Of Little Napoleons…the Health Ministry and… the Sultanah Bahiyah Hospital in Alor Star

OF LITTLE NAPOLEONS… ..THE HEALTH MINISTRY AND… ..THE SULTANAH BAHIYAH HOSPITAL IN ALOR STAR

AHMAD SOBRI

It is appalling that the Malaysian public had to witness yet again another squabble between the Works Minister and Health Minister about the unending controversy of the still uncompleted new Alor Star General Hospital.

Earlier, the Deputy Minister of Health Datuk Dr Abdul Latiff Ahmad apparently accepted blame on behalf of the Health Ministry saying delays were necessary so infrastructural changes could be made to accommodate the latest technological changes in medicine.

Not so, said the Health Minister Chua Soi Lek still insistent that the Works Ministry with its changing contractors were to blame for the mess. Samy Velu, obviously peeved with the finger-pointing, sarcastically accepted blame for the delays,

In Operation Desert Storm, shortly after Iraqi troops rolled into Kuwait in 1990, the United States deployed to Saudi Arabia more than 20,000 medical personnel to provide medical care to coalition forces.

The medical infrastructure for the war included 50 to 500-bedded combat zone fleet hospitals deployed in various parts of the war zone. The scope of treatment available at these facilities mirrored fully-staffed hospitals in the United States. The first 500-bedded Fleet Hospital was built in just 16 days, with the help of Navy Construction Battalion Units complete with operating rooms that can handle general surgical cases, neurosurgery, thoracic surgery, orthopaedic surgery, intensive care units and radiological facilities.

These facilities were further supported by 1000-bedded hospital ships, each of which were equipped with 50 trauma stations that form the casualty receiving area, 12 operating rooms, a 20-bedded recovery room and 80 intensive care beds. The entire medical network comprising 60 hospitals and infrastructure to take in both military and civilian casualties was ready in three months so war against Saddam Hussein could commence.

This level of efficiency appears to elude our health planners and hospital builders in Malaysia. Granted we are in peace time and all these hospitals are Malaysia’s version of “super-hospitals” designed to last us generations, it still doesn’t absolve the persons involved in this muddle for wasting hard-earned tax payer’s money.

The existing 800-bedded Alor Star Hospital was built in 1907. The previous hospital had all the major specialties but in particular was noted for its work in the subspecialty of Urology. In view of Alor Star’s half a million population and indeed Kedah and Perlis 3 million population, more medical facilities were required for the states.

But true to the current penchant of the MOH in wanting to build unwieldy hospitals of dinosauric proportions, clearly outdated in today’s medical world where information technology has ensured that hospitals should be more compact and modular, a new hospital located at Jalan Langgar to be built at a cost of more than RM550 million ringgit started construction in October 2000 and was scheduled to be completed in 2003. So why the 4-year delay?

Health Minister Chua Soi Lek had reportedly commented that JKR is basically to blame as building hospitals are “agak rumit” (can be difficult). It appears the Health Minister is quite unaware that as far as engineering technology is concerned the building industry in Malaysia can surpass world standards if they put their mind to it and are indeed tendering for jobs around the world. The same sadly cannot be said for our Ministry of Health who can’t attract even our own Malaysian doctors to come home.

Architects and engineers design and build what the customer wants. And what the customer wants is detailed out in specifications. And what were the specifications that the MOH gave that these builders had such difficulty delivering? Was it the RM47/sf vinyl seamless flooring instead of the RM2/sf marble flooring? Or was it the Class 100 instead of the Class10,000 Operating Rooms that confused the contractors? Or perhaps the suppliers realized that the space allocated to them for the installation of their supercon MRI was too small too late? Or it could just be the landscape where instead of lilies the contractors planted orchids.

Or… maybe someone realized that there is more money to be made if new specialties like neurosurgery and cardiac surgery were added on? So what if I, the Pengarah, sign off a few extra VOs (Variation Orders) and set the whole project back.

As Pengarah I may be awarded a Datukship for bringing new technology to the state and may be even rewarded by being promoted to being Director-General of Health someday and of course I will win the lasting adulation of my clinical colleagues who will be doing multiple overseas trips to choose new equipment and attend numerous courses and conferences to learn about these new medical marvels all on tax-payers money and sometimes by courtesy of the supplier himself who will of course would have no qualms marking up the equipment cost to accommodate these trips. So what’s a few years and a couple of million extra? Shortage of staff and specialists? That wouldn’t be my problem because by then I would have retired.

Puzzling indeed are media reports commenting that the new hospital would have state of the art cardiac surgical facilities. Because of the rising incidence of heart disease and the very gratifying results of surgical treatment more of these cardiac units were planned for Ipoh, Kuantan, Kota Kinabalu, Malacca and Kuala Trengganu (Though maybe not in this order).

Priority of course will be based on population statistics, incidence of disease, logistics, etc. But surprisingly the next cardiac unit due to open is in ALOR STAR. This appears to be mind boggling, as Alor Star is very close to the nation’s Northern regional center based in Penang when surely places like Kota Kinabalu, Ipoh or Malacca with a larger population base require these units more.

On closer investigation the decision to have it there may be the problem of Pak Lah’s favorite theory of Little Napoleon’s trying to sabotage the government’s efforts to have more equitable health care by hijacking health funds.

Granted everyone wants his or her hometown developed but healthcare cannot usually be rationed this way. Tax payer’s funds must be invested carefully based on need rather then parochialism.

For those in the know, Latiff, is of course, right. For individuals who advocate that the MOH should still be health managers of our health resources in this day and age, the saga and problems of the new Sultanah Bahiyah Hospital in Alor Star, the Sultan Abdul Halim Hospital in Sungai Petani, Sultan Ismail Hospital in Johore, the never-ending upgrading work in the Sultanah Aminah Hospital in Johore and the now crumbling Ampang Hospital should be a revelation of what happens when there is little accountability when projects of first world infrastructure are managed by a third world mentality.

If anything else, it should remind the public how callous officials are when public funds are involved.

22 Replies to “Of Little Napoleons…the Health Ministry and… the Sultanah Bahiyah Hospital in Alor Star”

  1. LIARS PASSING THE BUCK AROUND
    It is the absolute right of the State to supervise the formation
    of public opinion. If you tell a lie big enough and keep repeating it, people will eventually come to believe it. The lie can be maintained only for such time as the State can shield the people from the political, economic and/or military consequences of the lie. It thus becomes vitally important for the State to use all of its powers to repress dissent, for the truth is the mortal enemy of the lie, and thus by extension, the truth is the greatest enemy of the State.
    Joseph Goebbels,
    German Propaganda Minister, 1933-1945

  2. Excuse me. I have a simple question to ask.

    I don’t care about nice buildings and state of the art whatever, constructed at the phenomenal cost of some USDLS150.00 million (a cost mind boggling even by U.S. standards) but who pays for the cost of open heart surgery? Who has RM50,000.00 to spend to have the operation??

    What happen to those who could not afford the cost of this surgery? Too bad? No health insurance?

  3. bla bla bla … yada yada yada …

    to be honest I m sick n tired of the things goin on in Msia …

    even more sick n tired of the ignorants living in Msia …

    but I see no ways to make ppl change unless they get hit face on with the very problems that they created or chose to ignore …

    only when the country has gone down into the dumps then maybe the masses would wake up and the intellectuals stand a chance to correct the wrongs … otherwise let everyone dream on …

  4. And dont forget abt the defects faced by another hospital in Ampang. Too much corruption and bribery in the hospital sector and I can attest to that! Docotrs and even purchasers are on the take. So sick of it that I quit my job as if “you dont feed them, you wont get the damn deal” no matter how cheap and good your products are. Taxpayers money are actually given to these ppl who are on the take. Little Napoleans are more daring becos Bigger Napoleans are still on the loose. Monkey see, monkey do. What have you gotta say Mr PM?

  5. I think the Ministry that selects the contractor should take more of the blame and I believe in most major projects, the decision is made by the Finance Ministry.

    In yesterday’s papers it was also reported that the new hospital in Ampang, KL also has problems of fungus, leaking roofs etc.

    http://malaysiawatch2.blogspot.com/2007/03/another-hospital-disgrace.html

    Another case against Malaysia operating any nuclear power station in the near future.

    And KLIA is in the news for the wrong reason today. Power failure with no quick back-up facility. Guess a few planes may have landed without ATC guidance.

  6. well, Najis said tt he prepared to divulge e bumi equity calculation but still haven deliver. then semi value says he will show highway concession but also haven deliver. so how bout asking CSL to show cost breakdown of hospital construction. RM550mil for a crappy hospital building. High price n summore delay by 4yrs.
    If CSL says tt it is difficult to do it, then tt means tt his planning n execution competence is too low for e job so he should juz step down or get fired. It is by his own confession tt he is not good enuf.

  7. “there is little accountability when projects of first world infrastructure are managed by a third world mentality. ”

    This one sentence says it all.

    And it is not just the hospitals. It is just about everything else like the MRR2 fiasco, the Matrade building etc. the list goes on. The callousness arises from the fact that we have a half past six Govt. that is afraid to take the necessary actions when things go wrong. The practice of “close one eye” is a disease that goes to the very top. Why is that no one has been held accountable until today for all those fiascos and scandals? In a neighbouring country, a collapse in the earthworks while building a tunnel and killing three workers in the process resulted in a full scale enquiry and those responsible were severely punished. In Malaysia, you could expect such an incident to be swept under the carpet because the main contractor is a company linked to a major political party. This is the sad state of affairs.

  8. Prime Minister: “I’m still in control” Is he really?

    The head is having an Ostrich Syndrome, burying his head in sand, doesn’t seems to know what to do and too proud to admit to it.

    His ministers squabble among themselves but he is not aware, while his No.2,
    Najib needs an excuse to give his large enthourage of umnoputras on tow a holiday, and on tax-payers’ money!

    And btw, he was in South Korea to look into the National Service? Why South Korea when there’s so much to emulate from south of our border, boleh jalan kaki ke sana pun.

  9. Finally, it’s official! Chua Soi Lek is officially in the half-past-six list of Ministers.

    We have to wait very patiently for the next General Elections when we can then say to all these BN Ministers, Deputy Ministers, MPs and Assemblymen – vaaamoooooose!

    What could aptly describe them but some of the carefully chosen words of Shakespeare: “This is the rankest compound of villainous smell that ever offended nostril.” (The Merry Wives of Windsor, ACt 3, Scene 5, 82-84).

    Shakespeare is the greatest wordsmith that ever lived. His way with words penetrates our brains and lodge in our hearts. And, if he were alive today, he would have said so bluntly when confronted by BN’s unmitigated greed: “You are polluted with your lusts (Henry VI)

    Believe me, Shakespeare would have reserved some of his choicest words for SAmy Vellu and his train of corrupted projects: “It appeareth nothing to me but a foul and pestilent congregation of vapours.” (Hamlet). And of diseased and decaying hospitals, Shakespeare would have roundly heaped his scorn: “She has as many diseases as two and fifty horses.” (The aming of the Shrew)

    I am sure Confucius would have some very similar things to say. Let’s see what we can find in his Analects. Watch LKS’ blog.

  10. There were a meeting taken place in 2003 between Health Ministry(HM), JKR and the main contractors(MC):-

    MC: Project ini perlu siap cepat-kah?
    HR: Tentu. Hospital in mesti siap cepat. Tapi kami nak tambah sikit.
    JKR: Tambah apa?
    HR: Facilities untuk penyakit jantung. Ini penting untuk pesakit.
    MC: Macam ini kami nak tambah masa.
    HR: Berapa lama?
    MC: Kamu perlu satu tahun untuk approval. Satu tahun order equipment. Satu tahun untuk terima equipment. Kami perlu satu tahun bina wad jantung.
    JKR: You jangan cakap besar, 4 tahun cukup-kah?
    MC: Cukup, tapi mesti tengok budget juga.
    HR: OK, janji jangan “delay”. Budget tentu ada.

    Back to 2007:-
    CSL: Terrible, the delay of 4-year is unacceptable.
    SV: It is all because Health Ministry needed additional facilities.

    Well, please check what happen during the course of construction. Don’t tell us there were no document being exchange among the parties.
    This country of us, how can we be proud being Malaysian.
    And, we blame Singaporean is too arrogant!

  11. Minister Chua and Samy should talks behind closed door to settled the issue. Ministers must be reminded that all their wrongdoings must be conceal from the public knowledge. And the newspaper, which belong to the party, should not highlighted the squabbles between two ministers in the future, they should instead write about how the two minister has sat down together for years to resolve the delay of new hospitals. Who cares about the Rakyat? Is the contractors that we are helping here, any problems with that?

  12. If you were to do a mapping of all these fiasco, it will lead to a trail of corruption. If pressed further our SV will yield (as what happen to the MRR2) and link them to the finance ministry which gives out the contract. And who is the finance minister at the point of time. This goes to prove beyond any reasonable doubt that the whole cabinet is corrupted to the core and one is scratching each others back to share the loot. It is only the proportion of the loot for each others that we are not sure of; 70:30 or 50:25:25.

  13. The true fact is Contract was given out during TDM time to cronies who were not developers themselves but merely member of a ruling party or politicians. The numerous sub sub sub sub nature (only in Malaysia) Ahmad sub to Ah Kow (MCA), Ah Kow sub to Ah Tu (MCA), Ah Tu sub to Lan Pa. So what you expect project to move smoothly? JKR engineers may be doing an excellent job but that can’t stop sub sub sub sub contractors to go slow becos payment are hard to come by. So what quality of works you expect asal siap sudah.

    The 2 jokers are providing some light entertainment and blaming each ministry for the delay. The truth is the system that is at fault.

    Vote wisely and hope for a better tomorrow.

  14. The ministers can quarrel till the end of the days, nothing will be solved, no lessons will be learnt by them for future planning.

    A lot of time and resources are devoted to the spats with non productive retuns.

    At the end it is the tax payers who have to bear the ultimate costs of all the blunders.

    Almost every day, you open up the newspapers, you read about spats somewhere in the government, in the administration under Abdullah Ahmad Badawi.

    Have you read or heard that a government projects funded by taxpayers money being completed ahead of schedule, in superb quality, delivered ahead of time to the client, at below the cost estimates, well within the budgets allocated??

    Hardly or never. The country will remains in the “developing” cocoon comes what may 2020. Vision 2020 may just be a “fat hope” judging from the mentality of the governament voted by the people.

  15. Malaysia should be compared to a country pretty much like her. It is wrong to compare the medical facilities between Malaysia and USA. In Malaysia, it only cost a few ringgit to see the public service doctor and get a fair deal of medical services. In USA, without a health insurance, the medical personnel could just eject the patient from the medical facility the moment he or she says he or she does not have an insurance. Come to think of it, medical stuff is really expensive. Compassion comes with medical services. And if money is more important than anything else, medical services would become like a business. Example, you cut open the patient not because he needs that surgery, but because you want the extra money. It is therefore good for any layman to gain some medical knowledge and to know for himself or herself the kind of treatment that is best suited. But of course, he or she cannot be stubborn and refuse to listen to the advise of the doctor or the nurses. Simple treatment like for example Panadol. The side effects Panadol gives you might be different from mine. I might feel sleepy and you might be sweating away. I may need two tablets while you only need one tablet. If the effects of Panadol can vary from one person to another, other medicine and other forms of treatment vary too.

  16. “In USA, without a health insurance, the medical personnel could just eject the patient from the medical facility the moment he or she says he or she does not have an insurance.” Pengajar

    You cannot be more wrong.

    In the U.S. the health care system is among the best. Of course, it cannot beat the cradle to grave system of the United Kingdom.

    In the U.S. even an illegal alien or an undocumented worker will not be refused medical attention because he is illegal or do not have insurance. An illegal alien (or ‘pendatang haram’ in Malaysia) will not be refused medical attention. He will not be refused medical attention because he has no insurance.

    In Malaysia, if you are in need of emergency surgery you will not be admitted to hospital, be denied of medical care if you cannot afford to pay for it.

    If you are in need of a coronary bypass and cannot afford the cost which I believe is about RM50k you’ll be left to serve out your dying days at home. It is very much like a death sentence. In the U.S. the tax payer is left to pick up the tab – an operation like this costs some USDLS 55k. The availability and quality of medical services does not depend on your legal status, your ability to pay for them if you appear in the ER after calling 911.

    That’s how primitive Malaysia is with the health care of its citizens.

  17. blame here, blame there, blame this person, blame that person…..

    only blame, no action, been having 2 MCA guys for health minister now, and the same poo still reappears, perharps they should walk the talk or just resign.

    hope they suffer heavily in johor in the next GE

  18. Carnival being setup just across the road at Hospital Ampang. This carnival is here for the third year – does it not cause noise pollutant? Did it get approval and if yes, why is it approved when there is a hospital here?

  19. Have you seen or ever been to a chinese medicinal shop which we perceive to be so orderly, well organised, medicines easily dispensed with ease and precision sometimes using the old “daching” for olden day shops and digital scale for the more advanced, one would wonder how these two chinaman jokers in the health ministry could not even match these organised chinese traditional medicine facility. You could see throngs of people with health problems visiting the chinese doctor, getting diagnosed with the relevant prescriptions albeit paying out a substantial amount.

    They are happy and it has been going on for centuries with even the modern, educated people visiting with ease and confidence.

    These two health ministry jokers who cannot even complete a hospital in good time and in good shape should pay a visit to the Chinese sinsei and get one or two pointers on Organisation and Management and Precision.

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