Experts: Without Covid, No Breakthrough In Health Reforms

The Health Ministry can encourage public-private partnerships by further outsourcing medical services to GP clinics with facilities for blood tests, X-rays, NCD management, and medical screenings.

KUALA LUMPUR, Jan 10 – The collaboration between public and private sectors in epidemic control in the past two years shows health reforms are not impossible, though little breakthrough would have been made had it not been for Covid-19, public health experts say.

The Covid-19 crisis triggered a “make-it-happen” response that saw governments, both at the federal and state levels, and the business sector coming together to detect, vaccinate, and treat people for the coronavirus all over Malaysia.

Independent public policy and health care analyst Chua Hong Teck said the collapse of the country’s health system last year made these partnerships possible. He said “without breakdowns, there won’t be any breakthroughs.”

ProtectHealth, a not-for-profit company under the Ministry of Health (MOH), is often cited as the country’s biggest Covid-19 public-private partnership (PPP) success, with its handling of nearly 2,500 GP clinics, specialist clinics, private hospitals, and non-government organisations (NGOs) to administer nearly half of the coronavirus vaccine doses under the National Covid-19 Immunisation Programme (PICK), as of December last year.

Under the PPP arrangement, private and health care NGOs are paid a flat rate of RM19 per Covid-19 vaccine dose administered by ProtectHealth.

Chua further cited the role of the now-disbanded Greater Klang Valley Special Task Force (GKVSTF) in coordinating and accelerating the decanting of non-Covid patients from public to private hospitals to mitigate the congestion at public health facilities for Covid treatment.

Other examples include increased utilisation of private resources comprising facilities, equipment, and human resources by the MOH.

“We can do reform, but we need to push people,” Chua said during his presentation at the Malaysian Medical Association’s (MMA) Healthcare Reform: Healthier Futures for Malaysia forum held in hybrid format on Saturday.

He said the past two years also forced many health care facilities, including the MOH, to offer telehealth services such as remote patient monitoring for people under Covid-19 quarantine, while the Telemedicine Act 1997, which was enacted to regulate and control the practice of telemedicine, remains ungazetted.

Rising costs of medical treatment and an overburdened public health system as evidenced by the backlog of over 57,000 surgical and medical procedures last year have fuelled calls for urgent reform of Malaysia’s health system.

They include demands for prison reforms to better manage disease outbreaks and a change in health funding in Malaysia to a model similar to the United States’ Medicare and Medicaid health insurance coverage schemes that act as publicly funded reimbursement programmes.

MMA general secretary Dr R. Arasu, who was part of the GKVSTF, said the whole-of-society, whole-of-nation approach to the Covid-19 pandemic made it possible for Klang Valley’s “broken down” health care system last year to recover.

“We realised in July last year that our system broke down. That was the reality. And the only way we overcame that was truly [due to] whole of society, whole of nation.

“Everybody was involved, including the Ministry of Defence. So basically, if you want to solve the problem, you must not only talk about collaborative approaches, you must actually do it sincerely – you must listen,” Dr Arasu said.

Dr Arasu said while Covid-19 has managed to break some silos in the country’s health system, MOH can do more to encourage PPPs by outsourcing more services to private clinics.

He said many GP clinics are well-equipped with facilities for blood tests, X-ray services, non-communicable disease (NCD) management, and medical screenings that can be utilised to reduce the burden on public health facilities and ensure continuity of care.

“Why must the government do that? Why can’t they just outsource the entire thing to the private sector and negotiate a rate. We can work together and this can easily be done.

“We saw how ProtectHealth coordinated very well that about 48 per cent of total Covid-19 vaccination in Malaysia was contributed by the private sector,” Dr Arasu said.

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