Address critical shortage of beds at public hospitals

 

I’m glad to note that Prime Minister Anwar Ibrahim visited the third-class ward of the Hospital Kuala Lumpur (HKL) on April 11.

I’m even more glad he noticed that the ward was overcrowded.

Anwar said after the visit: “We have seen for ourselves how the third-class ward is a bit hot and crowded, and the (health) minister will bring it to the attention of the cabinet so that we can expedite what is necessary.”

On April 16, health minister Dzulkefly Ahmad was quoted by Utusan Malaysia as saying that HKL was set to undergo a RM200 million upgrade. The first improvement, beginning next year, will be to the air conditioning system at its wards.

The long-term plan, he said, would include the construction of more blocks to accommodate more wards.

That is to be welcomed.

I have visited some wards at HKL and they are overcrowded. It’s certainly not conducive for patients recovering from illnesses; and I suspect some become more sick in overcrowded wards.

Recently, much attention has been paid to the woes of doctors, including overwork and its resultant problems. Much has been said and written about the brain drain of doctors and the problems faced by contract doctors.

As important as the problem of overworked doctors is, as important as the contract doctor problem is, and as important as the brain drain is, there’s something even more important and urgent.

And that is the acute shortage of beds in Malaysian government hospitals.

It needs to be fixed fast because it involves patients’ health, and lives.

The shortage of beds is not getting the attention that it needs probably because professional bodies have spokesmen to press for solutions but patients or families of patients do not.

Most patients accept it or plead for an extension of stay or complain in vain to the hospital authorities.

Recently, I’ve been hearing more and more about the shortage of beds in public hospitals.

One person told me that the ward he was in was so packed and noisy that he could not sleep properly. He was glad to be discharged.

The accident victim also told me that he found the nurses to be a little slow in responding to his calls. “I was still a little dizzy and I needed to go to the toilet, so I asked a nurse to help me get up. She told me: ‘Get up by yourself’.”

I’ve also been hearing about how patients are often discharged as soon as possible to make room for new patients.

Just last week, I heard that a woman whose just-born baby had jaundice was discharged after two days and told to go for daily check-ups at a health clinic near her home.

I was told the ward was packed.

I also heard of the family of a woman who was in a coma after a road accident being told to take her home or shift her from the Penang hospital to a care home soon after she opened her eyes.

“Although she could not move or talk, and she was being fed milk via a tube, we were told to move her. We were told this was because she was at risk of infection from superbugs in the hospital,” the woman’s relative told me.

He suspects that the real reason is overcrowding because he noticed that there were too many patients in the ward.

How many beds are there in our public hospitals?

According to a factsheet from the ministry of health, there were 148 hospitals and special medical institutions in the country in 2022, offering a total of 45,167 beds.

In 2000, according to data from the Malaysian Department of Statistics (DOSM), there were 34,579 beds, which means there was an increase of 10,588 beds in 21 years in the whole of Malaysia.

That’s not even 1,000 beds a year.

If we take Penang as an example, in 2000, there were 2011 beds in public hospitals. This increased to a mere 2,133 beds in 2021, according to DOSM figures.

Overcrowding has its dangers: It means patients may have to wait longer than usual to be admitted to a ward and receive treatment; it also means that some patients may be discharged even before they have made a full recovery.

And with so many patients in a ward, the risk of infection is even higher.

Overcrowding – whether at the emergency rooms or wards – means that doctors and nursing staff will be overworked and will tire out faster.

And that’s exactly what is happening. Medical staff are protesting about overwork and the public is complaining about long waiting times.

But despite this I must say that I have been hearing good things about the service provided at government hospitals – especially the attitude and care shown by doctors and most nurses.

“The doctors are wonderful, have good bedside manners and are very hardworking but there are simply too many patients at the Penang hospital,” the relative of the coma patient told me.

Recently, I had occasion to visit HKL’s oncology ward to see a relative and I was told that the doctors were excellent and that the nursing staff were helpful.

That, I think, speaks well of the medical staff. Not long ago, many people had less confidence in public healthcare but not so today.

Also, private healthcare is too expensive. Malaysians who have sought treatment or been warded in private hospitals consider this sector a money-making machine.

Today, with the prices of goods and services continuing to rise, most people cannot afford private medical care.

That explains why public hospitals and clinics everywhere are brimming with patients. And that, in turn, explains the insufficiency of beds in public hospitals.

But overcrowding is not a new problem and, to be fair, the government has been taking measures to overcome it.

For instance, the government established a Special Task Force on Agency Reform to reduce patient congestion in public hospitals last year. It also allocated RM200 million for the outsourcing of patients from its hospitals to military, university, and private hospitals under Budget 2024.

But, as can be seen, it’s far, far from enough.

There is need for greater urgency in addressing this problem.

Considering Malaysia’s growing population (especially of the growing ageing population), the rise of new varieties of diseases, the sedentary lifestyle of many Malaysians, the increasing number of people going for regular medical checkups and the exorbitant cost of private medical care, the pressure on public hospitals will continue.

The government will be failing the people if it does not increase the health budget significantly and at the same time ensure there is no leakage of funds.

And it better have in place a plan for 20 or 30 years from now, when the ageing population would have greatly increased, so that there are enough staff, hospital beds and other facilities to ensure the health system does not collapse. - FMT

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.