MOH Estimates Up To 200,000 Backlog Surgeries, Including Electives

Estimated backlogs of up to 200,000 procedures in MOH facilities include elective operations like cancer, AV fistula, and gallbladder surgery, says DG Hisham.

KUALA LUMPUR, Nov 8 — Accumulated backlogged surgeries in Ministry of Health (MOH) hospitals is estimated to be as high as 200,000 cases, including elective procedures, due to the Covid-19 epidemic.

Health director-general Dr Noor Hisham Abdullah said the round figure takes into account elective operations such as cancer, arteriovenous (AV) fistula, and gallbladder surgery, in addition to over 60,000 emergency and semi-emergency surgeries postponed following the country’s third coronavirus wave.

“[The] elective you can wait, but the emergency and semi-emergency, we are giving that priority. That is about 60,000. So, if we include the lumps and bumps, I think the numbers will go up to 150,000 to 200,000,” Dr Noor Hisham told the health, science and innovation Dewan Rakyat special select committee on September 14.

Committee chairman and Bandar Kuching MP Kelvin Yii subsequently asked if the postponement and delays of non-Covid treatments had resulted in an increase in deaths, according to transcripts of the meeting published in the parliament committee’s “Transitioning from Pandemic to Endemic Covid-19 Safely and Sustainably” report that was tabled in Parliament Monday,

To this, Dr Noor Hisham said: “There were delays, but the impact of mortality, we are doing a study whether there’s a clear impact. But now, we are focusing on emergency, semi-emergency. So, we hope that we can clear that to minimise the mortality. But the elective cases, that’s fine because, lumps and bumps, you can queue, and wait.”

Former Health director-general Dr Ismail Merican said in April 2020 that cancer surgeries should not be deemed “elective”, pointing out that stopping certain procedures deemed as “non-essential” could prevent diagnoses of life-threatening diseases with grave consequences for such patients.

National Cancer Society Malaysia (NCSM) president Dr Saunthari Somasundaram previously gave an account of a cancer patient whose condition worsened as she could not get treatment.

Kim (pseudonym), a woman in her early 50s who had a lump in her breast, did investigations at Kuala Lumpur Hospital and was diagnosed with breast cancer in December 2020. She was thought to be in early stage 1 or 2, but no treatment date was given. A CT scan in May 2021 later showed that Kim’s cancer had metastasised to the lungs.

NCSM predicts an increase in advanced cancer cases and mortality due to deferred screenings and treatment, as public hospitals focused on treating a surge of Covid-19 cases while private hospitals limited patient visits.

According to the parliament committee’s report, MOH has already spent an estimated RM100 million to clear many of the backlog cases by referring them to private hospitals. It is asking for another RM200 million in Budget 2022 to not only outsource patients, but to rent operation theatres at private hospitals where MOH surgeons will conduct the procedures.

MOH secretary-general Mohd Shafiq Abdullah, who was also present at the committee meeting, said prices are capped at RM45,000 per surgery outsourced to private hospitals.

Health Minister Khairy Jamaluddin previously said there were 59,049 backlog non-Covid procedures comprising surgical-based and medical-based cases in MOH facilities as of September 30 this year.

He said a total of 38 public hospitals and 71 private hospitals nationwide have been engaged in the outsourcing of services, with 8,338 surgeries and procedures were successfully conducted, involving a total cost of RM73.5 million.

Khairy aims to cut backlog surgeries by 20 per cent as one of MOH’s key performance indicators (KPIs) in his first 100 days as minister.

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