Hos­pi­tals need spe­cial up­keep

The Sun (Malaysia) - - SPEAK UP -

FOR all in­tents and pur­poses, hos­pi­tals, es­pe­cially the ubiq­ui­tous gov­ern­ment ones across the coun­try, are spe­cial fa­cil­i­ties com­pared to other build­ings. Un­like of­fice blocks or shop­ping malls, gen­eral hos­pi­tals in par­tic­u­lar are heav­ily used on all fronts and run­ning round the clock, and can­not even stop op­er­at­ing for even a sec­ond.

Even a clock takes a break but not hos­pi­tals.

One needs to take a look at gen­eral hos­pi­tals, for in­stance, to see the con­ges­tion as peo­ple from ev­ery­where and be­yond seek treat­ment vir­tu­ally free in a coun­try that has one of the world’s best health­care sys­tems.

In a pre­vi­ous col­umn, I de­scribed the over-worked hos­pi­tal staff as “un­sung heroes”.

The point I’m mak­ing is that main­te­nance-wise, hos­pi­tals cer­tainly can­not fol­low the SOP adopted for other build­ings and fa­cil­i­ties. They are in a world of their own.

If Jose Mour­inho, the Manch­ester United man­ager, is called the Spe­cial One, gen­eral hos­pi­tals and other pub­lic hos­pi­tals in the coun­try are the Spe­cial Ones and their main­te­nance should be ex­tra spe­cial, too.

The is­sue has be­come even more crit­i­cal in the light of Tues­day’s fire at Jo­hor Baru’s Hos­pi­tal Sul­tanah Ami­nah (HSA). Six In­ten­sive Care Unit pa­tients died in this heart-wrench­ing tragedy that struck in the most un­likely of places of­ten deemed as the safest.

Amid the pan­de­mo­nium that fol­lowed, the heroic acts of hos­pi­tal staff and the prompt ac­tion by the fire­fight­ers helped save many lives.

Of course like for all tragedies, an in­ves­ti­ga­tion panel is be­ing set up to de­ter­mine its cause but the more im­por­tant thing is al­ways pre­ven­tion which is closely tied again to the ques­tion of main­te­nance.

It’s only af­ter this tragedy that we hear of Health Min­is­ter Datuk Seri Dr S. Subra­ma­niam talk­ing about an au­dit­ing ex­er­cise to be car­ried out to look into the state of gov­ern­ment hos­pi­tals, es­pe­cially those 50 years old and more, es­pe­cially from the fire risk point of view.

The HSA is 143 years old and one of the coun­try’s old­est hos­pi­tals.

Ac­cord­ing to a very se­nior doc­tor, a short cir­cuit oc­curred at the ICU of the hos­pi­tal a week ear­lier and the ward was shut down.

Malaysia is known as hav­ing First World pub­lic fa­cil­i­ties but the main­te­nance as­pect is still not a Malaysian cul­ture and some would de­scribe it as Third World. Even roofs of a newly-com­mis­sioned sports sta­dium and a hos­pi­tal have col­lapsed.

The se­nior doc­tor told me that all old hos­pi­tals in the coun­try do not have floor plans of build­ings and they are not even kept at the ar­chives of the Pub­lic Works Depart­ment.

And when five ser­vices at gov­ern­ment hos­pi­tals were pri­va­tised 15 years ago, when­ever there’s a sys­tem break down, like the elec­tri­cal sys­tem, the con­ces­sion com­pany will give con­di­tional ap­praisal of the present con­di­tion and the cost­ing to rec­tify the sys­tem.

The hos­pi­tal con­cerned will then send an ap­pli­ca­tion for a bud­get to nor­malise the sys­tem to the Min­istry of Health but more of­ten than not “life goes on as usual” as the min­istry faces bud­get con­straints, the doc­tor told me.

Then fin­ger point­ing fol­lows as the top min­istry of­fi­cers of­ten blame the con­ces­sion com­pa­nies for lack of main­te­nance but the com­pa­nies can’t do much with­out ex­tra bud­get and chang­ing the sys­tem is not part of their con­tracts.

This be­ing so, it’s time to re­visit such con­tracts where a higher pri­or­ity is placed on main­te­nance.

The doc­tor said pri­ori­tis­ing main­te­nance works in the bud­get is very much on an ad hoc ba­sis.

In the event of a fire, a hos­pi­tal can­not de­pend 100% on the Fire Depart­ment (Bomba) as it takes a while for fire en­gines to ar­rive.

“Ev­ery hos­pi­tal must be pre­pared to go into ac­tion when there’s a fire with all re­sources fo­cused and di­verted to help in that af­fected area and the hos­pi­tal’s own fire marshals to take charge while wait­ing for Bomba to ar­rive,” said the doc­tor.

The doc­tor is wor­ried that with the tragedy at the HSA, now all al­lo­ca­tions would most likely be di­verted to this hos­pi­tal per­haps at the ex­pense of oth­ers which are also fac­ing sim­i­lar risks es­pe­cially the ag­ing ones.

Al­most all hos­pi­tals es­pe­cially in the states are treat­ing well be­yond the num­ber of pa­tients they were built for, caus­ing serious wear and tear plus un­der-main­te­nance.

If there’s a sil­ver lin­ing or les­son that ought to be learnt from this tragedy, it cer­tainly is for de­ci­sion mak­ers at the Health Min­istry to get their act to­gether on the main­te­nance of the Spe­cial Ones.

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