Oleh/By		:	DATO' SERI DR. MAHATHIR BIN MOHAMAD 
Tempat/Venue 	: 	HOTEL HILTON, KUALA LUMPUR 
Tarikh/Date 	: 	06/12/84 
Tajuk/Title  	: 	PEMBUKAAN SIMPOSIUM MENGENAI 
			PENJAGAAN KESIHATAN 




Dif-Dif Kehormat; Tuan-tuan dan puan-puan.

Saya ingin merakamkan penghargaan saya kepada pihak penganjur Simposium
Mengenai Penjagaan Kesihatan yang telah memberi saya peluang untuk
berucap. Saya berharap perbincangan kali ini akan memberi sumbangan kepada
perancangan dan pengurusan perkhidmatan kesihatan di negara ini.

Ladies and Gentlemen,

2. Over the past 27 years we have been developing the medical and health
services of the country as part of the socio-economic development
programme. We have been able to develop infrastructures ranging from the
most peripheral midwives clinics to the high-cost high-technology
hospitals. We have also implemented various disease specific programmes to
reduce problems of major public health importance. The success of the
various programmes is reflected in the downward trend of a number of
diseases and the changes in disease pattern that we are currently
observing. We still have a long way to go in order to reach the status of
more advanced countries. The escalation of health care cost is a major
concern of the Government and we have to take steps to explore alternative
possibilities for health care financing, cost sharing and cost
containment. Although we believe that health is a universal right, the
attainment of that right at least at the minimum acceptable level must
necessarily be related to the financial capability of a country.

3. We have been building hospitals and have had a lot of experiences in
running them. But I believe there are three major areas which require
special attention.

4. First is the planning and designing of hospitals and the time taken to
complete these steps. Because of the special nature of hospitals, its
complex supporting services and peculiar engineering and utility
requirement, a hospital is one of the most complex building to plan,
design and construct. It requires a host of architects and engineers with
specialised skill and knowledge in hospital design and operation. There is
a need for us to build up sufficient pool of local expertise in this field
to cater for hospital construction and maintenance in the public and
private sectors.

5. Second is the construction and commissioning of the hospital itself. I
believe we can cut down further the period of building a hospital by
adopting different building methods and better coordination of the various
steps in its construction. Two hospital projects are now being implemented
under the turnkey system. We shall be following closely the progress of
these projects.

6. Third is hospital management. We need to infuse greater professionalism
into hospital management. The bringing together of medical personnels,
however highly trained they may be, in the most modern and well-equiped
hospital does not automatically result in an efficient and high quality
hospital care. They need to be supported by an effective resource
management, an appropriate working arrangement, clear assignment of roles
and functions, an efficient logistic and maintenance system, and good
information support.

Ladies and Gentlemen,

7. We have allowed a number of foreign firms to participate in our
development programmes, including the building of hospitals. What we hope
is that through association with local firms and demonstration of new
techniques, their local counterparts will be able to imbibe new skills and
expertise and thereby further improve our own capability. To use a
hackneyed phrase there would have been a transfer of technology.

8. Hospital care is the most expensive form of medical care. It requires a
high capital investment and an equal high running cost. It is also a
complex organisation to run and to maintain. The building of a hospital
must not only be fully justified, but also its design, equipping and
staffing should be such that construction and operation costs are kept to
the minimum compatible with good hospital practise. The design should be
simple as well as flexible to meet changing hospital practices. It should
also lend itself to easy maintenance. With regard to equipment, with the
present range now in the market, one should be able to choose the most
suitable in terms of cost and operation.

9. The growth of private sector medical services that we are observing now
in the Kelang Valley and in some of the major towns of the country is
unprecedented. These facilities range from single practices and small
maternity homes to hospitals of a few hundred beds. The location of these
practices is obviously influenced by the pull of market forces, namely by
clients who can pay for the services. Whilst welcoming this development,
because it supplements Government effort in providing medical services to
the more well-to-do urban population, the Government is acutely aware that
it can further worsen the current disparity in medical care between the
rural and urban population. Such a development is clearly undesirable.

10. For those who cannot afford, the Government will continue to provide
fully or partially subsidised medical services to the extent that the
country's economy can afford. Those in the higher income brackets should
be able to pay for their treatment and thereby lessen the burden borne by
the Government in shouldering the cost of health care in this country. The
private sector can further facilitate this cost-sharing by keeping their
charges as low as reasonably possible, by cross subsidy and by opening
clinics and hospitals in areas which are relatively under-serviced. In
this way the services offered by the private sector will be accessible to
a greater number of people, including those who would otherwise flock to
the already congested Government facilities.

11. Every industry, more so the health industry, has a social
responsibility. Private medical services should not be motivated
exclusively by profit. After all it is society which has granted more or
less monopolistic rights to the medical profession to practise their
occupation, and it is public fund which supports medical education. In
return it is therefore natural that the public expect reasonable
accessiblity to medical care, and are not denied medical care by high
medical charges, undue concentration of facilities in high income areas or
any other form of barriers erected against them.

12. To meet the needs of the community, a private hospital has to offer a
minimum range of services and facilities. Although the use of private
hospital services is to a large extent dictated by the ability of patients
to pay, in my view it is extremely important for the hospital to be able
to provide the services and facilities that are commonly associated with a
hospital in order to serve the local community as effectively as
possible. For example, the hospital should be able to provide accident and
emergency services at all times. No accident victim for example should be
denied first aid support simply because he is not a regular patient or
cannot produce the required surely. The Ministry of Health is now
reviewing the current laws relating to the registration of private
hospitals to ensure that the minimum legal standards will facilitate
optimum medical care.

Ladies and Gentlemen, 

13. Once again I would like to thank the organisers for inviting me to
officiate at the opening of this Symposium. It is my hope that all of you
will have fruitful deliberation during this one day meeting. With this, I
have great pleasure to officially declare this Health Care Symposium open