This piece was compiled and summarised by Sudhasni.

After the recent General Elections, we sat pondering on all the long-standing health issues that require attention. This is because our health service has been chronically underfunded and relatively neglected for decades.

We, as the public, needed to realise that the political affiliations chosen to lead the country should be judged on not only their political knowledge or blatant promises — but also their focus and concern for healthcare for Malaysian citizens.

How do we do that?

Any political party that does not commit to spending at least six percent of Malaysia’s gross domestic product (GDP) on health is not to be supported. It is always important to note health expenditures involved should be funded by the government and not be an out-of-the pocket funding by the people.

To reverse the existing ‘inverse health care law’, the improvised health budget should be targeted at marginalised communities and improve their poor health outcomes. It is not exactly necessary to spend and invest these large sums on ‘centres of excellence’ when a significant portion of our population have no access to quality healthcare.

Breaking down on an important point in the recently proposed Budget 2023 — the RM3.7 billion increase will be wiped out primarily by the cost of treating diabetes which is estimated to be around RM 3.1 billion annually. This barely leaves anything for healthcare financing, non-communicable diseases, mental health, and the ageing population. It is to be noted that our healthcare sector is the primary contributing factor of economic progress in Malaysia.

In the reformation of the Malaysia Healthcare System, transparency, commitment and a strong political will is necessary. It is not a transient nor a static process. Instead of being a single-sided decision, the healthcare implementation needs to be a sit-down discussion on what is comprehensive and leaves no one behind.

As such, a primary policy by all political parties should be their commitment that the national health services planning, funding, and direction should be bipartisan, involving all political parties, with a significant, meaningful and real involvement from civil society.

Further initiatives on financing the healthcare system implies a critical and focused analysis on the target groups who need said financing. Government medical services come at a small but significant price and those who are able to afford those services may pay to obtain so to help support those who are less privileged.

This stepping stone, though small, will greatly help reduce the government’s burden, thus making healthcare more accessible and sustainable in the long run.

Having a critically underfunded or a rather neglected healthcare system poses a great threat as the attention-demanding healthcare issues constantly pile up as the years go.

This ‘funding-issue’ isn’t necessarily about the patients alone, rather is an umbrella for all adjoining issues, also concerning infrastructure and healthcare professionals. We have expanded the scope of our health services without the necessary human resource and infrastructure development to support it.

Take a walk around an adjacent government hospital, see its chipped paint-walls and damaged equipment. Some with many a fire hazard, the very scarce amount the country spends on focused infrastructure maintenance indicates that in order for patients to receive adequate and focused healthcare in a holistic environment — they need to be able to afford the volcanic private hospital fees. Paediatric wards with corridor laid beds would suffice as an explanation, or might we rather hear the tough decision making required to decide who gets a ventilator or the last ICU bed.

Speaking of healthcare, it is necessary to address the burnout of our healthcare workers. All contract healthcare staff need to be retained with permanent jobs because as much as they insist — Malaysia is indeed in need of more healthcare workers.

The essentiality of healthcare staff accounts not only for treating patients and handling the influx of cases — but more so to increase the prospect of research and development done locally — primarily focused on Non Communicable Diseases (NCDs) which requires backed-up data-based approach to areas with significant health burdens and to ensure that they are allotted the needed resources.

This pushes the capacity of teaching hospitals and health institutions to increase clinical awareness on disease research and in the long run, increase participation in the field.

In conclusion, the nation should collectively realise the importance or rather necessity of radical change to provide accessible healthcare for all. We require a transformative approach that focuses on inclusive growth with good access to achieve equality.

The government and policymakers should be held accountable for the birthright of every Malaysian citizen. With the rising population, our healthcare system needs to be future-proofed to meet its challenges and demands for better quality healthcare.

Reference

• https://codeblue.galencentre.org/2022/10/14/ge15-manifesto-health-is-a-critical-election-issue-dr-amar-singh-hss/
• https://galencentre.org/2021/09/27/12th-malaysia-plan-the-government-needs-to-review-its-strategies-on-health/
• https://galencentre.org/2021/09/27/12th-malaysia-plan-the-government-needs-to-review-its-strategies-on-health/