September 19, 2022
PETALING JAYA – Five hours – that is the amount of time sometimes spent by a 69-year-old retiree during her monthly medical check-ups at a public hospital.
Aminah, not her real name, who has several chronic illnesses, including heart and kidney failure, said oftentimes, she would get hypoglycaemia (abnormally low level of glucose in her blood) as a result of the long wait.
“On average, it took about three hours for the whole process to be done, but there have been times where it goes up to five hours.
“I once waited for far too long. I couldn’t even walk properly because my sugar level dropped, but the doctors were nice; they asked the nurses to hold my hands and bring me to the canteen.
“Now, I bring food and drinks whenever I go for my checks,” she said, adding that she hoped the waiting period at public hospitals could be shortened.
Recognising this problem, the Health Ministry is now seeking for public health expenditure increased gradually to 5% of Gross Domestic Product (GDP) from the current 2.58%.
Supporting the idea, health experts said this additional funding would be a much needed lifeline for the sector to improve its services.
Malaysian Medical Association (MMA) president Dr Muruga Raj Rajathurai said for many years, our public healthcare sector had been surviving with a minuscule amount of funding and yet it is delivering high-quality care.
Our ageing facilities and manpower shortages, however, he explained, were stretching the public healthcare system.
“MMA hopes to see an increase in the national healthcare budget to 5% of the country’s GDP to truly reflect the government’s strong commitment to reforms in the healthcare system.
“A substantial amount will be needed especially to address the shortages in manpower in public healthcare facilities,” he said, adding that he hoped the current 1,500 permanent positions for next year would be doubled.
He highlighted the importance of allocations to support specialisation programmes that will address acute shortages in specialists and ensure Malaysia is equipped with specialists as we reach the ageing nation status in 2030.
He said new facilities were also needed, especially in rural areas, to ensure equal distribution of healthcare services nationwide.
Dr Muruga Raj hoped that funds would also be injected into the setting up of specialised centres to lessen the number of patients travelling to Kuala Lumpur and Selangor for certain specialist care services.
However, he said this should be aligned with the development of manpower to avoid ‘white elephant’ situation whereby these infrastructures might be unutilised due to the lack of manpower.
He said the Health Ministry should also invest in research and development to reduce our dependence on foreign pharmaceuticals, hence ensuring Malaysia’s medicine security.
Universiti Kebangsaan Malaysia health economy and public health specialist Prof Dr Sharifa Ezat Wan Puteh said current public hospitals and certain clinics lack trained manpower, such as nurses, dietitians and psychologists so that it was hard for practitioners to do their work efficiently.
“Ideally, the ratio for doctors and patients in a state is 1:400, but in some sub-urban and rural areas in certain states such as Sabah, Sarawak and Pahang, the numbers are not promising.
“We also lack specialists because some of our specialists have turned to practise in the private sector, so we have to ‘compete’ and offer them a suitable placement and pay so that they will remain in the public sector.
“Allowing public practitioners to practise in a dual setting has been allowed for many years (with employers’ permission), but this did not solve all underfunding issues,” she said.
She added that a thorough healthcare reform and financing was needed to better provide healthcare services for our population.
Association of Private Hospitals Malaysia (APHM) president Datuk Dr Kuljit Singh said the increase in public healthcare funding was long overdue, adding that it was important not only for the establishment of healthcare infrastructures but also to better remunerate medical professionals in the government sector better.
“It is important because many countries have already increased their allocation, and some have maintained high GDP allocations for their health care.
“In Malaysia, this increase will help the government not only to build infrastructure, but it can be used to better remunerate the doctors and specialists in order to encourage them to stay in the government hospitals,” he said.
With the additional allocation, government hospitals could also further outsource services to private hospitals, Dr Kuljit said, adding that while they were happy to help, they hoped the government would provide reasonable reimbursement for their sustainability.
He said the extra financial allocation would also assist the government in reforming the healthcare system, especially in the current situation where everything is expensive.
He said increasing the allocation for health care was a good investment for the people, adding that having a healthy nation would benefit the country too.
“It is a good investment to me. It is very important because you can have a healthy nation, and the public will help the government by being more productive,” he added.