MOH: Patients Discharged From IJN Only When Stable, ‘Prudent Cost Control’ Essential

MOH says patients are discharged from IJN only when stable, with a monitoring period before returning to MOH hospitals. MOH adds that “prudent cost control measures” are essential due to rising expenses for referrals to IJN that are covered by MOF funding.

KUALA LUMPUR, Feb 27 – The Ministry of Health (MOH) clarified today that patients are discharged from the National Heart Institute (IJN) to MOH only when their conditions are stable.

This includes a monitoring period of at least six months to one year for adults, and one to two years for children, after which these “stable” patients return to MOH hospitals for ongoing care under cardiology and cardiothoracic departments.

“This strategic approach allows approximately 4,000 new patients to be referred to IJN annually, maximising cost-effectiveness,” MOH said in a statement today.

However, the MOH also acknowledged rising government expenses from coverage of patient referrals to IJN by the Ministry of Finance (MOF). Although operational as a private hospital, IJN is government-owned by the Minister of Finance Incorporated (MOF Inc.).

“While the expenses for these referrals are increasing annually, prudent cost control measures are essential to treat as many patients as possible with existing resources, ensuring fairness to taxpayers.”

CodeBlue published yesterday a letter by an anonymous pensioner who complained about IJN discharging all civil servants and pensioners, including himself, in past months to their nearest MOH cardiac centre due to an MOH directive, purportedly as a government cost-cutting measure.

He protested because of his complex condition, pointing out that although he was “stable” at the point of his discharge from IJN, his condition often deteriorated suddenly.

The pensioner – who had previously been under the care of IJN for 25 years – said the MOH cardiac centre that he was referred to told him they did not have the expertise to handle his case; nor did the MOH facility have a number of drugs that the pensioner was on. Using substitutes worried the patient due to his multiple drug allergies.

Hence, although the MOH’s statement was focused on the “stability” issue, the crux of the pensioner’s complaint was about the “complexity” of his condition that he felt should have merited continued IJN care.

The MOH’s statement today described the pensioner’s complaint as “misleading accusations”.

“Contrary to the article’s implications, MOH hospitals are well-equipped and staffed with qualified physicians and surgeons, offering services comparable to IJN,” said the MOH.

“The strategy of referring complicated and critical cases to IJN is aimed at optimising resource utilisation and ensuring the access of the general public to MOH hospital services. Therefore, sharing patient loads with IJN should not be mistaken as any form of incapacity on the part of MOH hospitals.”

MOH explained that IJN, which initially operated under Kuala Lumpur Hospital (HKL), have remained “long standing partners”, with IJN supporting public hospitals through patient referrals.

Currently, 10 MOH hospitals offer cardiology services, and seven provide cardiothoracic services nationwide.

“Together with these hospitals, IJN serves as a referral centre for patients requiring cardiology and cardiothoracic services, including civil servants, pensioners, and their dependents, with the government covering treatment costs.”

IJN Chair: IJN Hopes For Best Solution From Policymakers

IJN chairman Dr Noor Hisham Abdullah has urged the government to resolve the discharge of pensioners and civil servants to the MOH.

Dr Noor Hisham, who is also the former Health director-general, told Sinar Harian that IJN was forced to abide by government policy.

“IJN is the ‘recipient’, not the maker of policy. We merely abide by and implement existing policies and circulars,” Dr Noor Hisham was quoted saying.

“For this situation, we need to ask the policymakers, not IJN. We hope that this issue will get the best solution from policymakers.”

When contacted yesterday, an IJN spokesman referred CodeBlue to its previous press statement in September 2023 that dismissed a privatisation claim, in response to a pensioner complaining back then about the cardiac centre’s alleged refusal to treat retired civil servants. IJN is owned by the Minister of Finance Incorporated.

The September 2023 statement, citing a 2002 circular by the Health director-general, said patients are expected to be discharged back to the referring hospital 12 months after undergoing a procedure or surgery.

However, back in 2017, then MOH secretary-general Chen Chaw Min announced that the government still bore the medical cost of civil servants and their dependents, as well as federal retirees, at IJN. One of the conditions was for such patients to get a reference letter from specialists at government hospitals or clinics.

Rafidah Aziz: Don’t Play With Lives In Need Of Medical Treatment

Former International Trade and Industry Minister Rafidah Aziz described the discharge of civil servants and pensioners from IJN as a “most shocking development” and an “inhumane” measure.

“Surely ‘cost cutting’ should be targeted at the many wasteful ad hoc programmes, at all levels of government…for all kinds of ‘events,” she posted on her Facebook page.

“Not by playing with lives of those in most need of medical treatments, which smaller hospitals and clinics cannot provide.

“Has the Madani government suddenly taken a sharp U Turn…and IJN has done something truly at odds and against the grain with what is ‘Madani’.

Ischaemic heart diseases remained the number one cause of death in Malaysia, with 20,322 fatalities recorded in 2022, comprising 16.1 per cent of medically certified deaths, according to the Department of Statistics Malaysia’s (DOSM) 2023 report.

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