In response to the recent tabling of Budget 2022, as well as the related press statement by Health Minister Khairy Jamaluddin, Malaysian Medics International (MMI) would like to express our gratitude for the 1.5 per cent increase in budgetary allocation to RM32.41 billion for the Ministry of Health.
However, we would like to highlight several other pertinent issues in relation to the announcement which require further consideration.
MMI acknowledges and supports the many health-positive inclusions in Budget 2022, including the allocation of RM2 billion for the National Covid-19 Immunisation Programme (PICK) to secure its continuity, the commitment of RM2 billion for the improvement of the capacity of health facilities, additional personal income tax exemptions on medical expenses incurred during consultation or treatment from psychiatrists, clinical psychologists, and registered counsellors, the two to four-year contract extension for over 10,000 medical officers, pharmacists, and dentists, the expansion of the sugar tax to include pre-mixed beverages, and the introduction of excise duties on all e-cigarette and vape products.
MMI hopes that these increased allocations and new policies will be robustly implemented in the future to safeguard the health and wellbeing of the rakyat.
In the interim, we humbly call on the MOH, the Ministry of Finance (MOF), other relevant stakeholders and distinguished policymakers to consider the following:
1. Commit To Increasing Spending On Mental Health
While MMI welcomes the RM70 million earmarked for the betterment of mental health, as well as the RM320 million allocated for psychiatry and mental health spending, Malaysia’s expenditure on mental health continues to fall short of World Health Organization (WHO) recommendations, which recommends that 2 per cent of national health budgets be allocated to mental health.
This is despite the Covid-19 pandemic exacerbating mental ill-health issues, due to increased poverty-related stressors, incidences of domestic violence, and substance abuse rates, thus leading to projected increases in mental health service utilisation.
It is therefore imperative that our nation’s spending on mental health increases proportionally to meet these increased demands, with these funds directed towards the expansion and improvement of primary (preventative), secondary (curative), and tertiary (advanced curative) mental health services, as well as towards the digitalisation of mental health services in Malaysia.
2. Clarify Key Issues Related To Financial Security And Career Prospects Of Health Care Workers
MMI welcomes the increased emolument allocation for health care workers. However, we also recognise that the overall emolument increase of 1.9 per cent in Budget 2022 compared to the previous year, calculated from estimates of overall emolument figures from 2021 and 2022, may not be sufficient to keep up with headline inflation rates of 2 to 3 per cent, as estimated by Bank Negara Malaysia, thus suggesting a potential decline in real wages for health care workers.
We would appreciate clarification on whether additional financial schemes such as tax relief or one-off support payments for health care workers form part of the government’s plans to mitigate the disparity between wage growth rates and inflation.
Similarly, while MMI is enthusiastic about the RM100 million allocation for specialisation training for over 3,000 doctors and dentists, we would like to request further details on its anticipated distribution, including a breakdown by profession (medicine vs dentistry), specialisation, and specialisation pathways (i.e. ratio of those specialising via local Masters programmes vs those specialising through parallel pathways).
Lastly, while MMI recognises the positive ramifications of the two to four-year contract extension on the career progression and financial security of existing health care workers, we would appreciate further clarification on the options available to health care workers at the end of their contract extension, including whether the government has plans to introduce further contract extensions after the initial extension, as proposed in our previous press statement.
3. Redirect Revenue From Increased Taxation Towards Future Health And Social Service Allocations
MMI strongly supports both the sugar tax expansion and the enhanced excise duties on all e-cigarette and vape products, in recognition of the well-established role of excise taxation in reducing the disease burden of non-communicable diseases (NCDs) such as hypertension, diabetes, and obesity, by controlling the consumption of particular goods.
However, it is equally important to recognise that excise duties (or “sin taxes”) disproportionately affect lower-income groups, which are less price-sensitive than higher-income populations, and at higher risk of poorer health outcomes, due to their socioeconomic status.
MMI recommends that the MOF consider directing a significant proportion of the revenue raised from excise duties towards budgetary allocations for health and social services in the future.
These funds should be earmarked for national primary and secondary prevention programmes aimed at NCD risk reduction in susceptible populations, which are cost-effective interventions that mitigate the increasing burden of NCDs on the Malaysian health system.
Examples include smoking or vaping cessation clinics, national programmes delivering nutrition education, and community screening programmes for the early detection of NCDs.
In summary, MMI recognises and appreciates the increased attention paid by the government towards key issues in health care, as evidenced by the increased allocation for health care in Budget 2022.
Nevertheless, we believe that the aforementioned issues warrant further deliberation, so as to ensure a more robust, responsive, and equitable Malaysian health care system.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.