KUALA LUMPUR, Dec 23 — Ipoh Timor MP Howard Lee Chuan How has plans to pilot a mobile care project in his constituency that will focus on wound care.
The newly elected federal legislator from the DAP expressed hope that the mobile clinics will bring some relief to the public health care system by reducing patient arrivals at primary care clinics and hospitals.
“I’m engaging as many different forces, as many different players, and sources of finance as I possibly can to pilot the mobile care project,” Lee told CodeBlue in an interview in Parliament last Tuesday.
“I’m looking at setting up at least one mobile care centre with an MO (medical officer) or one MA (medical assistant), and perhaps another member of staff in a makeshift wound care centre for those with bed sores who are completely incapacitated, or people with amputation wounds.
“I’m even engaging in new forms and new ways of treating wounds – cheap economic ways of treating wounds.
“Wound care or mobile care has a very big correlation with, if addressed, a reduction of the burden on primary care. And when you have better primary care, you’re going to reduce the burden of hospital admissions and also hospitals. You see the chain reaction of the chain effect?”
According to the National Health and Morbidity Survey (NHMS) 2019, about 18.3 per cent of adults in Malaysia, or 3.9 million people aged 18 years and above, have diabetes. In Perak, diabetes prevalence is estimated at 17.6 per cent, or more than 272,000 adults.
Complications from diabetes include nerve damage, particularly in one’s feet and legs, that increases the risk of developing a foot ulcer (a sore or wound) that can get infected and not heal well. If an infection doesn’t get better with treatment, one’s toe, foot, or part of their leg may need to be amputated to prevent the infection from spreading.
Lee also expects the Ministry of Health (MOH) to play a role in the procurement of certain wound care drugs, paper applications, and such for his mobile care project — a proposition which he said Health Minister Dr Zaliha Mustafa did not reject in a meeting last December 15.
“But the idea is, I need to put my money where my mouth is. Let’s get the infrastructure done first. Get the hardware on the road and then we talk.”
Whole-Of-Society Approach In Curbing Overcrowding Of Emergency Departments, Public Hospitals
The 39-year-old legislator was also asked to comment on CodeBlue’s report on the severe congestion in Raja Permaisuri Bainun Hospital’s (HRPB) emergency department, where seriously ill patients, including ventilated cases, are stranded for up to six days due to insufficient critical care beds and staff.
CodeBlue reported that two HRPB patients died in general medical wards after they were stranded in the emergency room for more than four days, including one case that a doctor deemed to be a preventable death.
Lee said that when he was previously Pasir Pinji state assemblyman, he had suggested at the Perak state legislative assembly to decant patients from the public to private sector to reduce the burden on public health care facilities.
“Why not use an all-of-society approach to galvanise both private and public health care facilities to meet the needs?”
Lee, however, held that outsourcing public patients to private health care facilities – or the government purchasing private services – is not merely a simple decision involving the government just “footing the bill”.
“It’s a two-way negotiation – whether or not private hospitals, I would say, are accepting of what is within the fiscal capabilities of MOH or what MOH puts on the table. This is all about operationality; it’s all about fiscal doability.
“So yes, lives are at stake, but it’s not just about whether or not the government wants to force our patients onto private to accept. It is whether or not private would want to accept it on their terms.
“I think there’s equal responsibility – both in the public sphere and the private sphere – in this matter of the counting. I think we need to look at it in a holistic way, urgent as it may be and urgent we accept it is. Absolutely, unequivocally urgent.
“But I think the onus is not just on the government; it’s on private hospitals to take patients at the price that both sides agree on and take.”
Then-Health Minister Khairy Jamaluddin said in September last year that MOH outsourced 6,623 surgeries and procedures to private hospitals as of August 31, 2021, costing the government RM26.2 million.
The outsourcing of cardiology and cardiothoracic services – in particular to the National Heart Institute (IJN), a government-owned semi-private facility – cost another RM26.4 million.
Unlike private health care facilities, MOH does not generally produce a complete costing of its services, including the cost of facilities, equipment maintenance, land ownership, or staffing.