Patients Beware: The perils of private healthcare in Malaysia

The ethics void in the system

Over the last four years, I have received a large number of complaints about private medical care in Malaysia. My first article, “Medical Malpractice Nightmare in Malaysia” was published in the Asia Sentinel back in 2019. The situation has not improved since, and the Malaysian Medical Council (MMC) has responded by threats on my reporting. What’s most important is that aggrieved patients have only limited and expensive recourses to alleged wrong doings against them, which take years to conclude, if at all.

This article is a summary of some of the hazardous issues patients must consider when subjecting themselves to the private healthcare system in Malaysia.

Medical errors, mis-diagnoses, malpractice, negligence, misconduct, breach of ethics, and fraud is just as prevalent in Malaysia, as it is around the world. Official figures in Malaysia just don’t do justice to indicating the real magnitude of this issue. Data is not systematically collected.

The complexity of these cases and threats of legal action prevent the local media from reporting on most of these cases. Usually, only brief reports come out when someone may have won a case against the private healthcare system or any of the players involved. However, many cases are settled outside of court to keep them from the media. Sometimes the plaintiff’s lawyers issue a press release, as the local media wont report it.  

The long length of time to litigate medical malpractice cases is a deterrent. The system is slow, taking on average around four years. Some of the ‘victims’ I have spoken too have been trying to seek justice through the legal system for as long as 8-9 years. In some cases, claimants must sell some of their assets to litigate. In one case I am aware of the patient had to end up representing herself.  

The burden of proof by a claimant in medical negligence is so high, where many cases prove unsuccessful.

There are other hurdles such as the inaccessibility of claimants to access medical records, as the Malaysian Medical Council (MMC) guideline 002/2006 states that medical records are the property of the medial practitioner and healthcare facility. These records can only be obtained after claims have been made through the court process of discovery. There is even one case going on in court at this time where Prince Court Medical Centre is being sued by a plaintiff Christine Lees for releasing her medical records to a third party (Prince Court’s lawyers), for breach of confidentiality as evidence in a separate legal case.

The Malaysian Medical Council (MMC), which is the official registrar of medical practitioners will only consider cases of misconduct and breaches of professional ethics. The MMC screen claims through disciplinary tribunals, that are chaired and consist of peers, who know each within a small circle. Thus, the rate of claimants successfully obtaining results in their favour is very low. The MMC’s own statistics stated that although there were more than 3,500 cases reported to the ministry, only 150 annually make their way to an investigating panel. Over 14 years, only 14 doctors have been struck off, 39 suspended, and 73 reprimanded. Almost 90 percent are not investigated by the MMC and disciplinary action is taken is less than one percent. MMC Disciplinary Tribunal statistics were once publicly available, but now almost impossible to publicly access.

The biggest weakness within Malaysia’s medical legal redress system is that there is no mediation process within any legislation. Both the court and MMC processes are adversarial.

Mohd Ismail Merican, the former president of the MMC publicly warned in May 2018 of bias and prejudice by council members over discipline and professional misconduct, intimidation by senior council members and lack of transparency within council processes. Audio recordings made available to the writer clearly indicate this was certainly true in the case of a 35-year old Malaysian business consultant Nur Muhammad Tajrid Zahaian back in 2019.

The MMC is vigorously fighting a case in court allowing patients who had their cases heard under the MMC tribunal system being appealed in a court. This is the denial of natural justice.

With great limitations of the MMC, which ‘look after their own’, many are taking to the court system on claims of negligence, mal-practice, fraud and conspiracy. There are currently a number going through the court system now, of which two are summarised below:

The first case involves Prince Court Medical Centre, the same private hospital where Nur Muhammad Tajrid Zahalan’s case occurred. This case in 2016 involved twins who were born to a British mother. The twins were healthy at first, until one of them became seriously ill with a life-threatening infection. The mother has paid hundreds of thousands Ringgit to keep the son alive. At seven years old, the boy suffers regular pain and is disabled. He will have to have a number of surgeries, which will entail 8 to 12 months treatment each time.

It has come to light in the case, the doctor purporting to be a Paediatric Orthopaedic surgeon, on the Kuala Lumpur Medical Centre, had no such qualifications registered with the MMC or National Surgical Register (NSR).

In another case during the same year, a lady was diagnosed with a slip disc for the cervical, thoracic, and lumbar, together with arthritis. During her treatment, the patient was charged for equipment that wasn’t even used. She latter found the original diagnosis was incorrect, and her initial treatment has caused much pain and distress. She is now classified as disabled. Currently, the case against Pantai Indah Sdn Bhd and surgeons is in progress for fraud and conspiracy.

In both of the cases above, medical records presented to the court were marked ‘revised’, ‘amended’, or ‘addendum’, where MRI images were cropped. Documents are also incomplete or missing. This leads to claims of conspiracy between the hospital and the doctors.

In both cases above the patients were not offered any alternative treatment strategies by their consulting doctors. There is a tendency of doctors within the private hospital system to maximise the use of examinations, tests, and treatments to patients, especially to those with medical insurance.

Both the above cases show how unfriendly the court system and medical profession is towards victims.

One of the more alarming aspects of private healthcare is fraud. There have been a number of claims that patients are being charged for items and procedures that never took place. Some of these amounts are in five figures. Back in 2020, a hospital was fined RM200,000 for overcharging patients for masks. This appears to be only the tip of the iceberg.

This also leads to hospitals and doctors fraudulently making claims to insurance companies.

Seeking redress from the system is full of perils. The medical community is close knit and rarely speaks out against others. Thus, claimants in the court system find it very difficult to find reliable expert witnesses. Someone in the legal profession told me in confidence, that if you go against the doctors and one day get sick yourself and need them, your life will be in their hands. Lawyers, doctors, and members of the judiciary are all members of Malaysia’s elite establishment. Under such an environment, can a claimant obtain objectivity, with their peers in judgement?

Medical practitioners and the system around them are totally protected through a wall of peers, so wrong doers can get away without any consequences. Hospitals and the MMC are also compliant to this wall of silence. Justice is rarely done.

There is a complete lack of accountability in the system. Doctors and hospitals are unwilling to apologise in fear any apology will admit guilt and lead to legal retribution. The MMC will take legal action against claimants and those who criticise the organization and expose their failings to the public.

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