poor who already suffer from high cost of health care and rising food and living cost will suffer even further.”

“Not only will desperate patients further excluded but they will be forced to rely on precious savings to fund their healthcare needs,” he said in an interview. “This is a form of backdoor privatisation.”

“Such a scheme is fundamentally flawed and will only serve to deprive the low-income (groups) and poor of their right to specialist care,” added S M Idris, president of the Consumers’ Association of Penang. “Their basic human right is being taken away.”


They also fear that the creation of the private wings will move the focus of government hospitals and specialist shifts to paying customers instead of needy patients.

“Private healthcare in principle is to complement public healthcare and not assume the role of the public healthcare sector as the principle guardian of the people’s health,” opposition lawmaker Charles Santiago said.

Right now, major general hospitals have sections that are open to all patients who enjoy equal access to bed, medicine and specialists’ care. But the new scheme would mean that specialists’ care, operating theatres and other facilities would be open only to full-paying patients after 5 p.m. every day.

The government of Prime Minister Najib Razak, who came to power in April 2009, is on a major drive to remove subsidies in order to accelerate free- market measures and make the country more attractive for foreign investors.

He is eager to cut back on deficit financing that has plagued the country since the 1997 Asian financial crisis, undertaking measures such as removing subsidies on oil and other petroleum products and introducing a new goods and service tax.

Making the egalitarian health care system, which is heavily subsidised, a self-paying one, is one of his goals.

Social activists, lawyers and opposition lawmakers, including the Socialist Party of Malaysia, organised numerous protests against the FPP scheme this month.

Nasir, who led a large protest in several big hospitals and submitted memoranda listing the flaws of the FPP scheme, say that the despite Malaysia’s wealth, nearly 60 percent of the country’s 28 million people are considered to be in the lower-income groups.

Another four million foreign migrant workers – documented and undocumented – also depend on the same stretched and outdated health system and would feel the impact of the FPP scheme.

“The FPP scheme ignores quality foster care and treatment of patients who depend on regular public hospitals for their needs,” Nasir said. “We want the scheme cancelled.”

Santiago argued, “This abrogation of duty of the government to citizens is seen in the corporatisation privatisation schemes under the Najib administration. The scheme is the first step in the eventual privatisation of the public healthcare sector.”

Critics fear that poor patients might end up paying services and charges that are now provided free in government hospitals, such as medicines, board and lodging, surgical procedures, nursing, use of equipment and administrative costs.

“All these charges when added are exorbitant and beyond the means of many Malaysians,” Santiago said.

In a country already suffering from perennial shortages of medical personnel, the FPP scheme could well be an additional push factor that encourages doctors, nurses and specialists to move to the private sector.

There are 6,400 medical vacancies in the public sector, with a 2008 doctor- patient ratio of one to 1,105 patients.

As a result, medical officers in the public sector are heavily overworked and doctors often see up to 150 patients a day, Idris says. “With FPP, doctors will come under additional pressure.”

S Arulchelvam, secretary general of the Socialist Party, says that the FPP would result in discrimination in treating paying and non-paying patients. “The public-private mix would lend itself to corrupt practices as in the case in some countries where health care is a mix between public and private care,” he added. “The net benefit for the poor will be less access and a further erosion of equity.”

“Those who cannot afford to pay full rates should be given discounts or, in the poorest cases, free treatment. Patients in the second-class and those in first-class should pay a large percentage of the costs of treatment,” Arulchelvam said.

“This way, the primary role of public hospitals to offer equitable and accessible healthcare to all citizens is maintained. There will be a conflict of interest if the already overburdened public healthcare resources are further diluted to cater for private wings,” Idris explained.

 
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