26 October 2017
MP: Govt must address claims of lack of funds in hospitals
KUALA LUMPUR: An MP has asked the health ministry to answer several allegations that have surfaced recently pertaining to the challenges faced by government hospitals in the country due to a lack of funding.
In the Dewan Rakyat today, Kulai MP Teo Nie Ching brought up the allegations of government hospital doctors referring patients for treatment to medical facilities outside, faulty machines left in a state of disrepair as well as the current practice of reusing single-use medical devices.
She said one of the biggest complaints she received from patients of government hospitals was the lack of reagents to conduct tests.
“I have heard so many complaints of insufficient reagents in hospitals to conduct tests. At the end of last year, we heard many government hospitals admitting they did not have sufficient reagents to conduct blood tests.
“I have received complaints from Hospital Sultan Ismail in Johor that one patient went there on Aug 7 but there was no reagent to do a test. This was just seven months into the year and the issue has crept up again.
“I have heard complaints that many reagents are unavailable. I can show the minister the chemical report from the hospital.
“The patients were told that if they wanted the tests done fast, they could go to private hospitals to do these blood tests,” she said during the debate on the Private Aged Healthcare Facilities and Services Bill 2017.
@KKMPutrajaya? Surely this is a serious concern?
Press Statement DG of Health 25th October 2017 – Reprocessing and Reuse of Single-Use Medical Device
The Ministry of Health (MOH) would like to refer to the online media report published by Free Malaysia Today titled “Govt Hospitals recycling single-used devices to save money” and “Safe to reuse disposable devices, says health ministry”. The MOH view seriously this allegation which was perhaps made with the intention to sensationalise the matter, whereby the report quoted an unnamed source, suggesting that MOH hospitals are compromising on patient safety. The MOH would like to strongly refute that and emphasise that MOH has always upheld and prioritised on patient safety and standard of care in healthcare provision.
Firstly, the MOH would like to inform that all of the consumables and single-use medical devices utilised for patient with Blood Borne Diseases are disposed after single used. The MOH has published specific guideline in relation to this (Policies and Procedures on Infection Control) and health professionals are expected to adhere to this guideline in their clinical practice. Similarly, majority of consumables and single-use medical devices are also disposed after single use for other patients.
However, there are some single-use medical devices that are used more than once, whereby it has to undergo reprocessing via thorough cleansing and sterilisation processes before it can be reused for few times. This has been long practiced in Malaysia and it has no correlation with health financing or budget issue. In fact, this reprocessing practice is a norm even in private health facilities in Malaysia and in developed countries such as United States, European Nations and OECD countries. US FDA for instance, had listed 229 single-use devices known to be reprocessed or considered for reprocessing. The Medical Device Authority (MDA) has conducted a preliminary survey to look into this practice in Malaysian public and private hospitals. Interestingly, the finding revealed that 37 percent out of 40 private hospitals surveyed reuse and reprocessed the single-use devices, similar to the practice in MOH hospitals. The important factors which can never be compromised in this practice are infection control and the patient safety.
The patient safety culture is now stronger than ever in MOH and it has always been a priority for MOH to prevent harm to patients. The trending of Healthcare Associated Infection (HCAI) has improved tremendously over the years. For instance, the total HCAI prevalence in MOH health facilities was 1.65 percent in October 2016, as compared to 3.3 percent in March 2009 and 4 percent HCAI reported in a study conducted in 2009 by Centers for Disease Control and Prevention (CDC), United States. Similarly, the Healthcare Associated Blood Stream Infection in MOH health facilities is at all time low in 2016 which is only 0.22 percent, as compared to 9.9 percent quoted in the same study by CDC in 2009. These improvements were made possible due to proactive and comprehensive infection control measures and patient safety program at MOH health facilities.
The MOH also made a huge step forward when the Medical Device Act [Act 737] came into effect in 2012, whereby the medical devices are now better regulated in Malaysia. The Medical Device Authority (MDA) is in the process of drafting a holistic guideline and policy on reprocessing of medical device, by drawing expert opinions and best practices as practiced in United States, Canada, Australia and EU Nations for reprocessing of single-use medical device. This is an iterative process led by MDA and will take into consideration all kind of factors, with the main focus on patient safety.
The MOH would like to reiterate its full commitment towards delivering high quality healthcare services, delivered at reasonable cost and accessible to all. Patient safety will remain at the core of all MOH services and will not be compromised. The MOH urged for more responsible reporting by Free Malaysia Today in line with the journalism ethics and professional reporting.
DATUK DR. NOOR HISHAM ABDULLAH
DIRECTOR GENERAL HEALTH MALAYSIA
25th October 2017
October 25, 2017
Govt hospitals recycling single-use devices to save money
PETALING JAYA: Lack of funds is driving some government hospitals to recycle single-use devices at the risk of patient safety, a highly placed source in the healthcare sector told FMT.
“This includes equipment used in neurosurgery to cardiology, and even in general surgeries. In cases where equipment used to be thrown away, doctors are now being asked to recycle the equipment.”
The source gave the example of cardiac catheters, which are used inside blood vessels and are usually disposable, adding that the hospitals are also unable to repair faulty machinery due to the budget cuts imposed on the sector.
According to the source, the allocated budget was small to begin with, and the budget cuts are too big an amount to sustain.
“There was a cut of RM1 billion last year. So hospitals are going to get stuck with this as there has been a heavy increase in patients coming in from the private sector,” he told FMT.
His comments followed a report by FMT yesterday that a 30% spike in patients using government healthcare instead of private was due to an increase in the cost of living, coupled with the goods and services tax (GST).
The source said such cost-saving measures posed a health risk to patients.
“What if the equipment was first used on a patient that had an infectious disease? It could easily spread to the next patient.
“This is why they list the item as disposable so that you only use it once.”
Patients told to buy medication elsewhere
He said hospitals are also asking patients to buy medication and have their tests done externally due to financial constraints.
“All this has not been highlighted. Many patients are being told to do their tests outside the hospital, pay for it themselves and bring back their results to the hospital later.
“They claim that these are ‘unnecessary’ tests, but the truth is they just do not have the money.”
To make matters worse, he said, hospitals could not repair machinery that had broken down or needed to be serviced.
“There are many hospitals that are encountering this. There are some machines that have not be repaired for up to a year. All these machines are vital for operations, like cardiac monitors which have broken down and there was no money to repair it.
“They probably have to wait until the next budget allocation before they can repair it.”
If there was an emergency case, he said, hospitals would send the patient to another hospital that had a working machine.
Unfortunately, he added, hospitals had a waiting list for their machines, making this “a major mockery to the patients”.