Not All Private Hospitals Can Manage Severely Ill Covid-19 Patients: APHM

By Ashswita Ravindran | 15 January 2021

APHM president Dr Kuljit Singh says that not all private hospitals have the necessary features like sterility and airflow, or sufficient manpower, that are required to manage Covid-19 cases.

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KUALA LUMPUR, Jan 15 — Not all private hospitals have the capacity and capability to manage critically ill Covid-19 patients, the Association of Private Hospitals of Malaysia (APHM) said today.

CodeBlue sighted a message sent to private health care providers that stated decisions made from a meeting by APHM, as well as the Ministry of Health (MOH) who was represented by Deputy Health Minister Dr Noor Azmi Ghazali and his team with regards to the involvement of private hospitals in managing Covid-19 patients.

The message stated the decisions made, among which includes private hospitals are to manage Covid-19 cases on their own and up to the intensive care unit (ICU) level, MOH hospitals will no longer accept Covid-19 referrals from private hospitals, and MOH hospitals may soon transfer Covid-19 cases to private hospitals.

Private hospitals are also required to allocate 10 per cent of their wards, high-dependency wards (HDW), and ICU wards for Covid-19 patients.

Dr Kujit confirmed there was a meeting held between APHM and MOH on January 13, but said there was no 100 per cent agreement made from that meeting.

According to the president of APHM, private hospitals are in fact more than happy to cooperate with MOH in managing Covid-19 patients, however, not all private hospitals can manage up to Stage Five Covid-19 patients in critical condition, whose disease spans multiple organs.

“Not all private hospitals are designed to manage it similarly just like government hospitals, not all government hospitals are designed (to manage stage five patients),” Dr Kuljit told CodeBlue.

“Covid-19 comes with a lot of other things. We have sterility, airflow, and so many of those things have to be looked after and so many hospitals do not have those features.”

Dr Kuljit also pointed out that in government hospitals, their level five care is much more comprehensive than any top private hospital.

However, he said such discussions are still ongoing and APHM has told MOH that private hospitals are willing to take in Covid-19 cases, but based on their capacity and capabilities.

Dr Kuljit said that an assessment will be made on private hospitals to see if they are fit to care for Covid-19 patients.

“Our assessment is not because we are finding a reason not to do it. We are not being resistant, we are not saying no, we are strictly (looking) at the practicality and the scientific part of managing it.

“We don’t want to take it for the sake of taking it and spreading it to the whole hospital because we don’t have the infrastructure or we don’t have the manpower,” the APHM president said.

Dr Kuljit explained that manpower in a government hospital is different compared to a private hospital, as government hospitals are equipped with a large number of nurses, house officers, medical officers, and specialists, whereas private hospitals have fewer nurses and only specialists.

He said that private hospitals may allocate a few hospitals as hybrid Covid-19 hospitals, treating both Covid-19 and non Covid-19 patients, but no decisions have been made yet.

Dr Kuljit also said that some private hospital groups may then allocate one of their private hospitals as a Covid-19 hospital.

“The decision is not so clear yet among the private hospitals, but we’re working towards that direction, getting ourselves prepared to manage our own patients. Whether they are going to select a particular private hospital as a Covid-19 hospital, that decision hasn’t been made yet.”

Secondly, Dr Kuljit said that if MOH doesn’t have the capacity to manage Covid-19 cases, they will not be able to accept referrals from private hospitals.

“If they got the beds, they would still take them but at the moment they have no beds, what to do with the patient? It’s in our hands, we have to take it,” Dr Kuljit said.

“MOH has been very kind for the whole of 2020 — they have taken it upon themselves to treat all Covid-19 patients. That is very commendable on their side.

“Even up to today, if they got space, they don’t mind taking,” Dr Kuljit added.

Deputy health minister Dr Noor Azmi Ghazali today said in a statement today that in preparing for the next step in facing the third wave of the Covid-19 epidemic which is far more challenging than previous waves, MOH had a meeting with APHM on January 13.

“I am very satisfied with the outcome of the discussion and the collaboration, spirit, and solidarity that is shown by all parties present in the meeting,” Dr Noor Azmi said.

“MOH welcomes this development and will examine some issues and concerns that have been raised by APHM representatives in the discussion.”

The deputy health minister thanked APHM for their involvement and said more discussions will be held with APHM as well as with private hospital licence owners in the nearest time.

No Talks Of Nationalising Health Care

Dr Kuljit said that on January 12, he had met Prime Minister Muhyiddin Yassin and APHM had given the assurance that private hospitals will cooperate and help in the management of the Covid-19 epidemic.

“There was no talk on nationalisation and all that,” Dr Kuljit said.

“Never mentioned nationalisation to us, but what we told him is that we are going to corporate, we are going to do our best.”

According to the Emergency (Essential Powers) Ordinance 2021 gazetted today, private health care providers who fail to provide resources to the government or refuse temporary government takeover of their land or property in the fight against the Covid-19 epidemic may be subject to a RM5 million fine, 10 years’ imprisonment, or both for violations.

“They can legislate because we don’t have the power to tell them not to do it, but our written message is that we will always be corporate and we have never said in the past that we won’t do it,” Dr Kuljit responded.

Non-Covid-19 Patients Can Still Continue Treatment In Private Hospitals

Dr Kuljit also explained that private hospitals are not expecting a disruption of care for their non-Covid-19 patients, although these facilities are being roped in to manage Covid-19 patients.

“If the patient walks in with a fracture, if the patient walks in with diarrhoea, vomiting, we still have to treat the patient, we cannot send away the patient.”

“There may be areas of the hospitals that may not be suitable for Covid-19, so they can continue doing day to day,” Dr Kuljit said referring to management of non-Covid-19 patients.

“You won’t have much of an effect, you can still go to private hospitals for normal treatment.”

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