PETALING JAYA: More efficient use of resources, an emphasis on reducing overcrowding at public facilities and a shift towards preventive healthcare should be the emphasis of the next budget, say experts.
Leaders of the Malaysian Healthy Aging Society, Malaysian Medical Association and Association of Private Hospitals Malaysia agreed with the sentiments of former deputy health minister Dr Lee Boon Chye that the focus of the government should shift to prevention rather than treatment.
Lee and PKR president Anwar Ibrahim had last week urged the government to increase its allocation for the public healthcare system, advocating an increase of 20% to both operating expenditure and staffing levels for public health over the next two years.
Lee had said the health ministry’s budget did not prioritise prevention measures, noting that the public health sector employed 78,266 staff but its medical programme had nearly twice the size with 153,412 staff.
“This shows that the health ministry’s budget is more focused on treatment than prevention; this trend has to change,” he had said in Parliament.
The health ministry was allocated RM30.6 billion during Budget 2020 which was a RM1.9 billion increase from the RM28.7 billion the health ministry received in Budget 2019. Of that sum, RM27.9 billion was put aside for operations – with RM5.66 billion going towards public health.
The health ministry was the third biggest recipient of Budget 2020 after the education ministry (RM64.1 billion) and finance ministry (RM37.8 billion). The health ministry’s percentage of allocation from the total budget was 10.3%.
Dr Wong Teck Wee, a consultant cardiologist, said the country should look to doing more with the resources it already had, noting that Malaysia had one of the largest civil services in the world – it stands at 1.71 million as of March 2019.
“We need a more efficient and cost effective method to run public healthcare facilities with the help of data analytics,” he said.
“There are still long waiting lists to get treatment, and bypasses have taken anywhere from six months to a year… A lot of patients would have dropped dead by then,” he added.
Wong, who is also the president of the Malaysian Healthy Aging Society, said Malaysia should develop its preventive health policies and needed only to look to Singapore’s Health Promotion Board for best practices.
He said Singapore’s health board promoted preventive health to preschoolers, primary school pupils and tertiary education students – teaching them lessons that put them in good stead for the future such as healthy eating habits, proper social interaction and how to cope with stress.
“Prevention is the best cure, and it doesn’t cost a lot to train teachers to teach these students preventive health measures,” he said.
“They will bring these healthy habits back home and influence their parents, and they will also live with these habits as they grow up – which will then make sure they are healthy and productive as adults,” he added.
The Malaysian Medical Association (MMA) also urged the government to look into prioritising spending on preventive medicine as well as education and the upgrading of primary care facilities.
The MMA had made recommendations to the health ministry and proposed working with the 7,000 well-distributed, health ministry-trained GPs throughout the country in managing cases of non-communicable diseases (NCDs),” said MMA president Dr N Ganabaskaran.
“Outsourcing of NCD management to the private GP clinics which has long been overdue should be prioritised as it can significantly reduce overcrowding in our public healthcare facilities,” he said.
Mirroring Ganabaskaran’s call to outsource patients from the public to the private sector was Association of Private Hospitals Malaysia president Dr Kuljit Singh, who said that the health ministry must “zoom in” on the healthcare delivery aspect of their services.
He called for the finance ministry to put aside a special budget to let patients who are on waiting lists for elective surgeries or diagnostic imaging services such as CT scans or MRIs access to private hospitals.
Kuljit also suggested that a list be made of all the empty scanners or surgery slots that each private hospital offered on a software which would be updated in real-time to allow patients in most need of these equipment or services to utilise them without delay.
“It’s the quickest and most economical way. If not, the patients will end up waiting in agony and suffering. These are all patient-centric approaches that do not cost much. Most importantly, the people will be happy (since) they do not need to wait as long,” he said.