Assunta Hospital Dilemma
By A
Specialist
Assunta
Hospital was indeed set up as a charity hospital. It received tax-free
status almost immediately. It grew almost exclusively from public
donations. When the hospital was established, the doctors were all on
salaries. It then decided to employ specialists who were also on salaries
initially. It was hoped that what the specialists earned from
private fee paying patients would offset the costs of treating poor and
indigenous patients.
That has all
changed. Where does the money go now? The following is not a
complete list.
The Board
initially consisted of 4 people. It is self-appointing. The nuns at the
Catholic church has no power to appoint members of the Board. The Board now
has, I believe, 28 people. They are all relatively well-known
and rich people. Yet they and their families enjoy free medical
treatment. The annual cost of this free treatment to relatively rich
people has not been disclosed. It could run into millions of
Ringgit.
The
specialists continue to be paid a salary which is raised annually because of
inflation. In addition they charge fees which have also risen
sharply. Only a small portion of these fees is deducted for the
hospital. However this is paid back by way of EPF contribution.
Many of these specialists therefore earn millions in their
EPF and millions by way of fees. They have become multi
millionaires.
One of these specialists has also been appointed to the Board. This is a conflict of interest because he is able to control the other members of the Board who are his patients. The Board therefore agrees to anything that this Board member recommends. It is an incompetent Board.
There used to be a retiring age. No more. Doctors serve at the pleasure as their member of the Board. They continued to be paid salaries and earn EPF even if they have reached the age of 70 and beyond.
All patients pay even if they are poor. A small discount is given for those admitted to 4-bedded wards.
About 15 years ago one private physician working with an American administrator from the US found out that many new hospitals in the US were closing down. They were able to buy relatively new equipment from these closing hospitals for about 10% of the original cost. These two parties made the following proposal to the Assunta Board:
Through an independent company they would purchase at their cost a cardiac cathlab, an MRI machine, 2 state of the art echo machines, an EB heartscan, 2 stress test machines, an intensity modulated radiotherapy machine (for cancer), a digital jukebox retrieval image system for doctors to read images acquired in the privacy of their rooms, several on-line viewing monitors and an electrophysiology lab. To run the EP lab in private practice they would recruit the services of a Phillipino specialist on contract for 3 years.
All this was free to Assunta. What was required from Assunta was space for which Assunta could charge a rental.
Any profits accrued after deducting costs would be shared on a 50-50 basis with Assunta since they enjoyed a tax-free status.
One of these specialists has also been appointed to the Board. This is a conflict of interest because he is able to control the other members of the Board who are his patients. The Board therefore agrees to anything that this Board member recommends. It is an incompetent Board.
There used to be a retiring age. No more. Doctors serve at the pleasure as their member of the Board. They continued to be paid salaries and earn EPF even if they have reached the age of 70 and beyond.
All patients pay even if they are poor. A small discount is given for those admitted to 4-bedded wards.
About 15 years ago one private physician working with an American administrator from the US found out that many new hospitals in the US were closing down. They were able to buy relatively new equipment from these closing hospitals for about 10% of the original cost. These two parties made the following proposal to the Assunta Board:
Through an independent company they would purchase at their cost a cardiac cathlab, an MRI machine, 2 state of the art echo machines, an EB heartscan, 2 stress test machines, an intensity modulated radiotherapy machine (for cancer), a digital jukebox retrieval image system for doctors to read images acquired in the privacy of their rooms, several on-line viewing monitors and an electrophysiology lab. To run the EP lab in private practice they would recruit the services of a Phillipino specialist on contract for 3 years.
All this was free to Assunta. What was required from Assunta was space for which Assunta could charge a rental.
Any profits accrued after deducting costs would be shared on a 50-50 basis with Assunta since they enjoyed a tax-free status.
It was anticipated that the pay-back for
this capital investment would be about 5 years. The proposers wanted
tenancy for 12 years. At the end of 12 years all equipment including
goodwill would be transferred to the Assunta Foundation free of charge.
This would enable Assunta to provide low-cost treatment for poor
patients.
This plan was rejected by the Board. Reason – sources informed the proposers that some directors including the doctor wanted this business to be a stand alone private enterprise in which they wished to have a share. This was not acceptable to the proposers. The proposers then abandoned this plan.
This experience shows that Assunta Hospital has become transformed into a money making machine for the doctors, members of the Board and the Manager. They now use business promotion and employ debt collectors who behave like loan sharks.
What is the remedy? First the doctors and consultants should be on salaries only like IJN and the Mayo Clinic. The hospital should allow more doctors to work in Assunta as private contractors. This is now prevented by the entrenched doctors. What all doctors can earn as fees must be capped on a sliding scale. All directors and their families must pay full fees and costs. Second, there must be a new charity supervisory Board. An independent audit department must audit all payments now paid to doctors.
The nuns who are left still live modest lives. They have lost control. And so has the Catholic church and the Bishops.
This sad state of affairs has been condoned and promoted by the Minister of Health who has always been from the MCA. It is about time that this hospital be removed from the control of the MOH and come under the Minister of Finance.
This plan was rejected by the Board. Reason – sources informed the proposers that some directors including the doctor wanted this business to be a stand alone private enterprise in which they wished to have a share. This was not acceptable to the proposers. The proposers then abandoned this plan.
This experience shows that Assunta Hospital has become transformed into a money making machine for the doctors, members of the Board and the Manager. They now use business promotion and employ debt collectors who behave like loan sharks.
What is the remedy? First the doctors and consultants should be on salaries only like IJN and the Mayo Clinic. The hospital should allow more doctors to work in Assunta as private contractors. This is now prevented by the entrenched doctors. What all doctors can earn as fees must be capped on a sliding scale. All directors and their families must pay full fees and costs. Second, there must be a new charity supervisory Board. An independent audit department must audit all payments now paid to doctors.
The nuns who are left still live modest lives. They have lost control. And so has the Catholic church and the Bishops.
This sad state of affairs has been condoned and promoted by the Minister of Health who has always been from the MCA. It is about time that this hospital be removed from the control of the MOH and come under the Minister of Finance.
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