MEDICALLY REVIEWED

Ventilator Conundrum: Malaysian Medical Association(MMA) Seeks Valid Explanation for 104 Faulty Ventilators

faulty ventilators

HOW DID THIS HAPPEN?

MMA has called for accountability after the latest Malaysian Public Accounts Committee(PAC) report on the procurement of ventilators during the recent pandemic. 104 of the ventilators acquired during the pandemic were faulty, and were 4 times more expensive than the average.

The MMA president, Dr. Azizan Abdul Aziz, mentioned that the PAC report states that no one is to be held accountable for the blunder. The report was tabled in the Dewan Rakyat on October 30th, 2023. Dr. Azizan feels that not only is this a cause for concern, but in fact raises more questions than answers.

Ventilator Purchase During COVID-19

The Malaysian Ministry of Health(MOH) was set to procure 500 new ventilators with the assistance of Pharmaniaga Logistics Sdn. Bhd(PLSB). According to PLSB’s Chief Operating Officer Mohamed Iqbal, PLSB had strictly adhered to MOH’s instructions during the process. 

He stated that the government would direct Pharmaniaga on the budget and where to obtain the ventilators. Pharmaniaga’s role was meant to encompass procurement, delivery and facilitation of the entire process. This arrangement involved an initial sum of RM30 million advance payment for 500 ventilators to PLSB on March 25, 2020. 

However, PLSB only managed to secure 136 ventilators for RM20.12 million due to supply constraints from Chinese suppliers. It was also noted that the price is 4 times higher than the average. On top of that, PLSB retained an additional RM2.89 million for upgrades that were necessary for the purchased ventilators.   

The team mainly upgraded due to issues like unsuitable plug points needing upgrades, as well as problems with hardware, software, and other accessories.

The MOH received a return of the balance amounting to RM6.97 million from the advance payment. PLSB also reimbursed RM1.07 million for the ventilator upgrades, making the total cost of procurement for said ventilators to be RM24.1 million.

Absence Of A Written Agreement

Dr. Azizan lamented the fact that 104 out of 136 delivered ventilators were not usable, and no written agreement was available between the MOH, PLSB and the Chinese suppliers. This issue does not only involve a significant amount of public funds but might have also negatively impacted efforts to manage the COVID-19 outbreak in Malaysia.

Dr Azizan also mentioned that even though the process occurred during a time of urgency and distress, they should have insisted on proper documentation if standard procedures were inapplicable at the time. They could have shared documents, including signed ones, via the Whatsapp application.

Warranty Discrepancies   

The PAC report also found several discrepancies between the information provided by the MOH and PLSB regarding the warranties for the 136 ventilator units. A review of the documents PLSB submitted to the PAC indicated that the supplier had specified a warranty for the items purchased. However, the documents did not include all 136 ventilators and there was no acknowledgement of receipt.

Call for Action

Transparency International-Malaysia(TIM) President, Dr. Muhammad Mohan, expressed shock upon discovering that the deals for the emergency procurement of ventilators were done by Whatsapp. He stressed that official procurement confirmation must come via a proper supply contract with clear product specifications, the warranties, the supplier’s obligations on testing and commissioning, deliverables and technical support.

He also emphasised that the procurement should have followed standard operating procedures despite the pandemic and urged the MOH to clarify how it intends to handle this issue and preventive measures to prevent the recurrence of such an incident.  

PAC’s Recommendation To The MOH

This is not all. The PAC also looked into the wastage of expired COVID-19 vaccines. They also investigated excess personal protective equipment(PPE) purchased by the MOH. 8.5 million vaccines worth RM505 million expired on June 15, 2023. The committee also found more than 850,000 units of boot covers that expire at the end of 2024.

The PAC has made several recommendations to the MOH in light of these issues. The recommendations are as stated below:

  • Safeguard the public’s interest during emergency procurements.
  • Even in emergencies, documentation requires appropriate effort.
  • The MOH must immediately check the warranty status for all 136 ventilators and take action against the responsible party.
  • The MOH must make the best use of PPEs before their expiration date.

In a nutshell, the MOH should ensure proper documentation and accountability for the benefit of the Malaysian public. This will not only reduce the amount of wasted resources, especially during times of emergency but also improve the Malaysian people’s confidence in the healthcare system.

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