KUALA LUMPUR, June 24 — Integrating public and private primary health care services through a single financing system would help reduce hospital burdens in Malaysia, a public health expert said.
Dr Lokman Hakim Sulaiman, former Health deputy director-general (public health), told a recent forum hosted by CSO Platform for Reform that primary care, which acts as frontline service, should be prioritised in a health care system so as to reduce the number of people being admitted to hospital.
“If we look at the major cities, there are more doctors in private clinics compared to public health clinics. But public health clinics are facing greater burden than the private clinics.
“Almost 60 per cent of the patients’ burden is being experienced by public health clinics which have smaller numbers of doctors. There is no balance there,” he said.
A major reform in Malaysia’s health financing system is crucial to tackle this problem, said Dr Lokman, who is also a professor and public health consultant expert at the International Medical University (IMU).
“We do not have a single payment system. We have different payment systems, managed by private and public sectors. This problem will be prolonged until we have a single payment system,” he said.
“We need a major reformation to improve our health care system.”
Malaysia currently has a dual health care system comprising the public and private sectors, where patients usually pay out-of-pocket for primary care at private clinics, while treatment at public clinics is mostly subsidised by the government as patients just need to pay RM1 for consultation and medicines.
Furthermore, Dr Lokman said primary health care services, preventive measures, and promotional aspects should get higher allocations in MOH’s budget.
“The percentage allocated by MOH to public health programmes is small. From the amount of RM22 billion a year, approximately two or three billion only being allocated for public health. But if the public health care system fails, the hospitals won’t be able to bear the burden.
“This is not only applicable for Covid-19 and contagious diseases, but also non-communicable diseases such as diabetes,” he added.
He also stated that non-communicable diseases are chronic diseases and practical treatment should be carried out at the primary stage, which is outside the hospital, to reduce complications. So more investments in the primary stage of health care become essential in a health care system.
“If we postpone building a hospital in one Malaysia Plan, and if we invest in building more smaller health care clinics, that will give a huge impact,” Dr Lokman said.
He emphasised the importance of strengthening strategic industries for health security, such as production of personal protective equipment (PPE) and the ability to produce vaccines.
An independent survey by a group of doctors found that doctors and health care workers across public and private sectors had insufficient PPE amid the Covid-19 crisis that made them feel unsafe at work.
“We are facing a tough time. But I don’t think that producing face masks is a difficult technology. But we were forced to depend on other sources outside our country to get face masks,” Dr Lokman said.
“Without enough supply, how can we ask the public to wear face masks?” he added.
Dr Lokman also mentioned that Malaysia’s measures in controlling the spread of Covid-19, such as the Movement Control Order, have successfully borne fruit. He applauded the efforts of MOH in combating the epidemic in Malaysia.