18 Pages Posted: 15 Jan 2012
Date Written: December 30, 2011
This is a preliminary study which examines the impact of the “Private Healthcare Facilities and Services Act 1998 (Act 586) & Regulations 2006 (PHFA)” on the medical practice in the corporate private hospitals (for profit) in Malaysia since its implementation with effect from 1st May, 2006. This historical Act 586 regulates all private healthcare facilities and services for the first time in the country after 35 years replacing the Private Hospitals Act 1971. The rapid development of corporate private hospitals from the mid-1980s, which was in line with the “Malaysia Incorporated” concept had led to an unprecedented growth of corporate private hospitals, the repercussions of which, had wide social economic implications in the health care sector which resulted in inequitable medical and health resources, and in some resulted in poorer quality of care. It is not uncommon to hear negative media reports of unethical practice in the management of some of these private healthcare facilities: questionable hospitals’ charges and padded bills; emergency services denied due to economic reasons, unreported assessable deaths, are some of the major concerns to policy makers. Further, it has been reported that professional medical indemnity and incident reports as a result of adverse events, medical errors and negligence in private hospitals are on the rise. Recognising the urgent need to address these issues of accessibility, equity, and quality care under a new regulatory framework, the Malaysian Government stated explicitly the intention of the government that it would gradually reduce its role in the provision of health services and increase its regulatory and enforcement functions in the Seventh Malaysia Plan (1996-2000), the government’s five-year development plans, and gazetted a comprehensive legislation, Private Healthcare Facilities and Services Act 1998 (Act 586) which was implemented in May, 2006. This study takes a close look at the regulation at work on ten study hospitals in the Klang Valley. The research methodology is designed by utilizing case studies and employs exploratory qualitative approach using key informant perception interviews and personal communications to obtain the relevant data. The research design encompasses two levels of studies, one at the corporate private hospitals sector as the regulatees and the other level at the Ministry of Health, Malaysia as the regulatory principal authority. Using the agency theoretical framework, the study examines whether the regulatory intervention have the desired effect on the behaviour of both the regulator and regulatees, and whether regulatory intervention achieve the Government’s stated objectives of accessibility, equity and quality care. The empirical findings among others indicate that full compliance to the provisions of the Act 586 and its regulations remains a challenge in the corporate private hospitals. On the other hand, while the Act 586 provides the enforcement capacity, the Ministry of Health Malaysia, as the regulatory body appears to be constrained with the insufficient human resources and information capacity. Faced with this challenge, the regulatory body seems to adopt a cautious and a non-controversial approach of “row less but steer more” in its role in driving the private health sector.
Keywords: Healthcare, private hospitals, regulations, Malaysia
Suggested Citation: Suggested Citation
Nik Rosnah, Wan Abdullah and Lee, Kwee-Heng, Impact of the Private Healthcare Facilities and Services Act 1998 (Act 586) & Regulations 2006 on the Medical Practice in Corporate Private Hospitals in Malaysia (December 30, 2011). OIDA International Journal of Sustainable Development, Vol. 2, No. 9, pp. 89-106, 2011. Available at SSRN: https://ssrn.com/abstract=1985214