Life Sciences Cluster in Selangor (Part I: Healthcare providers) Selangor – The Best Place for Medical Tourism Medical tourism is a new rapid growing trend in the healthcare sector. Despite global downturn, Malaysia maintains more than 20% growth in medical tourism over . the past few years. In 2012, a total of 671,727 medical tourists arrived in Malaysia generating more than RM600 million in revenue. Due to strategic government support, a large number of private hospitals are actively participating in medical tourism. In this context, the report is answering some crucial questions. What are the driving forces of healthcare in Selangor? How does the state’s healthcare service industry stand out? With excellent infrastructure and accessibility, Selangor is the best location in Malaysia to promote medical tourism. Currently, there are 71 private panel hospitals registered with the Malaysian Healthcare Tourism Council (MHTC), of which 20 are located in Selangor and 22 in Kuala Lumpur. 2013 Life Sciences Cluster in Selangor - Part I: Healthcare Providers - Report on Life Sciences Cluster in Selangor - Summary 2013 Malaysia Selangor Rank in Malaysia Population (2012) 29.3 million 5.6 million 1 Average Annual Population Growth Rate 1.3% 1.3% 5 (2012) Average Life Expectancy 74.8 (estimate) 75.7 (estimate) 4 (years) GDP at constant 2005 751,471 million 176,239 million 1 Prices (2012, RM) (100%) (23.50%) GDP Growth (2012) 5.6% 7.1% 2 Investment Volume 41 billion (100%) 11.7 billion (28.5%) 1 (2012, RM) Workforce (2012) 13.1 (100%) 2.82 (21.5%) 1 Percentage of Total in Malaysia Market value of Malaysia Healthcare Sector (2012, 6.96 billion 2 billion (estimated) * 30.0 % RM) Total MoH Allocation 16.87 billion 2.1 billion 12.4 % (2012, RM) Number of Hospitals 339 100 * 29.5 % (2011) Number of beds (2011) 47,688 13,882 * 30.8 % Number of Hospital 16,493 6,324 * 38.3 % Doctors (2011) Revenue of Medical 600 million 116 million (estimated) * 19.3% Tourism (2012, RM) Medical Tourists (2012) 671,727 130,176 * 19.3 % Incentives for Medical • Investment Tax Allowance of 100% is given on qualifying capital expenditure Tourism incurred on construction of new hospital / modernisation / refurbishment of existing hospitals. • Healthcare services offered to foreign clients are qualified for tax exemption of 50%/100% on the value of increased exports income subject to 70% of the statutory income for each year of assessment. • Double tax deduction for hospital applying for local or international recognised accreditation. • More details on page 18-19 Useful Contacts • Ministry of Health Malaysia: http://www.moh.gov.my/ • Malaysia Healthcare Travel Council: http://www.mhtc.org.my/ • Medical Tourism Selangor: http://www.medicaltourismselangor.com/ • Malaysia Investment Development Authority: http://www.mida.gov.my • Association of Private Hospitals of Malaysia: http://www.hospitals- malaysia.org * Figures as per Klang Valley, inclusive Federal Territories Kuala Lumpur & Putrajaya 2 Life Sciences Cluster in Selangor - Part I: Healthcare Providers - Table of Contents 1. Overview of Malaysia Healthcare Sector ................................... 4 2. Growth in Malaysia’s Healthcare Sector .................................... 9 3. Growth Factors of Malaysia Healthcare Sector ....................... 11 (1) Ageing Population ............................................................... 11 (2) Urbanisation & Changes in Lifestyle ................................... 11 (3) Strategic Location for Medical Tourism ............................... 12 (4) Development of Supporting Industries ................................ 12 4. Trends and Developments ....................................................... 13 (1) Medical Tourism .................................................................. 13 (2) Specialty Hospitals – Focusing on Niche Areas .................. 22 5. Selangor at a Glance ............................................................... 23 (1) Why invest in Selangor? ..................................................... 24 (2) Investment Projects in Selangor (2012-2015) ..................... 28 6. Main Sources ........................................................................... 29 3 Life Sciences Cluster in Selangor - Part I: Healthcare Providers - 1. Overview of Malaysia Healthcare Sector Healthcare in Malaysia has undergone drastic changes over the years. Today, Malaysia has an efficient and easily accessible healthcare system. According to Frost & Sullivan, the Malaysian healthcare market was valued at US$2.25 billion (approximately RM6.96 billion) in 2012. Picture 1: Transformation of Healthcare in Malaysia, Source: MHTC and Invest Selangor 2013 Malaysia operates under a two-tier healthcare system, consisting of a government-run universal healthcare system (public sector) and a co- existing private healthcare system (private sector). Both the private and public healthcare sectors are still gradually expanding in terms of number of hospitals, with an estimated average annual growth rate of 2.4% and 2.6%, respectively. Based on “Health Facts 2013” published by the Ministry of Health Malaysia (MOH), Malaysia’s total expenditure on health was 4.4% of its GDP in 2011. Government and private funding accounted for approximately 53% and 47% of total health expenditure in Malaysia, respectively. 4 Life Sciences Cluster in Selangor - Part I: Healthcare Providers - Total expenditure on healthcare (in RM million) 38,000 37,000 36,000 35,000 Total expenditure on 34,000 healthcare (in RM million) 33,000 32,000 31,000 2009 2010 2011 Chart 1: Malaysia Total Expenditure on Healthcare (2009-2011), Source: MOH 2012 Picture 2: Key Facts of Healthcare Sector in Malaysia, Source: MOH 2013 The increasing healthcare expenditure in Malaysia over the years (refer to Chart 1) is mainly driven by greater privatisation within the healthcare sector and rising patient demands for better healthcare. Healthcare services in Malaysia are currently dominated by private hospitals in terms of number of hospitals, where approximately 59% of the total hospitals in Malaysia are privately owned (Refer to Picture 2). The number of private hospitals has dramatically increased from 50 private hospitals in 1980 to 209 private hospitals in 2012. However, as public hospitals tend to be larger in size compared with private hospitals, public hospitals boast a capacity of 42,707 beds versus only 13,667 beds in private hospitals. 5 Life Sciences Cluster in Selangor - Part I: Healthcare Providers - (1) Public Healthcare Sector Besides the main government agency i.e. the Ministry of Health Malaysia (MOH), the Ministry of Higher Education and the Ministry of Women, Family, and Community Development are also responsible for providing public healthcare services in Malaysia. Therefore, public hospitals can be broadly categorised into MOH hospitals and non-MOH hospitals. There are currently 140 MOH hospitals (with a total of 38,978 beds) and 7 non- MOH hospitals (with a total of 3,729 beds). MOH hospitals can be further sub-categorised into 4 types of hospitals: a. District Hospitals District hospitals generally have 100-200 beds, and are run by 6-10 medical officers. b. State General Hospitals State General Hospitals have 500-1500 beds. Each state in Malaysia has one state general hospital, except for Sabah, which has two. c. National Referral Centre National Referral Centre is the highest level of hospital in the hierarchy. The hospital has 2800 beds and is located in Kuala Lumpur. It receives referrals from other parts of Malaysia, especially for special medical cases such as neurosurgery and radiotherapy. It also provides outpatient and inpatient care services for the surrounding population. d. Special Medical Institutions Special medical institutions provide inpatient services for specific diseases in Malaysia. For example, the National Tuberculosis Centre, the Hospital for Leprosy and mental hospitals. The government heavily funds the public healthcare sector, whereby patients are only required to pay a nominal sum for treatment. (2) Private Healthcare Sector All private medical facilities in Malaysia are required to be licensed under the Private Healthcare Facilities and Services Act 1998 (Act 586) (To download, kindly visit: http://www.moh.gov.my/acts/30). Private healthcare facilities and services must comply with the regulations and requirements of Act 586, as enacted by the Private Medical Practice Control Section 6 Life Sciences Cluster in Selangor - Part I: Healthcare Providers - (CKAPS), Medical Practice Division, MOH, Private Medical Practice Control Unit (UKAPS) and State/Wilayah Persekutuan Health Department. Revenue RM 2 billion RM 6.98 billion RM 358 million RM 300 million (2012) (2012) (2012/6) (2011) Global 4 countries: 9 countries: 2 countries: 4 countries: Presence Malaysia, Malaysia, Malaysia & Malaysia, India, Indonesia, Singapore, China, Indonesia (JV on Vietnam & Australia & India, Vietnam, 26/3/2013 combines Indonesia Thailand Brunei, UAE & 3 hospitals from others Ramsay in Indonesia) Information in Malaysia Revenue (%) 89% (2012) > 68% (2012) 100% (Only 67% (2011) derived from Malaysian hospitals Malaysia during 2012/6) Brands KPJ Pantai (Contributed Ramsay Sime Darby Columbia Asia 68% of revenue), Gleneagles Market share 22% 15% 7% (estimated) 5% (estimated) (private) * 7 Life Sciences Cluster in Selangor - Part I: Healthcare Providers - No. of 22 11 3 10 hospitals Operating 2,600 1915 913 667 Beds Outpatients 2.4 million Unknown Unknown Unknown (2012) Inpatients