A New Hope For A Better Health Care System — Dr Myelone Tharmaseelan

By CodeBlue |

The pandemic has highlighted the interdependence of our health care policies, resources, finances, and affordable care for all Malaysians.

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When the new prime minister Ismail Sabri Yaakob introduced the new cabinet, the rakyat were disappointed that it was a mere reshuffle of the same deck of ministers. It was neither trimmed, nor were there new faces.  

The saving grace here, which was unanimously agreed on, irrespective of political stances, was the appointment of Khairy Jamaluddin as the new health minister.

Khairy’s new position is based on merit and his accomplishments. As the former coordinating minister of the National Covid-19 Immunisation Programme (PICK), he has a good track record of putting Malaysia on the map for being one of the countries with the highest daily vaccination rates, of about half a million doses.  

As the new health minister, he promptly announced that 80 per cent of the adult population will be fully vaccinated within his first 100 days in office, while also rolling out vaccines for teenagers aged 12 to 17, starting with Sarawak.

He will also seek to reduce the use of Covid-19 ICUs to 70 per cent of the total capacity and the take-up of normal beds to 50 per cent.

Khairy also announced that the Covid-19 pandemic phase will transition to an endemic phase to ensure that the reopening of economic sectors is done, with the public to adjusting to a “living with the virus” mindset.

To this effect, Khairy is advocating the use of rapid test kits (RTKs) that are much cheaper and can produce instant results. Though they are considered less accurate, people with suspected Covid-19 symptoms can get instant results, and if they are tested positive, to self-isolate, receive treatment and contact trace.

The minister has an uphill task to manage Covid19 statistics, of an average 20,000 cases per day, and the emergence of new variants of the virus that can trigger an outbreak at any moment. 

 Meanwhile, there are other underlying issues that need to be addressed as well.

Firstly, our health care system is not designed to deal with this crisis and has buckled under large-scale health challenges, requiring an urgent mobilisation of resources. As the virus targets the entire population, health care workers are stretched physically and mentally.

The existing hospital infrastructure and facilities lacked space to accommodate all the patients. The government should think about using cloud space and administrative functions that do not require direct patient care, thus allocating more physical space to be used for more severely ill patients.

Some of these issues can be alleviated with a public-private partnership (PPP) for increased efficiency and improved outcomes relating to health care delivery. The Ministry of Health (MOH) can also harness the potential of some 6,000 general practitioners (GPs) from the private sector by transferring some of their patients to them, as the costs incurred by the government (due to overheads in public health clinics) can be similarly charged by the GPs.

In addition to that, as the majority of private hospitals in Malaysia are owned by government-linked companies (GLCs), it will be easier for the MOH to engage, discuss and iron out the details, and integrate a more holistic approach on grounds of corporate social responsibility.

The MOH should also be strengthened to prevent the spread of any new variants, instead of dealing with such challenges only when they arise.

Meanwhile, the focus on Covid-19 patients has resulted in a growing backlog of other health care procedures, as well as the rising prevalence of non-communicable diseases like cancer, obesity and diabetes during the current pandemic. 

Another pressing need is to fix the dilemma of contract doctors. In December 2016, a system was introduced to address the glut of medical graduates from 11 public universities,  21 private colleges and 300 recognised foreign medical schools with a total of 4,000 doctors graduating annually.

According to the MOH, there have been 23,077 contract medical officers recruited since 2016, of which only 789 have been absorbed as permanent staff members. The rest were hired on a contract basis for between two to five years by the Public Service Department.  

Recently, hundreds of contract doctors went on a strike, demanding fairer treatment for more than 20,000 junior doctors who work on contract basis, though they played an integral part in combating Covid-19.  

All these doctors want is job security, equal and fair treatment, detailed and transparent criteria for admission into permanent posts, and a clear path to postgraduate specialisation.

The oversupply of doctors can best be managed by ensuring all public medical universities choose students on the basis of having straight As in the Sijil Pelajaran Malaysia (SPM examination.

Finally, we should look at the budget size, specific allocations and financial sustainability of current health care budgets. The MOH needs money for better facilities. Its current budget is now around RM32 billion, when it should really be closer to RM60 billion, because we need a better health care system and better facilities.

For the lower income group, the previous government has proposed a national health care insurance scheme by providing a RM10,000 health insurance coverage annually to all B40 families for treatment at private health care centres. The MOH should engage with civil society to ensure this is done effectively.

Along these lines, Budget 2022 has been crafted to focus on rebuilding public health resilience, enhance its capacity and quality, strengthen human capital in public health care and foster closer partnerships between public and private sector health providers.

The pandemic has highlighted the interdependence of our health care policies, resources, finances, and affordable care for all Malaysians. Our policies should ensure that all existing resources are utilised in an optimum manner. 

As a medical officer in the MOH, I am confident that Khairy will boldly resolve all the issues mentioned to his best ability.

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
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