KUALA LUMPUR, Dec 17 — University Putra Malaysia Teaching Hospital (HPUPM) has yet to be licensed under the Private Healthcare Facilities and Services Act 1998 [Act 586], according to the Auditor General’s Report.
The Auditor General’s Report 2019 Series 1 tabled in the Dewan Rakyat last December 10 showed that as of December 31, 2019, there has not been any form of evidence that HPUPM, a public university hospital in Serdang, Selangor, has obtained licensing and approval under the law that regulates the operation of private health care facilities in Malaysia.
Meanwhile, five public hospitals and three private wings under public hospitals have requested to get approval and licensing from Act 586.
According to the Ministry of Health (MOH), all health facilities in Malaysia must get approval and operating licences under Act 586, except for government hospitals under MOH. Besides that, the audit stated that public university hospitals like HPUPM are considered private hospitals under Act 586.
With MOH enforcing Act 586 that exempts its own medical facilities, the ministry plays the contradictory roles of both health care provider and regulator.
The Ministry of Higher Education (MOHE) has requested, through the Ministry of Health (MOH), in July this year to the Attorney General’s Chambers for university hospitals to be exempted from Act 586. It’s unclear if HPUPM, which is already in operations, has received an operating licence or an exemption from Act 586 since then.
During the audit, it was also reported that the Public Works Department (JKR) had also released their completion certificate for HPUPM late, only on March 15, 2019 when it was supposed to be done by April 22, 2018.
Although the completion certificate was released, the link bridge project was still not completed and only 93.3 per cent of the total medical equipment was provided as of December 31, 2019.
The link bridge was built for the purpose of transporting patients from Serdang Hospital to HPUPM. The plan was to build a bridge of 140 metres long to reduce construction cost, as well as to reduce the time taken to transfer patients.
The width of the bridge was supposed to be at least 3.6 metres, adequate enough to accommodate at least a two-lane passageway for pedestrians, patients on trolleys or beds, and to allow four-seater buggies to move in opposite directions simultaneously.
However, the auditors found that the link bridge that was completed on January 20 this year has a length of 445 metres, an additional 240 metres. This was apparently requested by Serdang Hospital, as the hospital pointed out that the original plan of the link bridge will disturb their services and affect the safety of patients in their hospital near their emergency department and labour room.
Moreover, the width of the actual bridge was two metres lower than what was fixed hence, the link bridge did not achieve its desired function.
It was also found that each air handling unit in all 10 operating rooms did not have a standby unit according to the Technical Brief of Requirement (TBOR).
JKR then responded by saying that the repaired air handling units were of high specifications and will not be spoilt if regular service is done.
Federal government auditors also found that the development of the Total Hospital Information System (THIS) was only done on Jun 12, 2019, a delay of 134 days. During the audit, it was shown that the deliverables through the THIS system were only 45.5 per cent.
The management of HPUPM also replaced the company developing the THIS system without the approval of UPM’s procurement board. The audit found that experts for the THIS system were called in from India to work in Malaysia through a visitor’s pass, not a worker’s permit.
MOHE responded by saying that it was difficult to get a worker’s permit for them, as the government had tightened the process for worker’s permits for those from India.
Hence, as expert reference was essential at that point of time, the experts were called in through visitors’ passes, which were only for the early stages — for customisation and implementation of THIS.
The delay in the development of the THIS system, despite the completion of HPUPM facilities, has led to several issues:
- Only 12 out of 21 clinics, wards, and departments have started operating.
- Only 65.3 percent of manpower filled.
- Lack of beds which fails to meet MOH’s bed-to-population ratio.
The national audit report also found that the cost of the HPUPM project has increased by 18.8 per cent from their initial budget of RM488 million to RM579.58million.
No Scheduled Maintenance Of THIS System At University Kebangsaan Malaysia Specialist Children’s Hospital (HPKK)
According to the audit report, it was found that the concession agreement for the THIS system in HPKK only states that service for THIS system will only be done if there are complaints from users after the Defect Liability Period (DLP).
Auditors found that if regular servicing was not done, the THIS system may fail to operate well and may disrupt the operations for HPKK.
There were also 1,241 computers and 94 tablets provided by the company that set up the computerised system in the hospital, but it was found that the HPKK only has 326 staff, way fewer than the computers received.
Although the hospital’s report said that the computers had been fixed, tested, and configured, it was found during their June 2020 audit that these laptops and computers were still kept in the store rooms.
As a whole, the auditors found that HPKK was built with facilities that support its main objective. However, there were certain weaknesses, including a suitable business model that makes it difficult to operate at an optimum level. As a result, the hospital will face difficulties in achieving financial sustainability.