Hidden costs in transfers
IN recent days, there have been many reports in the media about irregularities in the acquisition of medicines for Malaysia’s government hospitals. Tenders are also in place for other activities like repairs and upkeep of hospital buildings, running of hospital canteens, sanitation and laundry, purchase and servicing of medical equipment (consumables and non-consumables) and non-medical equipment (air conditioners, furniture, etc).
The modus operandi in granting these tenders differ little from the procurement of medicines. The excesses linked to poor practices in granting tenders explain why hospitals run out of money for things like essential medicines before the fiscal year ends.
Large numbers of healthcare staff are constantly being transferred from state to state. A transfer to another state at our own behest means we ourselves are expected to shoulder any expenses incurred during that transfer. However, if the transfer order is issued by the Health Ministry (MOH), certain expenses will be borne by the ministry. While this seems fair, there are loopholes in the system.
Assume Dr X in Hospital A in Sabah/ Sarawak is ordered by MOH to report for duty at Hospital B in Peninsular Malaysia. The expenses incurred to transfer the doctor will fall on Hospital A. Dr X will be expected to write four or five official letters to movers. These movers are on a special list of those who are registered with the MOH and this list will be provided by Hospital A to Dr X.
After Dr X sends the official letters out to the movers, each mover will submit a tender to Hospital A and the person in charge will make the selection. Usually only one or two of the movers contacted will respond.
After the person in charge selects the mover who wins the tender, a letter will be issued by the movers in which they will specify the mode (usually ferry), cost, dates, duration, etc, of the transfer of items. A copy of this letter will be provided to Dr X.
The transfer across the South China Sea via ferry takes about two to four weeks. If Dr X’s car is on that ferry, there is no guarantee that Hospital A, Hospital B or the movers will provide a replacement car or reimburse the doctor for car rental should he need transport to get to work (which he obviously will).
There is much more to this process than meets the eye.
1. Out of the list of movers that are provided to Dr X for the purpose of writing letters to inform them to submit their tenders, only some of the addresses provided are genuine. This is why only one or two responses are received after Dr X sends out those letters.
2. If Dr X were to make independent enquiries from other movers, he would discover that his belongings can be sent via air (ex-MAS cargo) and delivered to his doorstep within 24 to 48 hours in Peninsular Malaysia.
3. The delivery via other non-registered movers will generally be significantly cheaper by comparison.
If Dr X were to approach the administrative staff in charge of these arrangements in Hospital A and ask for a review of the tender, given that there are more efficient and economical alternatives, his request would not be entertained. The reason is because mutually beneficial exchanges take place between Hospital A’s administrative staff and the movers as part of their “business understanding”.
There is a way of intercepting the irregularity (read corruption) taking place in this process. Dr X will have to write an official letter to Hospital A’s administration and reject the offer for a mover appointed by and paid for by Hospital A before the payment voucher is issued by the hospital. This means that Dr X will now have to foot the bill of an MOH directed transfer himself.
Thousands of doctors, nurses and other paramedical staff have been transferred between states for umpteen years. By now, it is a welloiled system with an established base and is running on autopilot.
DR A Seremban