Healthcare Facility Crisis

by Dr Timothy Cheng

I write this in response to “Is our healthcare system in crisis?” in the Star, 10 Dec 2019. The recent case of polio has indeed alarmed many and while the health ministry looks into preventive measures, we should also realize that our healthcare system has already been in crisis in many other unseen and unheard ways.

A survey was conducted in DOBBS (Doctors’ Only Bulletin Boards), a Facebook group comprising of 16,000 plus Malaysian doctors regarding the state of public healthcare facilities. A total of 337 people responded to the survey, 73.5% were medical officers, 19% were specialists while the rest were house officers and staff nurses/paramedics. Attached are bar charts showing the distribution of facility issues based on the type of facility for further detail.

The survey included questions regarding basic facilities such as water/electricity supply, overall evaluation of facility maintenance, time taken to resolved facility issues, etc. Results were indeed shocking.

Nearly half (46%) of doctors rated the overall maintenance of their healthcare facility to be “poor” or “really terrible”, whilst 10% of doctors rated it “good” or “excellent”. The remaining 44% rated it “fair”.

Water supply was interrupted at least once a year in 40% of facilities, with about 10% of centers having water cuts up to once a month. Electricity supply was interrupted at least once a year in 50% of facilities with 10% of centers experiencing electricity cuts up to once a month.

80% of doctors said that their issues were not resolved even after 2 years of filing complaints! Only 7.5% of complaints weresolved within a month. 60% of issues were old and failing equipment such as operating equipment/anaesthetic machines, infrastructure issues such as cracked walls/broken lights/collapsing ceiling, etc.

A medical officer (trainee specialist) from a tertiary hospital in Selangor when interviewed, revealed that the operating theater in his hospital has been malfunctioning for a year due to leaky ceilings and humidity issues. The issues have been resolved after renovation but now certain major equipment are not working. All this has caused delay in operations and the transfer out of patients to other centers for treatment.

Healthcare facility issues have been plaguing the ministry of health for a long time and this is only the tip of the iceberg. Audits that are held ever so frequently are merely a show and a waste of money – how often have we received instructions to “wear white coats”, “fill up the wards” before an audit? The hospital is suddenly a flurry of paperwork and files, just to fulfill the requirements of certain certifications. Walls and walkways are suddenly painted and new signboards even installed.

From the results of the survey, it is evident that we need a better evaluation and assessment system of our healthcare facility and infrastructure as the current methods are ineffective. An open channel for those on the ground to file direct complaints rather than go through a bureaucratic process should be started to enable better reporting of facility failure.

We urge the ministry to take active steps in handling the issue of broken facilities as this is pertinent and directly affects the quality of care we offer out patients. Pay equal attention to all facilities, even to primary care and rural area facilities. Ideas such as cashless payments and electronic medical records are ideal but we have to handle fundamental issues first.

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