Advancing healthcare: Association of Private Hospitals Malaysia (APHM)'s milestone and future directionsJune 4, 2024
Present on stage after the officiating ceremony of the coffee table book are (4th from the right) Datuk Dr Kuljit Singh, President of the Association of Private Hospitals, Malaysia; the Minister of Health, Datuk Seri Dr Haji Dzulkefly Ahmad; and Dr Muhammad Radzi Abu Hassan, the Health Director-General.
The Association of Private Hospitals, Malaysia (APHM), today launched its coffee table book entitled: Our History, Milestone and Future' in conjunction with its 30th International Healthcare Conference and Exhibition - 'Shaping the Future of Healthcare - Trends and Insights for Tomorrow,' at KLCC for a three-day duration.
According to the association’s president, Datuk Dr Kuljit Singh, the book offers a comprehensive insight into the association’s contributions to the nation over the past 50 years, which are often overlooked or underappreciated. Over the past five decades, APHM has witnessed substantial expansion, evolving into a distinguished association that exclusively represents the private hospital domain. With a membership count of 157 out of the total 210 private hospitals nationwide, APHM continues to hold a pivotal position within this sector. "We are delighted that APHM is consistently regarded as a collaborative partner across various healthcare delivery domains, and we aspire for this partnership to further fortify in enhancing the breadth of our endeavors,” he added. Earlier during his welcome address, Datuk Dr Kuljit Singh shared his insights on granting amnesty for the recruitment of foreign nurses. "In the realm of private healthcare facilities, a notable scarcity of nurses persists, a challenge that we acknowledge to be similarly prevalent in public hospitals, as articulated by my mentors. Presently, private hospitals encounter limitations in expanding their service capabilities. Despite the global shortage of nursing professionals, substantial endeavors are imperative. "A survey conducted by the Association of Private Hospitals Malaysia (APHM) in November 2022, encompassing 103 private hospitals, revealed a demand for 9,224 nurses within the 2023-2025 time frame. Private hospitals are actively engaging in recruiting nurses from diverse Asian nations. We express gratitude towards the Nursing Division of the Ministry of Health for endorsing and subsequently proposing to their Ministry of Health the provision of an amnesty for the recruitment of foreign nurses by private hospitals. "Nonetheless, the amnesty period is slated to conclude in October 2024, and as of now, our hospital has not onboarded any foreign nurses. APHM earnestly appeals to the Ministry of Health for a compassionate extension of the amnesty by an additional year. Malaysian nurses are globally recognized for their excellence, underscoring the high demand for their services. From the Middle East to Australia, New Zealand, and even the United Kingdom, Malaysian nurses are sought after, reflecting the acute shortage within our nation. “We implore the Minister of Health and the Prime Minister to conduct a comprehensive evaluation of the repercussions of the nursing deficit in the country and the disinclination of local graduates to pursue nursing careers. Furthermore, we encounter challenges in collaborating with the Ministry of Labour to substantiate our stance on the local scarcity, necessitating extensive joint assessments to demonstrate the dearth of local nursing professionals. "The government must urgently address this pressing matter by streamlining the bureaucratic processes through a unified agency to expedite the resolution of this shortage within the forthcoming years. Medication pricing The Association of Private Hospitals, the Pharmaceutical Association of Malaysia (PHAMA), the Malaysian Organization of the Pharmaceutical Industry (MOPI), and the Malaysian Medical Association (MMA) are collaborating with the Ministry of Health to establish a framework ensuring transparent and equitable pricing of medications at wholesale, retail, and private healthcare facilities, encompassing private hospitals and clinics. "APHM and the industry vehemently oppose the enforcement of price ceilings, emphasizing the criticality of price clarity. APHM advocates for the public disclosure of medication prices in outpatient settings; however, the operational intricacies of such a practice necessitate meticulous refinement, with a plea to avert any punitive measures against our member hospitals. Legal costs incurred by private hospitals A recent ruling by the Federal Court on February 23, 2024, concerning a private hospital, has significant ramifications on the delivery of private healthcare in Malaysia. The appellant, a patient admitted to the emergency services of a private hospital, was deemed to owe a duty of care by the court. This verdict is anticipated to trigger an upsurge in defensive medical practices, consequently escalating the overall healthcare expenses to be borne by patients, insurers, and corporations. While private hospitals acknowledge the obligation to compensate patients who have suffered from proven malpractice, apprehensions linger regarding the reasonableness of the awarded sum and the certainty of the plaintiff receiving the full adjudicated amount. Ensuring a fair and just reparation to the aggrieved patient is imperative without unduly inflating the already exorbitant healthcare costs. In contrast to the practice in Singapore, where courts actively promote mediation before trial, Datuk Dr Kuljit Singh urged the Minister of Health to contemplate mandating mediation following consultations with international legal policy stakeholders. Healthcare costs The insurers have introduced a cost-sharing insurance scheme to address the escalating healthcare expenditures. These initiatives aim to render insurance premiums more accessible, enabling a broader populace to sustain coverage. Nonetheless, patients will be required to bear a portion of the medical costs, which could pose a burden for individuals grappling with severe health conditions. This transition may also necessitate heightened scrutiny of medical invoices and procedures, prompting patients to be more discerning and well-informed regarding their healthcare decisions. Datuk Dr Kuljit Singh disclosed that healthcare providers, such as private hospitals, will encounter a blend of prospects and hurdles as patients grow more financially conscious, potentially driving the demand for outcome-based value. Healthcare facilities may pivot by offering more competitive pricing and automated therapies to allure and retain patients. Conversely, private healthcare providers might confront financial strains as patients and insurers resist escalating costs, potentially impacting profit margins and operational viability. Insurers confront the task of enlightening policyholders about new schemes and fostering adoption. The surge in administrative responsibilities linked to managing cost-sharing agreements and navigating intricate fee structures could necessitate investments in technology and customer support. The enduring successful execution of this strategy could stabilize the insurance sector and fortify insurers' capacity to furnish sustainable coverage. From a national standpoint, the surge in healthcare expenses and insurers' reactions carry broader economic and societal repercussions. A concerted endeavor involving the government, regulators, healthcare providers, and insurers is imperative to tackle the underlying causes of healthcare inflation. In the medium to long term, adept management of comprehensive systemic reforms could contribute to a more pragmatic healthcare framework. Given that the healthcare landscape transcends hospital care alone, it is hoped that all stakeholders, including government bodies, payers, and patients, refrain from attributing the bulk of healthcare cost escalation solely to private hospitals. The ultimate billing is unveiled at the culmination of the entire healthcare delivery process within a hospital. Unfortunately, hospitals grapple with cost containment challenges while other entities evade scrutiny. Private healthcare facility act At this juncture, Datuk Dr Kuljit Singh took the opportunity to express gratitude to Datuk Seri Dr Dzulkefly Ahmad, the Minister of Health, for his gracious efforts in expediting and streamlining the licensing process for new hospitals and license renewals through Cawangan Kawalan Amalan Perubatan Swasta (CKAPS) during a meeting on April 1, 2024. "Private hospitals stand to achieve significant cost savings, leading to a reduction in private healthcare expenses for our patients. This can be realized by ensuring a seamless licensing system with minimized waiting times. Our ongoing plea to the Ministry of Health on this matter has been prolonged, and we hold an optimistic outlook that the new administration under Datuk Seri Dr Dzulkefly Ahmad will enact the requisite reforms. In collaboration with private hospitals, our joint efforts with Protect Health, a division of the Ministry of Health, are progressing satisfactorily. However, we aspire to make a more profound impact on the nation by extending aid to patients awaiting treatment. Our keen interest also lies in supporting the government, particularly in the realm of cardiac surgery," added Datuk Dr Kuljit Singh. Cardiac surgery is not the sole focus but a significant one. Kuala Lumpur boasts approximately 7 cardiac facilities, Penang hosts 5 centers, and the Southern Region accommodates 6 private institutions. These cardiac centers are collectively managed by 10-15 seasoned cardiac surgeons, a majority of whom have undergone parallel pathway training. This serves as a direct testament to the association's endorsement of the ministry's initiative to amend the Medical Act to bolster the nation's pool of well-trained surgeons. Moreover, Talent Corp collaborates with private hospitals to recruit experienced Malaysian surgeons from overseas to serve in our facilities. Health equity and universal healthcare access In light of these efforts, the Minister of Health, Malaysia, Datuk Seri Dr Dzulkefly Ahmad, highlighted in his opening address, "Our health system remains underfunded at approximately 4.4% of GDP, significantly lower than expected for a country of Malaysia's economic stature. Fresh from attending the 77th World Health Assembly in Geneva, he said the challenge of healthcare provision transcends public or private sector boundaries. It necessitates a holistic national approach, integrating local health sector participation and global collaboration to present a unified front for health equity and universal healthcare access. This model aligns profoundly with Malaysia's healthcare transformation in financing and services. "The integration of technology for healthcare communication is increasingly vital. We are exploring the expansion of virtual consultations, electronic medical records (EMR) systems, health information exchanges, robotics, IoT in healthcare, connected technologies, and virtualized healthcare delivery within hospitals. We must embrace and prioritize this healthcare system evolution. "Moreover, we must emphasize precision care and population health management, delivering tailored care that not only meets individual needs but also upholds societal well-being through precision public health. This juncture calls for collaborative efforts to navigate the optimal path forward, with our digital health division spearheading this initiative to fortify and advance healthcare services. Preventing delays in critical diagnostic treatments "Public healthcare facilities, including clinics and emergency departments, are grappling with overwhelming patient volumes and extended wait times. My ministry is diligently focusing on preventive measures and health outcomes to avert unplanned and avoidable hospitalizations. Various initiatives have been initiated to outsource health services to private hospitals, encompassing cardiology, cardiothoracic surgery, radiology, and nephrology. Leveraging the strategic purchasing capacity of Protect Health cooperation, this public-private partnership aims to utilize spare capacity in private hospitals to reduce wait times and prevent delays in critical diagnostic treatments and care. Lifestyle shifts have led to a surge in non-communicable diseases, such as diabetes mellitus, hypertension, and depression, even among youth. The aging population trend necessitates enhanced provisions for general, geriatric, and palliative care, escalating healthcare expenditures. This calls for significant investments and a strategic reorientation to foster a robust healthcare industry and workforce. Healthcare is no longer viewed as a cost center but as a productive profit center. "This paradigm shift has garnered traction in policy circles within the government. Health financing modernization is pivotal in reshaping healthcare services. It stands as a cornerstone of my reform agenda, exploring innovative avenues to modernize health financing in both public and private sectors. Health financing reform Consequently, the newly established Health Transformation Office within the Ministry of Health is actively steering the reform agenda, building on past initiatives and global best practices while engaging diverse stakeholders. Furthermore, Malaysia must chart its unique path for health financing reform, tailored to our ecosystem's context and healthcare stability. This imperative cannot be delayed, even amidst imperfect economic conditions; progress is paramount. In light of the challenges outlined, a shift towards preventive care over curative measures is imperative. The 'Sihat Bersama 2018' initiative must evolve into a tangible blueprint, as encapsulated in the National Agenda for Healthy Malaysia (ANMS), promoting a healthy lifestyle, enhancing health literacy, and empowering individuals and communities to proactively manage their health. A holistic healthcare approach will yield superior health outcomes, alleviating strain on healthcare facilities. |
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