Groups: GPs can help ease emergency dept case load

Kuala Lumpur General Hospital (HKL) —AZMAN GHANI/The Star

PETALING JAYA: The medical fraternity is suggesting a public-private partnership by tapping the underutilised pool of private general practitioners (GPs) to help alleviate congestion at hospital emergency departments.

Malaysian Medical Association (MMA) president Dr Muruga Raj Rajathurai said that the private sector’s role through public-private collaboration should be one of the ways forward in the Health Ministry’s engagements.

“Apart from the need to increase manpower at public healthcare facilities to manage the high patient load, the government should tap the strength of the 8,000 private GPs that are well distributed nationwide.

“Most of the cases at public healthcare facilities are chronic cases that can be referred to private GPs through a public-private collaboration.

“This will decongest the public healthcare system. Most patients, we believe, will find it more convenient having their follow-up at a nearby private clinic,” he told The Star yesterday.

Dr Muruga’s response comes after Health Minister Dr Zaliha Mustafa’s statement on seeking comprehensive solutions with stakeholders to address the issue of overcrowding at hospital emergency departments.

She said some of the ways include extending working hours, streamlining bed management systems, and adding more healthcare providers.

Dr Zaliha had said that by the end of last year, patient arrivals were expected to return to the same levels as before the Covid-19 pandemic, which was about eight million patient arrivals per year.

Dr Muruga welcomed her strong commitment to resolving the issue of overcrowding at public healthcare facilities in the country.

The MMA, he said, is looking forward to meaningful engagement with the ministry and other stakeholders in the hopes of resolving the issue.

Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah said redirecting green zone cases from the emergency department to private general practitioners could help alleviate the congestion.

“The public-private partnership was successful during the Covid-19 pandemic with testing and follow- ups. So now we just have to extend it for emergency cases.

“This can be done through subsidised treatment. Educating the masses is the most important thing to do so that emergency services are not misused.

“A mother with a baby having a fever – for us, it’s trivial, but for her, it’s an emergency,” he said.

He added that the issue surrounding the overcrowding at the emergency department has been a longstanding problem, with many studies and engagements having been done before.

“Employing more staff and carrying out study after study is costlier to taxpayers,” Dr Raj Kumar added.

Malaysian Public Health Physicians Association president Datuk Dr Zainal Ariffin Omar suggested that patients be transferred to private facilities with a reasonable payment or reimbursement mechanism.

“It is not appropriate to increase hospital admissions for the sake of reducing overcrowding, as it will overburden the hospital and add pressure,” he said.

“As for opening or increasing the operating hours of some health clinics for outpatient treatment, this must be done with a mechanism for improving space, the number of staff, and incentives,” he added.

The ministry, he said, must engage all parties and be brave as the gatekeeper in the healthcare facilities system and not entertain non-serious cases using hospital facilities to the point of causing confusion.

However, Association of Private Hospitals Malaysia president Datuk Dr Kuljit Singh said private hospitals have limited capacity to help at this stage due to a lack of beds for paying patients and insurance policy holders.

“The issues of manpower shortage still exist, particularly in nursing; hence, we are not able to assist further.

“We have a long wait time at our own private hospital emergency rooms.

“The request to have foreign nurses help us in private hospitals is still being discussed, and we hope there will be a decision soon,” said Dr Kuljit.

Former Health deputy director- general Datuk Dr Christopher Lee expressed his thoughts on the issue by tweeting that hospital directors must set up a sustainable and effective system to address congestion in emergency departments.

“Remedial actions are not new. Some of them had previously worked. Sustainability or lack of [is] often the Achilles heel,” he tweeted on Monday.

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