On July 5, 2025, a CodeBlue article highlighted the plight of certain patients being deprived of, or having their treatment delayed in, public hospitals. It also raised concerns about establishing private facilities as alternatives for those with insurance coverage or the financial means to pay.
The services provided by the neurosurgical unit at Universiti Malaya Medical Centre (UMMC) and UM Specialist Centre (UMSC) were cited as examples of this problem.
I am writing this response as someone who had the privilege of establishing the neurosurgical unit in question, and who also served as both Medical Director and interim CEO of UMSC prior to my retirement. My intention is to provide a perspective from the other side of the coin.
UMSC was created in 1998 with the purpose of retaining senior staff within the university. It initially utilised excess facility time at Universiti Malaya Medical Centre (UMMC) and, over the years, fulfilled this role effectively.
By the time I stepped down as interim CEO in January 2021, UMSC was making significant contributions to UMMC through service payments, providing much-needed financial support to the public system. This contribution grew steadily and became an important expectation of the university.
Doctors practising at UMSC are also required to contribute a portion of their earnings back to the public system. These funds have supported clinical departments in research and academic activities, the Faculty of Medicine in its teaching mission, and UMMC in providing care for disadvantaged patients.
Until 2001, neurosurgery at UMMC was dependent on individual consultants who typically stayed only a few years. Over the following two decades, the unit grew into a team of eight specialist surgeons, producing quality research and establishing its own training programme by the time of my retirement in January 2025.
This was possible because UMSC allowed talented doctors to remain in the university rather than leaving entirely for private practice. I had the privilege of working alongside colleagues who went on to become recognised leaders in their subspecialties across the region.
The unit also developed some of the most advanced treatment facilities in the region, including intraoperative MRI and CT imaging suites, as well as radiosurgery facilities (Centre for Image Guided and Minimally Invasive Therapy, CIGMIT). These world-class resources benefitted both private and public patients.
Importantly, they were established through a successful Public-Private Partnership (PPP) model that did not require ongoing government subsidies, while still ensuring support for patients who struggled with treatment costs.
This PPP succeeded because of strong collaboration between UMMC and UMSC, which enabled an innovative business plan to be implemented.
With regard to concerns about doctor misconduct, such behaviour has unfortunately always existed in small numbers. These individuals, however, were the minority and were dealt with when identified.
Far more doctors made personal sacrifices—foregoing private work to treat public patients, or transferring patients from UMSC to UMMC when financial concerns were foreseen.
As is the case worldwide, escalating health care costs—driven by advances in technology—pose immense challenges for both patients and health systems.
It is important to recognise that UMSC has enabled many positive outcomes: retaining expert academic staff for training future doctors, funding care for underprivileged patients, and providing world-class facilities.
While challenges and occasional misconduct are inevitable, such issues can and must be managed by strong senior leadership guided by integrity and vision.
I served this system for 25 years. During that time, I had the busiest neurosurgical practice, yet my team never had a six-month waiting list. There was always a queue, yes, but patients were prioritised based on clinical urgency.
I do not believe any patient requiring urgent treatment was ignored. If indeed a patient was told they must wait six months for neurosurgical treatment, this warrants thorough investigation.
I fully acknowledge that those raising concerns had their reasons. Having worked in health care for 35 years, including in two other countries, I can say there is no perfect system—none pays doctors what they feel they are worth, nor provides patients with every modern treatment at a price they deem acceptable.
I am not here to defend every weakness in Malaysian health care. But I must stress this: a few negative complaints should not be allowed to derail an initiative that has brought real benefits to the university, the hospital, and ultimately, the nation.
As an academic, I believe this hybrid model—though imperfect—offers a promising alternative to the system we have today.
It remains a work in progress, but with senior management guided by integrity and vision, it holds great potential for the future. It works because of symbiosis; if it is split, all benefits will disappear and UMSC becomes just another private hospital with a government hospital for its neighbour.
Dr Vicknes Waran is a consultant neurosurgeon at Subang Jaya Medical Centre and Columbia Asia Hospital Bukit Jalil. He is also a retired professor of neurosurgery at Universiti Malaya.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
