While Malaysia has been one of the more effective countries worldwide in flattening the COVID-19 curve, it has not been without cost, including a severely impacted private health sector.
Omnia Health Insights spoke with Datuk Dr Kuljit Singh, President, Association of Private Hospitals of Malaysia and Omnia Health Live panellist to better understand the role of the nation’s private hospitals in the coronavirus response, and what needs to happen next as the country emerges from the crisis.
Dr Kuljit explained that the pandemic has had a major impact on private hospitals, with revenues falling as low as 20% of their normal levels over the past eight to 10 weeks. Much of this was down to providers seeing fewer patients owing to the national Movement Control Order (MCO, the lockdown measure implemented to restrict people’s movements).
But he also attributed the fall to a decline in medical tourism to “zero”: the country’s hospitals treat medical tourists from Bangladesh and Indonesia principally, along with other parts of the world.
He nonetheless remains optimistic, believing that it’s only a matter of time before normal visitor levels resume, before adding that there was no need for promotional marketing to lure patients back. The main group of medical tourists is waiting for the borders to open, which depends on their nation’s government, and of course the Malaysian government.
With Malaysia’s private hospitals not seeing COVID-19 patients, support was provided instead to the public sector. This came in the form of 60-80 functioning ventilators, provided “on the spot” with no payment expected in return (each cost up to USD 47,000), dialysis slots and even specialists, in the event that staffing levels were low or if exhaustion set in.
Ultimately, the crisis has been well managed by the Ministry of Health, Dr Kuljit shared, with the extra support offered not needed: some of the ventilators have been returned in their original condition, untouched.
Addressing the question of technology in reaching patients remotely, Dr Kuljit believes that telemedicine has potential - but warned that it has to be done carefully without compromising existing clinical medicine norms, in that examining patients in person still has deeper values that mustn't be overlooked. He added that it's ideal for follow-up consultations, and for any early discussion with potential patients who may wish to meet the doctor.
Learnings and collaborations
Help was also received from another source, this time outside of Malaysia.
A cohort of doctors of different medical specialities was received from China for three weeks to provide guidance on different aspects of COVID-19. Dr Kuljit revealed that much was learned from the specialists, from how to manage gaps to the warning signs to look out for in social, mental health and intensive care areas, among others. It was an effective collaboration that “made a lot of sense”.
Returning to the collaborations theme, he highlighted the pressing need for a more effective public-private partnership to outsource ICU facilities when required in a pandemic, explaining that countries worldwide had experienced a major lack of intensive care beds during the height of the crisis. While it was a problem that Malaysia ultimately didn’t have to face, another pandemic may yet emerge.
Accordingly, he called for a strategy to embed healthcare facilities in public spaces such as commercial airports – that can be quickly converted in the event that healthcare facilities are once again consumed – and for the rapid conversion of wards into ICUs.
Pandemic aside, Dr Kuljit highlighted other challenges facing the Malaysian healthcare sector, namely that private healthcare is perceived by patients as expensive, and public facilities can be crowded, necessitating a long wait.
Omnia Health Live
Dr Kuljit will be participating at Omnia Health Live on 24 June, when he will be joined by providers in a session examining healthcare’s mid-term and post COVID-19 era. Join Dr Kuljit and others for their virtual panel on delivery system transformation - register for free today to add the session to your calendar!
He revealed that he is particularly looking forward to hearing from other providers on how public-private partnerships can be made more effective, as well as any salient lessons from COVID-19 to move forward in healthcare.
Through comparing notes and sharing experiences, he hoped, patients will be better served in the long run – along with the mortality rate reduced in any future pandemic.