1. Extra Rental Space for Compliance: Private Medical Practice Control Section (CKAPS) regulations often necessitate clinics to hire additional administrative staff for compliance purposes. As a result, clinics are forced to rent larger premises, significantly increasing rental costs, especially in urban areas like Kota Kinabalu.
2. Increased Administrative Staffing Costs: Compliance with CKAPS demands specialised administrative personnel to handle documentation, audits, and licensing. This adds substantial payroll costs to clinics already operating on tight margins.
3. Disparity in Medical Equipment Costs: Medical equipment in Sabah is significantly more expensive than in West Malaysia due to logistical challenges and limited local suppliers, further straining clinic budgets.
4. Higher Drug Costs in Sabah: Drugs and medical supplies are priced higher in Sabah due to transportation and shipping costs, compounded by lower economies of scale due to fewer distributors and smaller market demand.
5. Time-Consuming Licensing and Permit Processes: Obtaining or renewing a clinic license through CKAPS involves prolonged bureaucratic processes. Delays in approvals can lead to lost revenue and additional costs for clinics eg. rentals etc, while waiting to begin operations.
6. Frequent and Stringent Compliance Audits: CKAPS mandates frequent inspections, requiring clinics to allocate time and resources for compliance preparation. This disrupts daily operations and often necessitates hiring consultants, adding to operational expenses.
7. Mandatory IT Integration Costs: CKAPS requires clinics to implement electronic medical record (EMR) systems, incurring high setup, training, and maintenance costs. For rural clinics in Sabah, there is poor or zero internet connectivity makes compliance even more challenging, very costly or just impossible.
8. Renovation and Infrastructure Upgrades: CKAPS often requires clinics to have their infrastructure to meet compliance standards, such as designated waiting areas, storage rooms, or disabled- friendly access. These renovations are costly and burdensome for clinics.
9. Logistical Challenges in Rural Sabah: Clinics in remote areas face higher transportation costs for equipment, medical supplies, and compliance-related inspections due to Sabah’s challenging geography and grossly underdeveloped infrastructure.
10. Stagnant GP Consultation Rates: While general practitioner (GP) consultation fees have been capped at RM10 to RM35 since 2006, operational costs have risen dramatically over the years. This has created a financial stress and crisis to run a GP practice in Sabah.
In spite of increased medical equipment, drug, and labour cost, the Private Healthcare Facilities and Services Act 1998 (Act 586) standardises the GP consultation rate equivalent to those in Peninsular Malaysia.
Our Members of Parliament gave themselves a salary increment of 148 per cent in 2015, highlighting the disparity in prioritisation of essential services such as GP practices.
Five Recommendations For The Ministry Of Health To Consider
1. Introduce Location-Based Flexibility: Tailor CKAPS regulations to accommodate the unique challenges faced by clinics in Sabah, which will also directly decrease the burden of patient care seen in our public services.
2. Streamline Licensing Processes: Expedite clinic license approvals to avoid unnecessary delays and costs.
3. Subsidise Medical Equipment and Drugs: Provide financial support or subsidies to reduce the disparity in equipment and drug costs between Peninsular Malaysia and Sabah.
4. Adjust Consultation Rates: Revise the GP consultation fee cap to reflect inflation and rising operational costs.
5. Offer Grants for Infrastructure Compliance: Provide financial assistance to clinics needing renovations to meet CKAPS standards.
Addressing these systemic issues will help reduce the financial strain on GP clinics in Sabah and ensure sustainable health care access for the region’s population.
Dr James Jeremiah is the immediate past president and founding president of the Association of Private Practitioners Sabah.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
