MammoSEL Programme

I saw a brochure today, advertising a free mammogram service provided by the Selangor government for women above 25. I turned to the back of the brochure to look for the contact details and found that it was provided by a certain “Forrest Medical Group” in Malaysia. This got me curious as I was wondering who were these people, the Forest Medical Group.

Obviously, I am not privy to the big picture here but I am quite concerned at the fact that the group’s Executive Director, Beh Jiun Jye, was the DAPSY International Affairs Bureau Secretary in 2003. This raises some red-flags in my mind. I am just wondering how this medical group got involved in this project and if it went through the proper transparent procedures.

Somehow, I have this sinking feeling that this would not be the case here.

PS: Maybe someone more connected than me can do the sleuthing and find out what are the specifics of the deal and programme.

Update@2010-11-23: Not that I am suggesting that there is any impropriety afoot, but Beh Jiun Jye is currently in the running for a position in DAP Selangor this weekend. It just does not look good on Pakatan if they do things like the BN – regardless of the merits of the programme. I just hope that they did not.

Update@2010-11-25: Was alerted by a reader. Seems like the BFM page is down after being up for almost 2 years. Not sure why. Anyway, the google cache is still up tho.

Published by

Shawn Tan

Chip Doctor, Chartered/Professional Engineer, Entrepreneur, Law Graduate.

16 thoughts on “MammoSEL Programme”

  1. Hi Shawn,

    Thanks for the interests shown in helping provide information on the FREE Breast Cancer Screening program, provided for the women of Selangor, age 35 years above.

    The MammoSEL program i believe is the first of its kind in Asia. Comparable only to the NHS Free Mammogram program in UK, BreastScreen in Australia, USA and a handful of European countries.

    In Malaysia, LPPKN Mammo Subsidi provided by Federal Government is available for breast cancer screening, mammogram. But shortlisted women have to fork out RM50 at selected medical centers with no transport provided going there. Since started in 2007, RM29 million has been spent with ONLY 12,000 women benefiting from the LPPKN Mammo Subsidi.
    (From various media releases & LPPKN website)

    Under the MammoSEL, all eligible women of Selangor 35 years above can enjoy the benefit of FREE breast cancer screening with transport as well as light refreshment provided. The Selangor government is committed to invest RM5 million to cover 56,000 women for breast cancer screening.
    (From latest Selangor budget announcement & various media releases)

    The RoI of amount spent versus the number of women covered show that with efficient operations and innovation, we can showcase Selangor that is able to do more with much less. Always benchmarking with existing Federal ministries standard.

    Why breast cancer is chosen simply because in Malaysia & the rest of the world, breast cancer is the the No 1 cancer killer of women. In Malaysia, 30% of all female cancer is breast cancer with the cervical cancer at 10% and various other cancers making up the rest.
    (From latest National Cancer Registry statistics)

    Forrest Medical Group has been around a long time, positioning ourselves as the lowest-cost provider of medical services, particularly radiology in Malaysia.

    Over the years, we have provided outsourcing radiology services to Ministry of Health hospitals, Army Hospital, UM Specialist Center, United Nations organization, many private hospitals, clinics as well as corporate patients.
    Most of these government hospitals have radiology scan waiting time that runs to 8-12 months. Due to perpetual equipment bottleneck and huge patient volume, alot of scans do not get done in time for surgeries or treatment. So, Forrest Medical Center help to cut long waiting time for patients in some of the hospitals to 2-4 weeks, by absorbing the patients backlog through efficient turnaround time & lowest unit cost compared to the hospitals’ own internal numbers.

    We are the pioneer in stand-alone radiology medical center in Malaysia, with state-of-the-art medical systems MRI, Digital X-ray, Digital Mammography, Ultrasound plus innovative back-end processes & technologies.
    We are also the lowest-cost radiology services provider in Klang Valley and possibly Malaysia.

    Prior to launch of MammoSEL, the state has made detailed comparison on the costing of mammogram service from existing government & private hospitals. Besides LPPKN Mammo Subsidi, government hospitals charges RM200 for non-civil servants with 3-4 months waiting time, while private hospitals charges between RM150-250. Transport is not provided.

    For this program, MammoSEL is something new and unique without precedent in Malaysia. No other state does this. On its scale & reach, it’s probably only comparable to LPPKN Mammo Subsidi.
    But MammoSEL with a much smaller budget are able to cover more women for breast cancer screening. That should be something to be happy about, especially with breast cancer cases continuing to hit more & more women nowadays.

    Early detection saves lives! If you have a female family member or friend 35 years above in Selangor, do get them screened for breast cancer under this FREE MammoSEL program, transport provided. Get in touch with your local ADUN office to register…

    From our medical & commercial track record, we have always been interested to do innovative works, projects & programs that will enable delivery of healthcare at highly affordable cost, especially to working families & the middle-class.

    1. Thanks JJ, for the sales pitch.

      However it is NOT FREE because the Selangor government is paying about RM90 per person, which is about the price of a mammogram outside (RM120). So, we can say that the Selangor government is footing the bill.

      And more importantly, you have side-stepped my main concern, which is how this project was awarded and whether it went through the proper transparent procedures since it is state money that is being used.

      Since it will be bringing in millions of state money to whomever the money is channeled to, if it did not go through proper procedures, it is still something wrong regardless of how many lives it can save. There are ways to provide the same level of service to the people, and save just as many lives, with proper procedures adhered to.

      In summary: I am not denying the merits of early screening, but I am questioning how it was awarded. Even if the government is not paying a single sen for this, I am still questioning the procedures involved in awarding the project.

      This, you have FAILED to answer.

  2. Hi Shawn,

    As highlighted above, the mass universal breast cancer screening program has never been done before in Malaysia so we had to design the whole mechanics & processes from the ground up. We are doing things hospitals or centers in Malaysia have never done before. We are pioneering this in hope that what we are doing can be replicated by others in the aim of reducing breast cancer deaths in Malaysia.

    After year-long evaluation of the cost and benefits of the program, the Selangor state roll-out MammoSEL. As there’s no direct comparison or comparable benchmark in Malaysia, cost, patient satisfaction and overall value of the program was used as guide to greenlight the project.

    Anyhow, we are happy if there’s any other centers able to do the program for less cost as long as the benefit of screening reaches more people. In the meantime, most women that we are seeing are first-timer to mammogram and the pick-up rate for breast cancer is 1 out of every 100 patients we have screened. So, every day we are doing the program we help saves lives.

    So, while waiting for Federal agencies like LPPKN to catch-up in terms of coverage & cost, we will continue to improve and upgrade this breast cancer screening program. There are plans to use data gleaned from the running of this program to publish scientific papers in collaboration with UM to highlight key learnings that public health policy makers can incorporate to improve on medical delivery and cost effectiveness.

    As everyone involved in this program comes from various racial & political background, we hope it can show that Malaysians can come together to drive innovations that will improve the lives of the people through more affordable & efficacious healthcare.

    1. Thanks for the non-answer again. Whether is it free or if people from across the political spectrum are involved, it still does not answer the fundamental question.

  3. Hi Shawn,

    As was explained in background, the Selangor state followed their procedures in going ahead with MammoSEL. It must make commercial & clinical sense for the state to move this forward.

    That’s why it took a year long evaluation of feasibility studies with on-the ground pilot patient groups and cost quotations from 8-10 different hospitals & medical centers to verify costing.

    So now this low-cost, high impact program, MammoSEL is launched for the benefit of Selangor women 35 years above. It is a non-partisan program open to everyone eligible without regards to income, race, religious or political background.

    1. Thanks for the answer.

      Just out of curiousity, since the government requested quotes from multiple service providers, did they also call for an open tender? Or were the quotes just used for cost comparison? I am not in the health industry but I would think that the prices for ad-hoc visits and a bulk-programme would be very different indeed. Did the Selangor government get bulk order quotes?

      Anyway, too many question marks here. I am just a regular rakyat wondering about these things. A quick survey of the people around me at work resulted in a collective sigh – plus ca change, plus c’est la meme chose.

      I am sure that you have other business to tend too, seeing that you are running for a post this weekend. Good luck.

      And thanks again for taking your precious time out to answer on my little blog.

  4. Hi Shawn,

    Thank you for opportunity to clarify so that the important benefits of MammoSEL gets promoted without prior misconception or cynicism.

    The founders of Forrest Medical Group have been in the healthcare industry a very long time before we set-up. We have been involved in pharmaceuticals, medical equipment, hospital development etc.

    Private hospitals in this country basically operate like a cartel. High prices, overcharging, unnecessary procedures, underqualified support staff etc. Every now and then, there’s a tug of war with medical insurance companies that result in hospitals been blacklisted for dubious overbillings. Like one in Bangsar & another in Sunway last year by ING. In today’s news, we have Minister of Health complaining on high prices & overcharging by private hospitals. Yet nothing gets done, year in year out. Anyway, discussing Malaysia private healthcare industry always get me excited.

    As explained earlier there’s a significant part of the program that we had to design from scratch. Hence, the year long pilot studies testing logistical arrangement & follow-up patient satisfaction from various locations in Selangor. The cost quotations was for comparison. As mammogram is not a high-volume medical service performed by most hospitals, the unit rate & bulk rate received isn’t much different. Additionally, patients transport is never provided & separately quoted, as its not the core service of those hospitals. All this add to their charges. As well as turnaround time that is longer since most hospitals operate only 9am-5pm, 5 1/2 days schedule for outpatient services. Whereas Forrest Medical Center runs 8am-11pm, 7 days week.
    So, some important operational parameters couldn’t be fulfilled by other hospitals.
    All in all, the limited MammoSEL budget has to be maximally optimized for clinical care & patient satisfaction.

    As a recognition of our track record in outsourcing radiology services based on our works with Ministry of Health’ General Hospitals, we have even been used as a case study in the Government’s ETP under healthcare plan to help Malaysia capture new economic growth areas. We are proud of our work in advancing clinical excellence in this country as well as cross-sharing of good practices from overseas like through our unique tele-radiology collaboration with UK Hospitals.

    As a Malaysian fortunate enough to have studied in the UK, i have had to work with people of different races, cultures & beliefs. Similarly in our organization management, we are individuals with different political beliefs across divide like UMNO, MIC, Gerakan, DAP or apolitical. But we all believe in making healthcare services affordable to as many people as possible.
    So, i hope you see all of us as individuals first and not through the shade of political prejudices. Hopefully we can practice a new mature political culture where we are respected for our talents despite difference in team members’ orientation.

    Thank you again for the opportunity to share.
    Just let me know if there’s any other input on making MammoSEL better.

    1. You know, the last part of your answer is what ticks me off. The issue isn’t politics, it is corruption.

      The PR government, particularly in Selangor, tries to project a clean image. However, like I said, it’s not just me. Even a random person sees this as just the same old thing – cronies on the dole. Don’t believe me, just tell someone that this is a FREE service provided by the Selangor government in partnership with a healthcare provider whose ED is currently running for a position in DAP Selangor. Then, ask them if they smell something odd.

      On my side, this thing just smells odd (regardless of its merits) and the rabbit hole just seems to go deeper with each answer that you give. Each answer actually piques my interest more and more but I won’t be digging any deeper because I have other better things to do. Maybe someone else will.

      Disclaimer: I am not a member of any political party nor do I support any of them.

      Selangor government provide a blanket subsidy for mammogram screening (including taxi fare – like the NHS) in all health-care providers in the state. A payment mechanism can be worked out either through medical insurance companies or even possibly through a GL or other mechanism.

      The prices can be brought down by going into a cross-marketing deal with the ‘cartels’ so that each health-care provider pays the government a commission/referral fee for bringing in the volume of customers. Plus, the government takes on the cost of marketing/advertising/educating the public.

      While many of the private hospitals are government linked/owned, I doubt that permission from something like this would need to go higher than the CEO of each individual hospital. It’s not rocket science and it will bring in another few hundred thousand in revenue for each hospital.

  5. Hi Shawn,

    Thank you again for the opportunity to clarify.

    Of course, as a Cambridge graduate and a talented senior government officer, your fresh perspective on this is always interesting to me.
    As an innovator, when you conceptualiza & design a proposal for research, should you also be given opportunity to be invited to conduct the research and possibly commercialize it later for the public good? If you are passionate and knowledgable on the research matter, how then do you reward innovative and creative problem-solving people?

    For your above suggestions, that is the current way breast cancer screening has been done since 2007 by LPPKN the Federal agency. Through the LPPKN Mammo Subsidi, each participating hospital is allowed to collect RM50 from the patient and also be reimbursed RM50 by the government for each patient they receive under this co-subsidy program.

    For the women patients, they are out-of-pocket by RM50 for the mammogram. Plus the cost of arranging their own transport & time.

    For the participating hospitals, they all get to earn RM100 for each patient.

    For the LPPKN, they have to pay the hospitals RM50 per patient as well as absorbing the cost of marketing, advertising, educating & administering the Mammo Subsidi program to the public. However, transport charges not provided so not yet included.
    Since 2007, LPPKN has spent RM29 million on this to cover just 12,000 women in the whole Malaysia, not just Selangor.
    That works out to RM2,420 per mammogram/women.

    So based on the current ways of doing things, MammoSEL cost of RM90 per mammogram/women covering 56,000 women in Selangor is a huge cost-savings and creating broader impact to fight breast cancer…

    Maybe the Government & participating private hospitals need your fresh perspective to bring some sanity to the current Mammo Subsidi system.

    1. My views on innovation, IP and rewards are expoused elsewhere on this blog. My views are not the ‘typical’ way people view things in Malaysia. So, we will not be able to agree on that point on rewarding innovation/creativity.

      As for your numbers, let us avoid mathemagic.

      The RM90 that the Selangor government spends on the programme is just for the mammogram + transport. The LPPKN spends RM50 per patient. So, let’s assume that the LPPKN patient costs RM120 per person (out of pocket and transport), which is about the cost of my quote while your earlier cost quotes (RM200 at gov and up to RM250 at priv) are inflated.

      The LPPKN spends an additional RM2370 extra for all the extra hidden costs. Now, you claim to be able to do almost 5-times the number of women for 1/6 the cost? I know that the government has inefficiencies but this means that you are almost 30 times more efficient than the government programme. CONGRATULATIONS!!

      But like I said earlier, regardless of the cost of the programme, right/wrong has nothing to do with money. Even if you are 100 times more efficient, I still do not agree to mixing business and politics. That was my fundamental issue, from the very start.

      I am not arguing about the merits of early screening nor cost, I am questioning the mixing of business/politics.


  6. Hi Shawn,

    We may disagree on viewpoints but at least the facts are laid out for people to make their own judgement of the benefit of the breast cancer screening program.

    The MammoSEL cost of RM90 for 56,000 women is inclusive of mammogram, transport, marketing & administrative overheads.
    It’s a no-frill, low-cost high impact program.

    We are slowly getting help mobilizing the grassroots from trades unions, private clinics, pharmacies, multi-national companies etc at additional no cost to MammoSEL. Just people seeing a way to make a difference, that’s all.

    It is a truly a novel way of running breast cancer screening in Malaysia. We hope to nudge the Federal government with their immense resources and clout to really cut out the fat and funnel more savings to get more women screened to fight breast cancer death…

    Thanks for the opportunity to share.

  7. Hi Shawn,

    With the facts disscussed here and available elsewhere on breast cancer, any individual with interests & no political background are welcomed to propose a better breast cancer screening program to corporate, state or Federal governments for implementation.

    In a competitive market, people will weigh cost, quality & satisfaction in deciding any products or services these days. So, we hope MammoSEL will set a benchmark that we can be replicated and replaced away by something else better.

    Anyway, private mammogram costs in SJMC, Sunway, Gleaneagles & Tropicana are ~RM250. The rest like Assunta, Pantai, KPJ hospitals are ~RM150. A few other hospitals about ~RM120. So, my average of RM150-250 is valid. They are all a phone call away. Contact information available in the Web anyway.

    Government hospitals shockingly like Selayang, Serdang, Ampang, Putrajaya charges RM200 for mammogram for non-civil servants with waiting time of 3-4 months some more. Even the civil service union like Cuepacs is telling me, MammoSEL is beneficial for women patients turned away from government hospitals due to long waiting time.

    Again, thanks for the opportunity to share.

    1. You still DO NOT get it. Sigh.

      Cost has nothing to do with it. Quality has nothing to do with it. Even if the programme is FREE it still does not address my fundamental concern. Sigh.

      Dude, the very first phone call I made got me a quote for RM120. The RM150-250 is considered average in weasel speak. Since you are running for position in a political party, this must come naturally to you.

      You have been stretching the truth. If you are going to give a range, you should say that they are between RM120-RM250. Purposefully misrepresenting and/or leaving out the lower price range is bordering on the dishonest, to say the least. If you were unaware of the cheaper prices, I question the credibility of your so-called ‘research’.

      Please feel free to continue digging a hole if you so desire. 🙂

  8. Hi Shawn,

    For a Cambridge scholar & respectable senior government officer, there’s no need for name-calling.
    The public can always compile and verify the range of charges in the market. For private as well as public hospitals. Contact information is available in the Web for everyone to do their own research. I welcome the public to always price check all of their medical services for their own future needs.

    Thank you again for opportunity to share.

    1. I have not called you any names but merely characterised your actions appropriately. But if you feel slighted, I apologise for whatever it is that you terasa and encourage you to grow a thicker hide seeing that you are seeking position in a political party. You will need it.

      I give up.

      The fundamental issue is the mixing of politics and business, which is something that you have chosen not to address, for some reason or other. You have just been beating round the bush.

      PS: Feel free to dig a deeper hole for yourself.

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