A Healthy Population, a Prosperous Nation
The increased privatization of the health sector has resulted in the shift of health-related expenditures and risks from the society at large to that of the individual level. While it may be argued that it is proper for any person to bear a fair share of her medical expenditures, the shift in the sharing of such costs and risks has resulted in inequitable access of adequate healthcare to certain groups within the society.
The paradox arises when those who can best afford healthcare are ones who need healthcare the least; it is the poor who can least afford to live in a healthy environment (e.g. lack of proper sanitation) and a healthy lifestyle (e.g. good nutrition).
There should be increased public funding and investment in improving the standard of the public health sector by increasing the RM10.7 billion allocation in 2008 Budget or 8.3% of total estimates to at least 10% or RM12.8 billion.
One of the key mechanisms to keep medical inflation in check is to “right-site” healthcare. Thus, there needs to be a major paradigm shift from a near absolute focus on provision of medical care to one which minimises the need for costly medical interventions.
Good health requires more than just access to quality and affordable medical care. Research has convincingly shown that medical care has played a less important role than other factors in improving health in countries like the UK. Healthy lifestyles play a bigger role than medical care in achieving good health.
The Ministry of Health should do this by enhancing health promotion and education as well as disease prevention capabilities, carrying out health education and promotion initiatives like a National Healthy Lifestyle Programme, National “No to Smoking” Campaign, Nutrition Programme and a School Health Programme.
In line with the special salary readjustment for the police force on top of the revision of the civil service pay recently, the DAP proposes a 20% additional increment for all doctors serving in government service, and an additional 10% increment for all support stuff such as nurses and pharmacists.
This forms a necessary step to incentivise doctors who are currently in service and attract more young doctors to service in government hospitals, at least for the initial years.
The medical profession in Malaysia are certainly one of the most poorly paid medical professionals in the region, resulting in many qualified Malaysian doctors seeking greener pastures overseas where they are in demand. At the same time, low wages compromises our healthcare system with sub-standard doctors recruited from many Third World countries.
To strengthen the medical practice in Malaysia which has been in decline in recent years, there is a need to combine the strengths of academic and clinical practice via the creation of academic medical centres of excellence in UM and UKM campuses.
The strong clinical research component within these centres would focus on the major diseases affecting the populace and would play an important role in the formation of national health and disease control policies.
To ensure that the above targets are achieved it is necessary that the entry requirements for medical courses at these universities be uncompromising in terms of standards. There should be a separate entrance examination for medical-related degree programmes be conducted to ensure that there isn’t a disparity in standards between the various entrance examinations.
A team of independent academicians should be set up to evaluate the cost effectiveness of the privatisation exercises involving the public health sector. The findings, after making comparisons of the strengths and weaknesses in the systems of various countries, should be made available to the Malaysian public so that we can make an informed decision whether we wish to have any further privatisation of the health services in this country.
Until the above study is released to the public, there will be a strict moratorium on all further privatization of components of the public health care sector.
Finally, a National Health Financing Oversight Committee, under the direct purview of the Parliament, should be set up to ensure that the funds allocated to health care are properly utilised and prevent waste via corruption or leakages.
(Speech 13 on 2008 Budget in Parliament on Monday, September 10, 2007)
