Despite the large funding they receive, government healthcare facilities continue to lack essential disposable medical and protective equipment to treat patients, doctors said.

Billions of ringgit are allocated annually to the Health Ministry, the provider of public healthcare services. This year, the ministry received RM41.2 billion, more than 10% of Budget 2024.

Doctors who spoke to The Malaysian Insight on condition of anonymity admitted that medical equipment shortages are common in government healthcare facilities, especially clinics and hospitals in rural and remote areas.

A doctor at a hospital in Negri Sembilan said he had faced shortage issues in the intensive care unit (ICU).

The hospital where he works often runs out of reagents needed to dilute blood samples in the blood gas analysis (BGA) machine. The BGA machine aspirates blood from a syringe and measures pH and the partial pressures of oxygen and carbon dioxide.

Taking an arterial blood gas (ABG) involves using a needle and syringe to directly sample blood from an artery.

“We do it for ICU patients; all those who are intubated have to take the ABG sample.

“Typically, for one patient, we would run the sample four to five times within a 24-hour period.

“Inside the BGA machine, there is a reagent to dilute, to ensure there is no blood clot, and to run through the system.

“However, the reagent finishes very quickly, and we often face a shortage. So, when this happens, we just go clinical,” he said.

The doctor said that in such situations, they have to monitor the patient to assess how the patient is responding to medication.

“So we don’t have a quantitative number to show if the patient is improving or not,” he said.

The doctor added that the hospital where he works has only three BGA machines.

No glucose strips

The doctor said there had been times he had run out of glucose strips while treating patients.

“Although it doesn’t happen all the time, it has occurred. We cannot deny or ignore it.

“So, while treating patients, we might have to go and get the strips from a different ward or floor,” he said.

He said an assistant medical officer manages the inventory and needs approval from the department head to make a request to the ministry for supplies.

The ministry will sanction the request, but sometimes when the department submits a proposal for extra supplies, citing higher usage than normal, they don’t get it.

“So we have to make do with what is given to the department,” he said.

A doctor in Sabah said medical equipment shortages are common in rural clinics.

“I’ve experienced shortages of blood collection tubes, needles, syringes, glucose strips, blood lancets, and more.

“Even doctors have faced shortages of face masks, gloves, and some protective equipment,” the doctor said.

The disparity in healthcare access between rural and urban areas underscores the need for medical reforms.

A doctor in the government sector said it is common to run out of medical equipment at the end of the year.

“Something I’ve encountered during my years of service in the government sector is the shortage of critical medical equipment towards the year-end.

“For example, we’ve faced situations where there was a lack of pigtail catheters, which are a safe and effective method for draining pleural effusion.

“When we run out of supplies, the doctors, especially those in the surgical department, have to find other ways, like using antibiotics and closely monitoring the patients,” the doctor said.

Recently, an 80-year-old patient who visited Tanglin Health Clinic in Kuala Lumpur was informed that a glucose test was not possible as the clinic had run out of blood lancets.

When asked, the nurses said supplies had yet to be replenished.

Under Budget 2024, the Health Ministry’s RM41.2 billion allocation comprises RM35.2 billion for operating expenditure and RM6 billion for development expenses. Prime Minister Anwar Ibrahim said RM5.5 billion would be used to procure medicine supplies, consumables, reagents, and vaccines. – August 3, 2024.