I REFER to the letter by Subramaniam Ponniah of Klang ("Hospital transfer claims not convincing" -- NST, July 3) regarding outpatient treatment at Hospital Tengku Ampuan Rahimah in Klang.

The decision to transfer general outpatients to primary healthcare clinics is a policy decision by the Health Ministry with the exception of some hospitals where outpatients are still treated on their premises.

Hospitals function as secondary and tertiary referral centres and provide specialist outpatient care for cases referred to them by the primary healthcare provider.

All referral cases to the specialist clinics are given appointments according to the nature and urgency of the cases.

Any case that requires immediate attention is attended to by the emergency department.
Patients referred by primary healthcare clinics are admitted through the emergency department as their condition, upon arrival, has to be reassessed and stabilised, if necessary, before being sent to the ward.

However, there is provision for direct admission of a patient if there is prior consultation between the primary care provider and the doctor in the department the patient is to be admitted to.