Alifah Zainuddin | CodeBlue

MOH deputy secretary-geneneral (finance) Norazman Ayob says the ministry plans to establish Sultan Idris Shah Serdang Hospital as a National Heart Centre, in its bid to create centres of excellence under Rakan KKM. He describes IJN as “quasi government”.

KUALA LUMPUR, Oct 29 — The Ministry of Health (MOH) plans to designate the Sultan Idris Shah Serdang Hospital Heart Centre as a national heart centre, a role traditionally associated with the National Heart Institute (IJN).

Under the government’s new Rakan KKM initiative – a programme aiming to offer “premium economy” services at selected public hospitals for elective outpatient, daycare, and inpatient care – MOH intends to establish more centres of excellence within the public health care system, according to MOH deputy secretary-general (finance) Norazman Ayob.

“I know there are still a lot of questions about what this initiative is about, but basically, number one, it is not about privatising public hospitals. What we’re seeing here is the creation of centres of excellence within the public health care system,” Norazman told the MIH Megatrends 2024 conference last Friday, organised by MOH in collaboration with KPJ Healthcare.

“For example, let’s take our Serdang Hospital and its Heart Centre. We plan to establish it as a National Heart Centre. Of course, IJN is currently the National Heart Centre, right? But it’s not actually government-owned, right? It’s quasi government, I would say,” Norazman said.

“As far as the MOH is concerned, we are now identifying specific hospitals to be centres of excellence, like the National Cancer Institute and Kuala Lumpur Hospital’s Urology and Nephrology Centre,” he added.

Since its launch in December 2022, Serdang Hospital’s cardiac facility – a RM546 million project – has struggled with a series of maintenance setbacks.

In May, The Star reported that the centre’s four operating theatres (OTs) were unusable due to ongoing issues, leaving over 1,000 patients in a backlog for procedures.

While three OTs were reportedly back online by June, another round of electrical failures in July prompted a three-week closure, leading to further delays.

Last October 4, The Star reported, quoting an anonymous source, that all four OTs were operational again following extensive repairs to address recurring electrical issues.

Meanwhile, IJN, long regarded as the nation’s primary heart centre, is under pressure to implement cost-saving measures for the government. MOH is the payer for government-dependent patients at IJN, mostly pensioners and civil servants.

CodeBlue reported yesterday that both the MOH and the Ministry of Finance (MOF) recently directed IJN – which is owned by the Minister of Finance Incorporated (MOF Inc.) – to switch government patients from innovator to generic drugs to reduce MOH’s cost burden, following the government’s decision to allow pensioners to continue their care at IJN. Last year, MOH’s payments to IJN Sdn Bhd (IJNSB) exceeded RM600 million; outpatient visits formed majority of the cost.

The government’s blanket decision to shift IJN to generics – going beyond its existing dual supplier policy in drug tenders – has sparked panic among pharmaceutical companies. Industry sources warned MOH about potentially poorer clinical outcomes from a change in treatment regimen for high-risk heart disease patients at the top cardiovascular and thoracic care hospital.

Rakan KKM Hospitals To Offer Elective, Non-Emergency Services Only

Prime Minister Anwar Ibrahim recently announced during his Budget 2025 speech that Rakan KKM will launch in five MOH hospitals, including Cyberjaya Hospital, with investments from government-linked investment companies (GLICs).

These selected hospitals will offer premium economy services to “mid-tier and high-income” patients who can afford additional care options, Norazman said. These services would include doctor selection and a dedicated treatment lane separate from public patients.

These services, however, are only for elective and non-emergency cases, as Rakan KKM’s goal is to utilise government hospitals’ “excess capacity” after hours and on weekends.

Norazman told CodeBlue that the MOH is still finalising the list of Rakan KKM hospitals. “It depends on the capacity of the hospital. Of course, hospitals that have exceeded their capacity, we will not [force] them.”

CodeBlue understands that more than five MOH hospitals are currently under consideration and have been shortlisted for Rakan KKM, with Cyberjaya Hospital deemed “ripe for it” as it is not at full capacity, having only begun operations in November 2022.

On human resources, Norazman said in addition to MOH specialists currently in service, retired specialists would have the opportunity to return to government service under this model.

“First, we will have to seek the assistance of our specialists — but this is totally up to them, right? There’s no compulsion. If they want to be part of this programme, they are free to do so. If they decide that they don’t want to take part, that’s fine also.

“Let’s not forget that we also have our doctors and specialists who have retired. They are still fit to serve. We allow them the opportunity to come and serve.”

Will Rakan KKM Be Subject To Act 586?

When asked if Rakan KKM would be subject to the Private Healthcare Facilities and Services Act 1998 (Act 586), Norazman said the issue is currently under discussion within the ministry.

“This is also a debate within our ministry, because we are, in fact, using a public hospital, but part of it will be providing what we call a service quite similar that of a private hospital service, although in terms of charges, it won’t cost as high as what private hospitals charge.

“If we introduce this and find there’s no need to comply with Act 586, it would mean that these hospitals running Rakan KKM would have an advantage over private hospitals,” Norazman said.

He described Rakan KKM as “a kind of sandbox” and noted that, for now, the initiative is limited to partnerships with GLICs to avoid direct competition with private hospital groups.

“But having said that, of course, if this is a success, then I think we would see more requests from private investors to be part of this. But as I said, this would be a very good experiment as to how Act 586 will actually be applied in this context.”