A proposal by theGalen Centre for Health and Social Policy that the government should lease a medium-sized private hospital in Petaling Jaya and convert it to public use is well-intentioned and reflects the frustration with the challenges of new hospital construction in Petaling Jaya (PJ).
Galen Centre chief executive Azrul Mohd Khalib rightly pointed out that building a new general hospital in PJ is not a video game exercise. The critique of the construction-first approach is fair, but the proposed solution, leasing a private hospital and operating it as a public facility, carries many of the same structural problems it seeks to avoid, while missing the more fundamental issue entirely.
It is not solving the underlying issue, which is access to health care services that the public needs.
Why Leasing A Private Hospital Isn’t The Answer
The staffing crisis is the core problem, and wet-leasing a building does not solve it. As Azrul himself acknowledges, the 304-bed Pasir Gudang Hospital remains more than 60 per cent unfilled despite being declared operational.
A leased private hospital in PJ would immediately face the same constraint. A medium-sized private hospital of 200 to 300 beds requires hundreds of nurses, doctors, pharmacists, and allied health professionals. These do not materialise with the lease agreement. They must be recruited from a market already hemorrhaging personnel into the private sector and abroad.
Converting a private hospital to full public operations would likely trigger the departure of its existing private-sector clinical staff, who joined on private-sector remuneration terms and conditions.
The government would inherit a building stripped of the human capital that made it function. Refilling it with public-sector staff means cannibalising surrounding hospitals and clinics – Kuala Lumpur Hospital (HKL), Universiti Malaya Medical Centre (UMMC), and Shah Alam Hospital – reducing their capacity to solve PJ’s capacity problem by creating a new one elsewhere.
Operationally, private hospitals are built and configured for private-sector patient volumes, billing systems, case mix, and financial models. Converting them to handle public-sector demand, higher volumes, more complex social presentations, and a different clinical profile, without significant reconfiguration, is operationally optimistic.
The Real Problem Is Access
PJ’s health care problem is not simply that there are insufficient beds. It is the existing mix of public and private facilities is inaccessible to the population that most needs them: the lower-income working population, uninsured, and elderly without family transport.
A large proportion of PJ’s population can physically reach both public and private health care facilities. If new facilities are required, the focus should be on day care treatment centers.
What prevents access is cost, information asymmetry, wait times, and the absence of a coordinated pathway between primary, secondary, and tertiary care.
Reform Access
The government already has a tool it has consistently underutilised; the private hospital network that offers diagnostic efficiency and treatment. Rather than leasing one hospital outright, the Ministry of Health should negotiate structured public access agreements with multiple private hospitals across PJ and the surrounding corridor. It needs to formalise agreements at the hospital, general practitioners (GPs), and private labs.
Specifically, the government should establish a reserved bed allocation system, requiring private hospitals above a defined size to maintain a percentage of beds, perhaps 15 to 20 per cent available for public patients under a negotiated government rate. This converts existing private capacity into accessible public capacity without conversion costs, staffing disruption, or capital expenditure.
The government health clinic network in PJ is underperforming as a primary care gate. Clinics in Damansara, Taman Medan, and Kelana Jaya are overcrowded and understaffed. Efficiency is poor due to poor systems.
Strengthening these facilities, upgrading them into day care centres and fully equipped Mother and Child Health Care (MCHC) centres, extending operating hours to evenings and weekends, and formally integrating private GPs into the network, would transform them from bottlenecks into genuine first-line facilities.
Empowering these upgraded clinics to manage a broader scope of chronic conditions, including diabetes, hypertension, asthma, and mental health, would divert a significant volume of cases currently presenting unnecessarily at tertiary emergency departments, reducing pressure on UMMC and Shah Alam Hospital without adding a single new bed.
Telemedicine and digital health, already partially enabled under existing MOH policy, should be mandated as the first point of contact for non-urgent cases across all government-registered primary care facilities in the PJ corridor. Reducing unnecessary physical visits by even 20 per cent would materially reduce pressure on emergency departments across the system.
The MySejahtera and Peka B40 frameworks already have the data infrastructure to identify high-risk individuals, and proactive outreach through community health workers, Community Nursing Sisters, and health inspectors should be expanded to keep vulnerable populations out of the hospital in the first place.
National Health Insurance As The Structural Solution
The core driver of PJ’s access problem is not geography, but the absence of a universal financing mechanism that allows Malaysians to access both public and private health care without being constrained by income.
A national health insurance scheme, structured as a mandatory social contribution pooled across employers and employees, would fundamentally change the equation.
It would allow patients to seek care at any accredited facility — public or private — while the state manages cost and quality through the insurer function.
Countries including Singapore, South Korea, and Taiwan have demonstrated that national health insurance, when properly administered, expands effective capacity without requiring proportional increases in public hospital beds.
Malaysia’s EPF infrastructure is ready to administer such a scheme. The political will to implement this has been missing. Perhaps a model can be developed by using Petaling Jaya as a base?
Conclusion
The debate around PJ’s health care gap has been framed, understandably, around the absence of a government general hospital. That framing is not wrong; PJ does need better secondary and tertiary public coverage. But the solution is not to simply replicate the hospital infrastructure model in a new location, whether through construction or lease.
The solution is to optimise the existing system and infrastructure (private hospitals, public clinics, GPs, telemedicine platforms) and resources ( community health workers) that already exist in and around PJ and make it accessible and affordable for the public.
A national health insurance scheme provides the financing architecture to make that access universal and sustainable. Access reform costs a fraction of what a leased or built hospital would and has it advantageous in terms of health care deliveries.
Dr Mohamed Rafick Khan is a trained physician with 12 years of experience in military medical services and over 22 years of experience in the assurance industry. He retired as the CEO of a multinational reinsurance company in 2019 and remains active as an independent international assurance industry consultant.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
