New Straits Times : June 2007

IN health care, it is the patient who matters above all else but try telling that to the robbery victim in Malacca who suffered four hours of excruciating pain from a gunshot wound to the abdomen after four hospitals reportedly refused to treat him.

Brought to the government-run Malacca Hospital, his wife was told that surgery was a no-go as the hospital’s CT scanning machine had malfunctioned. She contacted three private hospitals but they refused to admit him. The full circumstances of the incident — in which the doctors at the Malacca Hospital finally performed the operation as the man’s condition had deteriorated — are not yet clear. Cases of hospitals refusing treatment or admission may be isolated, but all are unacceptable, especially this latest one, which takes place over a year after the implementation of a law specially designed to prevent just this sort of thing from happening in the first place.

The Private Healthcare Facilities and Services Act, which compels hospitals to treat anyone admitted to their emergency wards, came in the wake of complaints about private hospitals turning away patients needing emergency care, and about exorbitant fees. The cabinet two years ago even warned that culprits would have their licences revoked, indicating the gravity of the problem. Sheer common sense dictates that hospitals with the facilities must render these services during an emergency. Those unable to do so should at least help stabilise patients and arrange for their transfer to another facility.

Left unchecked, this problem will lead to a suspicion that our private hospitals are inherently reluctant to take in "high-risk" patients — those in a life-threatening situation whose death could lead to malpractice litigation against the hospital, or those who can’t afford to pay the cost of treatment. Government hospitals must be commended for working under the constraints of limited resources, and in many cases serving as the "hospitals of last resort" for those turned away from private facilities, but they will from now on need to take greater effort in making sure that their equipment, especially those as vital as CT scanners, are kept in good working order at all times. If cases of patients being turned away from private hospitals continue, we may very well end up with no choice but to rely more and more on government hospitals, at least until private hospitals do more to convince us that they too fully abide by the "treat first, ask later" dictum.