Monday, October 26, 2009

IJN should be spared the "the second wave of privatisation"

IJN Holding and Tan Sri Nor Mohamad Yakcop has denied it. Tun Dr Mahathir Mohamad has in so many words repeated the call that IJN should not be privatised.

However, Najib's budget speech last Friday mentioned "the second wave of privatisation". The exerpt from his budget speech taken from his blog here is below:

Implementation of Privatisation Initiatives

28. The Government will gradually reduce its involvement in economic activities, particularly in areas where it competes with the private sector. For this, the Government will privatise companies under Ministry of Finance (MOF Inc.) and other viable Government agencies. The second wave of privatisation aims to enable the companies and agencies to operate more efficiently and expand their activities. This will reduce their financial dependence on the Government.
The big picture for the healthcare industry will have to consider the various trade agreements the country has commit itself to. The liberalisation process will involve the service sector and healthcare is included.

Despite all the assurance given, these considerations could make all of those involved in IJN very nervous. IJN is owned by MOF Inc..

If IJN is privatised

If IJN is to be privatised, it will come at the cost of rising medical cost to patients. There is no two way about it. Doctors fee and salary will rise. Medicine will be charged more expensive. Hospital support will cost more.

For IJN which is dependent on Government GL, that portion of the service will remain for the time being as long as Government has no other alternative hospital for heartcare.

However, there is the likelihood that if IJN is privatised, the Government throughput will be revoked later as further liberalisation policy will put pressure on Government to open up its patients to other private hospitals.

By then, IJN will have to compete in the same manner like other private hospital. This will defeat the purposes IJN was established.

IJN was established for the purpose of developing the nation's competency in healthcare, in particular heart care. Since it cost money to train and keep such specialists within the public healthcare system, a semi-private hospital was established using throughput of Government patients.

Another reason is to provide quality heartcare for the public. This objective should never be compromised.

The major shareholder of IJN was MOF Inc. since Government investment was usually placed under MOF then.

If IJN was to be privatised, one way would be to sell to a corporate entity in the manner the attempted bid by Sime Darby. BUt that have been rejected.

Another possibility is via Management By Out (MBO). For the current Management to buy even a portion for significant representation, it will cost them a bomb. Try value the land, property, equipment and other intangible after netting off the loans. That rules out an MBO.

If this blogger is a corporate player with a billion at his disposal and only see hospital business as lucrative, one way to get into IJN is to do a privatisation with critical members of IJN. In a normal hospital, the critical part of the operation are the nursing staff but they are not quite critical in a takeover exercise. Nurses are usually paid staff, not unionised, and thsu do not have bargaining power. For Specilist Hospitals in Malaysia, the Specialist are critical for the time being till their numbers become abundant that they lose bargaining power.

A shrewd corporate player would entice the doctors into a joint takeover seen as an MBO. Then create a situation to dilute their shareholding or buy them out for control like what happenned before elsewhere. Finally, turn the hospital into a purely profit making commercial entity. It is all kaching.

Saving IJN for public

The purpose this corporate game is exposed is to illustrate that privatisation of an institution like IJN will not serve to benefit the nation but will only be a short term financial excercise that benefit the greedy few.

Thank god there are no such doctors in IJN since they have signed a joint statement to reject Sime Darby takeover. They have stated that of utmost importance to them is their hippocratic commitment to patients healthcare.

But the risk of takeover is forever there.

In order for patients interest to be safeguarded, IJN should remain within the public healthcare system and structured as to ward off any attempt for takeover.

IJN was established as a corporate entity and was intended to be sustainably self sufficient and financially independent. The organisation and operation was developed for such a need. It means a simple single operation structure will not be sufficient.

As it is, IJN had taken up a sizeable borrowing with a Sukuk loan. So it requires a subsidiary need to be established for the loan to pass through and 'contain' the risk. (It is quite elaborate to explain.)

It is no more suitable to maintain the pharmacy, support services, and manpower development into departmental units within the hospital operation. By establishing subsidiaries, it could operate efficiently as cost centres able to reduce cost or profit centres that generate revenues through joint ventures or other modes.

The idea here is to improve revenue flow using the existing operation.

The manner these subsidiaries are arranged will depend on the purpose of the excercise. For IJN, the purpose is to maintain sustainability of the operation. The challenge to sustain operation increase as public demand increase and to reduce dependence on subsidy.

Of utmost importance, it has to emulate IMalaysia to be 1IJN: Pesakit diutamakan, Pemulihan didahulukan.

Another reason for institutions like IJN need to achieve sustainability is basically economics. The Government coffer is not bottomless and there are also other priorities.

Where to IJN?

There are many issues confronting the healthcare industry today. For one, what is the extent in the role of the private healthcare? The public's concern is that it is seen as merely cost plus profit money making venture. It is not contributing towards increasing accessibility to quality healthcare at affordable prices for the public.

The public healhcare remains burdened to take up that slack. IJN is only one of the pieces in the public healthcare system albeit a successful experiment.

The need is now to emulate working models like IJN or enhance the reach of such model to enable the lower income public without insurance and company coverage access to such quality healthcare service. As it is, IJN gives priority to Government patients and it is partly subsidised.

For such services to be made available all over the country, more such centres need to be built or existing institution need to be expanded geographically. THese need thorough thinking, planning and implementation.

How will the role of institutions such as IJN be? Will it be as a feeder to develop more doctors and medical administrator to other centres? Will it be dedicated to increase competency and research and development activities?

Will it be just one of the many specialist hospital dedicated to heartcare?

Should IJN remain as an investment in MOF Inc. to generate income? Or will it take some leading role by being part of the Ministry of Health?

All this can be explored with IJN being part of the public healthcare system.

In the spirit of IMalaysia: Rakyat didahulukan, Pencapaian diutamakan, the Government need to develop a sustainable public healthcare system that would serve the bigger healthcare need of the nation.

* Edited 8:30 PM


Anonymous said...

bila belum dapat jawatan tertinggi, macam2 janji ditaburkan, rakyat diutamakan. pemimpin kita ni tak ubah macam lidah "Y" la...asyik nak menipu rakyat...konon nya dasar privatisation tidak akan membebankan rakyat... PODAH...pemimpin kita kena lapangkan masa tengok wayang SICKO oleh produser Michael Moore,dasar liberalisasi kesihatan untuk golongan koperat ni lah yang akan menindas rakyat jelata dan dinafikan hak kesihatan...Penyamum punya pemimpin !

reverie said...

very informative content.the privatisation of IJN can lead to Malaysia becoming like the countries in the west where the health expenses for elderly sangat-sangat mahal dan mengarut. Right now we can still enjoy benefits from the services in IJN. Thanks for the info.

antubiul said...

That why Malaysia need a new goverment be it indian, chinese or Malay as the prime minister. Privatisation doesnt not really benefits Malaysian, you can see TM, TNB and Water plus Highways. After privatisation, TNB still enjoy subsisidies, TM has one of the highest rate plus the water tariff. Privatisation means prudent spending, less relying on the the goverment aka people moneys and better services tharefore it should be translated into low charges unfortunateley not.By now the BN goverment shoudl embark on how to provide free or cheap medical service plus medicine to the people. They shoudl ask themselves whay the people elect them to be up there, People fisrt or Najib first aka BN aka UMNO. Every year the directors are being paid hefty amount .Should privatisation be every Malaysian owns the company and hold at least 1 share per person?

Pekerja pariah IJN said...

Ini semua mesti pasal doktor yang tamak. Mereka nampak saja baik dan corteous. Yalah budak baik dan pandai dari sekolah. Itu dulu tapi sekarang dah berubah.

Gaji dia orang berpuloh ribu sebulan tapi bonus nurses dan orang bawah yang hanya beberapa ratus pun dia orang jealous.

Dgr2 allocation bonus ada surplus few hundred thousand. Itu pun dia orang insist semua kasi pada senior consultant.

Senior Consuktant2 di IJN dah greedy and arrogant. I suspect the Sime Darby takeover ada mereka dibelakang bersekongkol.

Tak semua doktor macam ini tapi beberapa doktor saja sudah cukup untuk ranapkan IJN.

MEsti ada nanti golden handshake la apa. Konon tanpa mereka IJn wud not be what it is today. Turn it the other way. Without IJN they wud not be as rich and lucrative as they are today.

Doktor2 ni pun banyak masuk lambat. Asyik pergi oversea. Tak peduli patients tunggu berjam2. They just dont care.

Of late pasal sibukkan nak manouvre, ada sampai amabikan pesakit hingga ada yang mati. Ad apesakit tak patut dibedah dia bedah pasal nak duit punya pasal.

Mata dia orang ni lihat duit dan gila kuasa.

Anonymous said...

Pekerja pariah IJN..

Gaji Dr Rob sebagai CEO IJN berkuatkuasa 15 Oktober sebanyak RM 65,000 sebulan.

Gaji Deputy CEO Dr Azahari RM 45,000 sebulan.

Dr Razali yg sebelum ni diarahkan jadi Chairman IJNSB, dah tolak jawatan tu psl politik doktor2 ni jugak.

Dulu beriya-riya benar melobi sampai jumpa Tun M cerita mcm2..duit IJN dah abislah, banyak sgt bos2 gaji besaq la..sumanya tak betul kat sini.

Bila dah dpt arahan suruh jawat jawatan, mula la mengelat. Antaq email kat suma staff bg tau yg dia masih lagi Medical Director. La ni kata Acting CEO la plak.

Depa ni ingat surat ARAHAN dari kerajaan tu macam surat tawaran minta keje ka? Ingat main-main ka? Apa agenda doktor2 ni sebenarnya? Korang nak semua ke? Tu la..bila dah tamak benda lain tak nampak dah!

Sekarang apa citer Dr Rob? Ko dengar la ckp si Ezani tu. Dia mmg kepala gangster kat sini. Tp kalau doktor pompuan atau pun nurse cun...itu lain cerita!

Si Ezani ni..Dia ni cita-cita besar. Ada member dia habaq mai, dia jadi macam ni bila kat luar rumah jer. Psl dia ni species yang takut bini. Agaknya dah ada kes la dulu. Agak aku laa..

Dia berangan nak ganti tempat CEO Dr Rob tu sbb kontrak Dr Rob cuma setahun. Datuk Azahari sbg DCEO kontrek 2 tahun. Tu psl la dia dok jual merata nama pompuan tu.

Radzif pegang sampai 3 jawatan: Grp MD, CEO IJNSB & CEO IJN College pun gaji dia cuma separuh dari yg Dr Rob dapat skrg ni sbg CEO satu anak syarikat. Apa cerita ni!! Doktor2 jer ke yang bikin IJN sampai ini macam hari ni? Orang lain? Dok goyang kaki saja ke?

Tapi, bukan semua doktor2 gitu. Ada yg baguih. Ramai yg takut seksa kubur. Ramai yg takut tak reti nak jawab bila di hisap Allah nanti ke mana pegi suma anugerah Allah beri tu. Depa ni sifat riak & takabur tak nampak la. Ramai..

Jadik..pendek kata..yg pariah tetap pariah..yang gemok cuma doktor2.

Dr.Zhivago said...


I have news for you.

Your blog has been banned from access by the IJN Sdn Bhd new CEO! (or maybe her cohorts)

I/we believe it has got something to do with your posting as well as the comment posted by Pekerja Pariah IJN.

The truth hurts & your blog, if its allowed to be accessed by IJN staff will de-rail whatever plans these people had in-store for IJN.

Mind you, your blog is the one that trashed the Sime Darby take-over plans 10 months ago.

Now the same players is at it again, battered and with bruised ego, but this time using another channelled.

It's no secret that the said doctor is proud to used the influence of the daughter of an elder statesman in forcing his agenda. The same way he used her to get your attention when you exposed him during the SD takeover.

You apologised back then, but this time around you need not to. He got another lady in front of him, this time around, to face the public.

More later.

But, i/we is wondering what do u called a person of high position in an organisation leaking CONFIDENTIAL information to the public??

A traitor?? Perhaps. But the choice of word is too strong. Help me out here please.

What's the motive of Datok Dr Nasir Muda in exposing the E&Y report to Big Dog?

A real mind boggling since he's such a nice person. Or is he not?

More of that later too.

Have a good night.

Walang Perapu said...

A Voice

Your blog di block oleh management IJN.

Someone must be uncomfortable with the comments made by Pekerja Pariah IJN and anonymous.

Apadah ... baru commentor dah tak senang duduk. Mesti ada cerita ini.

Anonymous said...

Hello, sepanjang tinjauan saya, tiada block of your blog. Mungkin Walang Perapu tidak pandai navigate komputer di IJN. Adalah beberapa kerat users di IJN pakai komputer melalui nominee sebab mereka ni kurang arif dalam penggunaan komputer. Ini mungkin punca masalah yang dikatakan oleh Walang Perapu. Merapu saja.

My Say