Saturday, July 7, 2012

Dialysis Outrage

My dad, Hong Hoe, was angry when he read about the unreasonable requirements being imposed by the Ministry of Health on a non-profit organisation providing dialysis at affordable rates to the Rakyat as reported in the May 25, 2012 online issue of the Selangor Times(1)..

"The rapid development of corporate private hospitals from the mid-1980s, which was in line with the “Malaysia Incorporated” concept had led to an unprecedented growth of corporate private hospitals, the repercussions of which, had wide social economic implications in the health care sector which resulted in inequitable medical and health resources, and in some resulted in poorer quality of care. It is not uncommon to hear negative media reports of unethical practice in the management of some of these private healthcare facilities: questionable hospitals’ charges and padded bills; emergency services denied due to economic reasons, unreported assessable deaths, are some of the major concerns to policy makers. Further, it has been reported that professional medical indemnity and incident reports as a result of adverse events, medical errors and negligence in private hospitals are on the rise"(2).

Thus, the Private Healthcare Facilities and Services Act 1998 (4) was implemented on May 1, 2006 to regulate healthcare facilities and services in the country.


St. John Ambulans Malaysia - Kawasan Pantai Selangor (SJAM-KPS) (5) operates 14 fully-furnished dialysis centers nationwide with more than 230 dialysis machines and more than 450 dialysis patients under their care. 

In 2002 SJAM-KPS became the first NGO to receive the International Organization for Standardization’s ISO 9001:2000 certification for quality management of ambulance and haemodialysis services. This was upgraded to 9001: 2008 in August 2010 to ensure more stringent quality service.

It was reported that the Private Healthcare Facilities and Services Act compels SJAM-KPS to have at least 4.5 sq metre of space for each patient. In addition, a dialysis centre’s water treatment room, reprocessing room and store room must be located separately from the dialysis room. Apart from the requirements, it was also reported that SJAM-KPS has yet to receive the ministry’s approval to begin operations of their three new dialysis centres despite waiting for nearly a year.

SJAM-KPS Commander Datuk Burnard Yeoh questioned the rationale of imposing the Private Healthcare Act on SJAM as it is a non-profit organisation and its centres fulfill the international standards of ISO9000:2008. He feels that these requirements are unreasonable. “If the government doesn’t amend the law, we’re giving up. We cannot cope,” he added.

Commander-in-chief Datuk Dr Low Bin Tick said it was unreasonable for Putrajaya to impose such requirements on them as their centres have limited space compared to private hospitals.

To add insult to injury, the health ministry has suspended the RM50 subsidy per treatment for new patients in SJAM-KPS’ dialysis centres since June 2010 due to their failure to comply with the new law.

“Why punish the patients?” questioned Yeoh.

Pushed to a corner, SJAM-KPS felt it might as well surrender all its dialysis centres to Putrajaya.

This is an example of the reservation both the Malaysian Medical Association and the Malaysian Dental Association had expressed in their memorandum(6) on The Private Healthcare Facilities and Services Act, 1998 submitted to the Minister of Health, Malaysia on July 13, 2006

The memorandum pointed out that "there are certain stipulations and requirements in both the Act and Regulations which are too exacting and often ambiguous and which may adversely affect the provision of health care to the people in Malaysia specifically and the practice of medicine generally. One particularly serious implication is the possibility that practitioners, who in general strive to provide a genuine professional service and care to their patients, may, on the slightest failure to comply with the stringent requirements spelt out throughout the Act and Regulations, be heavily penalised".

The health ministry declined to comment when contacted by Selangor Times, which is owned by the Pakatan Rakyat government of Selangor.

However, in an interview as reported in The Sun Daily on June 18, 2012(7), Health Minister Datuk Seri Liow Tiong Lai said it was the St John Ambulance Malaysia (SJAM) which has not fulfilled the need for having ample doctors and visiting nephrologists.

Coming close from his WWW15 flip-flop(8), we wonder where is the truth!

We are lucky both my dad, 97 and aunty Anna, 88 do not need dialysis. Thank God!


1.      Selangor Times May 25, 2012

2.      Nik Rosnah WA, Lee KH.  Impact of the Private healthcare Facilities and Services Act 1998 (Act 586) and Regulations 2006 on the Medical Practice in Corporate Private Hospitals in Malaysia. OIDA International Journal of Sustainable Development , Dec. 2011 Aug;2(9):89-106. Click HERE for the full paper.

4.      Download your copy of the Private Healthcare Facilities And Services Act 1998 HERE 

5.      St. John Ambulans Malaysia - Kawasan Pantai Selangor (SJAM-KPS) Dialysis Service

6.      Memorandum on The Private Healthcare Facilities and Services Act, 1998 submitted to the Minister of Health, Malaysia on July 13, 2006 by the  Malaysian Medical Association and the Malaysian Dental Association. Click HERE for a copy

7.      The Sun Daily, June 18, 2012

8.      It’sno wonder MCA is Cee Liow by Zorro-unmasked 

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