KUALA LUMPUR, Jan 23 — The Ministry of Health (MOH) has proposed turning its Private Medical Practice Control Section (CKAPS) into a statutory body to regulate the quality of health care delivery in private facilities.
MOH deputy secretary-general (finance) Norazman Ayob, who is also the chief reform officer, envisioned CKAPS to act like the Joint Commission, an independent organisation that is the United States’ oldest and largest standards-setting and accrediting body in health care.
“We want to strengthen regulatory control of private health care facilities, based on value-based health care and diagnosis-related groups (DRG),” Norazman told a town hall last January 13 at MOH’s headquarters in Putrajaya on the ministry’s Public Service Reform Agenda.
“If we look at other countries like the US, they have a Joint Commission. This Joint Commission monitors the quality of health care delivery in all private health care facilities.
“They have a report card that is displayed and presented every year to see which hospital gets the most cases, but where patients are forced to return to get the same treatment at the hospital.
“In fact, in the US, there will be a post-audit after a patient undergoes treatment in a private hospital. That means other specialists will evaluate their peers on whether the specialist did it correctly. If the patient returns to the same hospital within a year after undergoing a procedure, that hospital must reimburse 50 per cent of the payment made by the patient. That’s how they evaluate private health care quality in the US.”
Norazman said, however, that upgrading CKAPS into a statutory body is still a preliminary proposal, pending discussions with the Public Service Department (JPA) and the Ministry of Finance (MOF).
Both general practitioner (GP) clinics and private hospitals have long complained about CKAPS’ bureaucratic regulations. The Association of Private Hospitals Malaysia (APHM) wrote in its 2024 Fact Book that the “bureaucratic maze” of regulations increases operational costs.
The MOH’s proposal appears to go beyond setting standards for private health care facilities, but to also look into health outcomes.
Rakan KKM Baseline For DRG, Launch By July In Selangor
Norazman announced that the Rakan KKM programme will be launched latest by July in a few MOH hospitals in Selangor, such as Cyberjaya Hospital and Sultan Idris Shah Serdang Hospital.
“This supports value-based health care as a baseline for DRG,” he told the town hall.
He said a DRG reimbursement model provides “certainty” to patients in private hospitals on how much they will be charged for procedures or treatment, unlike the fee-for-service model in which patients are billed “for everything you use. Literally, there’s no limit.”
“DRG is tied to quality health outcomes in private health care facilities.”
Norazman also said the MOH will begin using the DRG model to allocate funding to its hospitals, especially for operational expenditure, starting with Melaka Hospital.
Rakan KKM, the so-called “premium economy” wing of government hospitals, aims to provide “different services” for patients who can afford to pay.
“The quality is the same, be it for those who can or can’t afford it, just that we’ll charge those who are willing to pay,” Norazman said.
According to the Rakan KKM website, “premium economy” services for elective outpatient, daycare, and inpatient services include personalised care, specialist choice, and enhanced privacy.
Norazman touted Rakan KKM’s objective in retaining doctors and nurses in the MOH, but did not specify how much more they will be paid to serve paying patients than regular patients in the “public” wing.
“I understand that in Singapore, a basic entry level nurse can earn SG$3,000, which is nearly RM10,000 if converted. A staff nurse in Singapore can easily get SG$6,000 (RM19,779) to SG$7,000 (RM23,076),” he said.
“[Rakan KKM] will help ensure that doctors and nurses stay in the MOH by narrowing the wage gap, compared to what they earn in the private sector or overseas.”
Norazman also did not explain how additional human resources can be allocated for the Rakan KKM programme amid manpower shortages, especially nursing. He stressed at the town hall that health care workers’ participation in Rakan KKM will be voluntary.
From January 2024, the MOH was forced to divert all nurses from specialist clinics to wards in its hospitals nationwide, except the obstetrics & gynaecology (O&G) and paediatric departments.
Nursing manpower is also short in private hospitals, forcing the government to open up recruitment of foreign-trained nurses in the private sector.
