Materia Medica Malaysiana

SHORTAGE OF NEUROSURGEONS Patients face deadly wait

Every minute counts with head or spinal injuries, but a shortage of neurosurgeons in government hospitals means some patients face a deadly wait.
Some patients had died and others suffered permanent injury while waiting for treatment, said medical sources.
Surgeons in government hospitals were on call almost every day of the year, and overwork and stress were taking a heavy toll on them, the sources said.
This situation may worsen, they say. Two of the 10 neurosurgeons in public service are on the verge of quitting to enter private practice.
With neurosurgery available in only six government hospitals, some urgent cases such as accident victims with head and spinal trauma now travel for hours for treatment.
Operations for other patients, such as those with tumours and neurological disease, are sometimes scheduled weeks, if not months, away.
These delays have resulted in deaths, particularly in the Kuala Lumpur Hospital neurosurgical unit.
These deaths, and cases of permanent injury such as blindness, were concentrated in HKL largely because it was the country’s main referral centre, he said.
Head of HKL’s neurosurgery department, Dr Mohd Saffari Mohd Haspani, denied that patients faced long waits.
However, deaths were unavoidable because there were simply too few neurosurgeons in public hospitals, which took "the majority of patient load", he said.
"In KLH, we do more than 2,000 neurosurgeries a year and I think that is more than any other neurosurgery centre in the world," he said.
Some patients’ conditions inevitably deteriorated when they travelled long distances.
"For head injuries, time is of the essence.
"For a patient from Malacca or Seremban referred here, the journey will take hours."
Ideally, travel for treatment should not take more than two hours.
KLH has three neurosurgeons, while Ipoh has one, Penang two, Johor Baru one, Kuching two and Kota Kinabalu one.
"Obviously when a patient is critically ill, we will push them up the waiting list and operate on them," he said in an interview.
"So it is not patients dying while waiting for surgery in that sense, it is the wait of transferring them from one place to another place to get to the neurosurgeons.
"We have shortened our waiting (time) to a minimum, to one or two weeks only.
"Sometimes we need imaging (which is one) of the factors that delay our operation time, but this is less than a month."
Meanwhile, Health director-general Datuk Dr Ismail Merican said the Government would ensure neuro- surgical treatment was available to all who needed it.
"We will ensure the services are available to them, we know who the surgeons are and will call them to make arrangements," he said.
"Nobody will be deprived of any service."
He said the Government was aware of the problem the shortage was causing, and would look into networking between public hospitals, private hospitals and universities.
He said the ministry planned to concentrate on improving human capital development in the Ninth Malaysia Plan and this would include neurosurgery.