Is IJN Discharging All Civil Servants + Pensioners Due To Cost?!

Is IJN (Institut Jantung Negara) discharging all civil servants and pensioners, following an MOH directive due to government cost-cutting measures?!

Take a look at the viral claim, and find out what the facts really are!

Updated @ 2024-02-27 : Added new section on KKM’s response to these claims
Originally posted @ 2024-02-26

 

Claim : IJN Discharging All Civil Servants + Pensioners Due To Cost!

A letter posted by CodeBlue has gone viral, in which a pensioner claimed that the National Heart Institute (IJN) is discharging all civil servants and pensioners, following a Ministry of Health (KKM) directive due to government cost-cutting measures.

Here is the anonymous pensioner’s letter (archive), which is rather long. So feel free to skip to the next section for the facts!

At a recent visit to our National Heart Centre (Institut Jantung Negara, IJN), I was shocked to be informed that I was being discharged. This happened despite 25 years of my receiving extensive care at IJN with many admissions and multiple procedures.

Recommended : KKM Refutes IJN Discharging Pensioner For Cost Reasons Claim!

 

No Evidence IJN Discharging All Civil Servants + Pensioners Due To Cost!

Fact #1 : It Was A Personal Opinion

Let me start by pointing out the disclaimer at the very bottom of the article, which states that the letter was published as a “personal opinion”.

This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

Fact #2 : Letter Did Not Provide Any Evidence

I think it is also important to point out that the letter appears to be published “as-is“, without any additional context or verification. Unfortunately, the letter itself does not provide any evidence on its own.

Was the pensioner really discharged from the National Heart Institute (IJN) because of cost-cutting measures, or because he was deemed well enough to be transferred back to the referring hospital?

Is this a new KKM policy, or was it already in effect for some time? Did the other hospital really not have the necessary medicine he needed? Were the substitutes the pensioner received not the proper ones? Were his fear of allergic reaction to those substitute drugs well-founded?

It is simply impossible to tell, without knowing his full history, and what exactly he is talking about. He didn’t even mention what drugs he was on, and what substitutes he received! But let’s see what we can find out, shall we?

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Fact #3 : IJN Is Still Treating Government Patients

From what I can determine, the National Heart Institute (Institut Jantung Negara / IJN) is not discharging all civil servants and pensioners due to new cost-cutting measures. In fact, it is still treating civil servants and pensioners, because it is fully-owned by the government, under the Minister of Finance Incorporated.

In fact, IJN clarified this on 5 August 2023, when similar accusations by “Concern [sic] Pensioners” went viral on WhatsApp and social media, claiming that IJN has been privatised, and refuses to treat retired civil servants, and was instead transferring them to other hospitals.

As IJN clarified, while it operates privately under the Malaysian Private Healthcare Facilities and Services Act 1998, under the purview of the Health Ministry, its primary mission is to provide exceptional medical services to all Malaysians, including government employees, retirees, and citizens.

However, the Public Service Department (JPA) requires all civil servants and retirees (and their dependents) to get a referral from a doctor or cardiologist from public or private clinics / hospitals, before they can seek treatment at IJN because it is a cardiac tertiary hospital.

Patients with government GL may refer to the JPA circular Appendix SR. 2.1.1 (G) provided in the official MyPPSM portal or refer to their human resources on the process, as every government agency has its own terms and requirements on their employee’s eligibility and coverage when seeking treatment at our centre.

Back in August 2023, IJN said that about 84.7% of its patients came from the public sector – government employees, pensioners, and their dependents. Only 14.9% are private, paying patients, while just 0.4% were foreign patients.

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Fact #4 : KKM Issued IJN Follow-Up Circular In 2002

Interestingly, it appears that this Malaysia Ministry of Health (KKM) policy started in October 2002 – more than 21 years ago!

That was when the Office of the Director General of Health in Malaysia issued circular no. 12/2002, called (translated) Guidelines for Follow-Up Treatment at the National Heart Institute for Government-Dependent Patients (PDF).

Fact #5 : Government-Dependent Patients To Be Discharged After 12 Months

According to the October 2002 guidelines (officially called Pekeliling Ketua Pengarah Kesihatan 12/2002 Garis Panduan Rawatan Susulan di IJN untuk Pesakit Dibiayai Kerajaan), here is the pertinent section that I translated:

i. patients who are not undergoing surgery or invasive treatments in IJN do not require follow-up treatment at IJN, and should be transferred back to the referring hospital after consultation, examination, and treatment.

ii. patients who are waiting to undergo surgery or invasive procedure within 1 year can receive follow-up treatment at IJN until treatment is completed.

iii. the follow-up treatment period for patients who have undergone surgery or invasive procedure at IJN are:

  • 6 to 12 months of follow-up treatment at IJN after surgery / invasive procedure
  • 1 to 2 years of follow-up treatment after last surgery for paediatric patients with “complicated” heart issues that require multiple surgeries

iv. Patients with complications that need to be warded, or require intensive care, by cardiothoracic specialist, or cardiologist, will receive follow-up treatment according to their condition. Such patients will be transferred to their referring KKM hospitals when IJN specialists determine that they no longer need to be treated at IJN.

v. Patients who were referred to KKM hospitals can be referred back to IJN when necessary. The follow-up treatment will depend on the conditions stated above.

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Fact #6 : Anonymous Letter On CodeBlue Was Criticised

In response to the letter being posted on CodeBlue, Datuk Dr. Christopher K.C. Lee – who was the former National Advisor for Infectious Diseases in the Malaysia Ministry of Health and a member of the Selangor Public Hleaht Advisory Council (SELPHAC), stated that only stabilised patients would be asked to return to cardiologists and doctors at other MOH hospitals for their follow-up. He also pointed out that this would free IJN to attend to other people who need more urgent care.

Only pensioners/civil servants who are stabilized will be asked to return to cardiologists/physicians at MOH for followup. This allows others who really need IJN care the opportunity to do; without clogging up IJN & running up the bill there. Pls see the Big Picture!

In response to a CodeBlue editor pointing out that the “issue is not about stability at the point of discharge, but complexity”, he responded:

Complexity can be subjective. In particularly complex cases, there can be discussions with the MOH cardiologists. However, most cases can be ably managed by the MOH cardiologists & shd be referred back. This has been in practice for a while & helps to keep the system sustainable.

Perhaps the anonymous letter should not have been posted “as-is”, without providing the necessary context as this isn’t a new policy – the circular was already in effect since October 2002.

Fact #7 : KKM Refutes Claims

On 26 February 2024, the Malaysia Health Ministry (KKM) issued a statement, refuting those claims, and clarifying the partnership between IJN and KKM hospitals.

I wrote a separate article on this, which you read for more context: KKM Refutes IJN Discharging Pensioner For Cost Reasons Claim!

 

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Dr. Adrian Wong has been writing about tech and science since 1997, even publishing a book with Prentice Hall called Breaking Through The BIOS Barrier (ISBN 978-0131455368) while in medical school.

He continues to devote countless hours every day writing about tech, medicine and science, in his pursuit of facts in a post-truth world.

 

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