Letters
by Balwant Singh

I read with great interest regarding plans to privatize the National Heart Institute announced recently. As a former heart patient, who had surgery performed in Penang Hospital Heart Centre, another government facility offering cardiac services, I would like to clarify a few points regarding this issue.

Firstly , the main reason IJN has been successful is the fact that it has managed to attract and keep a group of dedicated cardiologists and surgeons, who continued to develop the service and subsequently contribute to the success story it actually is today.

This is possible because IJN has managed to escape the long bureaucratic arms and clutches of the civil service which more often becomes a hindrance and certainly a push factor for doctors leaving for the more lucrative private sector.

By being a semi private entity, decisions for advancement of services, introduction of new treatment etc, training and even better remunerations for staff are more readily made, unlike the usual delays and difficulties encountered within the Ministry of Health framework.

Secondly , it has to be pointed out that services in IJN for civil servants and their families are borne by the government. Therefore, IJN is actually not providing any free healthcare, but instead charges the government normal market rates for decent cardiac care.

Although mechanisms for some subsidization do exist, it is reasonable to conclude that the average Joe Public, like me who is not in the civil service and without any company guarantee letter will be asked to pay for treatment, and more often will be referred to government cardiac centres in Serdang , Penang , Johor Bharu and Kuching, Sarawak if he is unable to afford it.

Treatment will be subsidized however, if a government hospital refers the patient to IJN for some specialized treatment not available within the Ministry hospitals. In conclusion , the taxpayer’s money is still funding IJN in a huge way.

In the last 10 years, the Ministry of Health to its credit have invested heavily in terms of finance and manpower in setting up its own heart centres , notably in Penang , Serdang and Johor Bharu where patients were finally able to undergo almost free open heart surgery.

I am personally very thankful to cardiac surgeons in Penang Hospital who demonstrated fantastic dedication and extreme professionalism in rendering their services.

Centres such as this, although blessed with great infrastructure, huge allocations and training facilities failed to match the success of IJN due to perennial problems of staff shortage with senior surgeons and cardiologists leaving for private sector due to slow promotions and low salaries .

They however have huge potential to match IJN provided they manage to keep their senior doctors with better perks and remuneration, similar to those provided for the IJN specialists.

I am puzzled on why nobody from Ministry of Health, including the DG and his deputy did not respond to this issue by clarifying that the Ministry already has its own heart centres which are up and running. Instead the Minister, albeit supporting the IJN privatisation , chose to remain silent to the fact that hospitals such as Penang GH do have established heart centres and have been around for more then 10 years .

I therefore fail to understand the reasons stated by the government in privatizing IJN especially with taxpayers most likely continuing to fund treatment. Privatisation is not always a better option for patients.

Sime Darby on the contrary will benefit from the guaranteed number of civil servants seeking cardiac care , especially with Ministry of Health heart centres still having severe manpower shortage. Like all privatized projects , profits are still the main objective , and contracts are usually discovered to be astonishingly lopsided, years after they have been signed.

The government should instead maintain IJN as it is , and even learn from the IJN success formula and use it to further develop and consolidate existing government hospital heart centres into regional centres of excellence similar to IJN but closer to the public . As always , the patient’s interest and not the shareholder’s should come first in every deal involving health care .