The Malaysian Medical Association (MMA) hopes to see an increase in the national health care budget to 5 per cent of the country’s GDP to truly reflect the government’s strong commitment to reforms in the health care system.
For many years, we have been managing with a miniscule amount and yet delivering high quality of care. However, our facilities are aging and there are shortages in manpower that is stretching the system.
A substantial amount will be needed to address the shortages in manpower in public health care facilities.
We still have a long way to go in addressing the issue of contract doctors. We hope the current 1,500 permanent positions for next year could be doubled.
We also hope there will be increased allocations to support specialisation programmes. Emphasis is needed in this area to address both the acute shortages in specialists and to ensure Malaysia is equipped with specialisations that will be in high demand when the country reaches ageing nation status.
In 2030, Malaysia will reach ageing nation status, where 15 per cent of the population will be 60 or older.
Aging public health care facilities will need funds for maintenance and upgrades. Although most of the facilities are ageing, the MMA proposes that a proper assessment be done to determine which facilities need to be given priority.
New facilities are also needed especially to reach rural communities and ensure equal distribution of health care services nationwide in line with the aims of ensuring Universal Health Coverage (UHC).
The rural interiors of Sabah and Sarawak are where these efforts are needed the most. There is also a need for a respiratory centre in Kedah.
We hope funds will also be used to set up specialised centres in the northern and southern regions of Peninsular Malaysia, since there are still patients traveling to Kuala Lumpur and Selangor for certain specialised care services.
However, the development of manpower must be made in tandem with building of infrastructure to avoid the emergence of white elephants, in the form of under-utilised infrastructure due to lack of manpower.
If new facilities are built, we will also need roads and other infrastructure for access. This supporting infrastructure should not be coming out of the health care budget, but perhaps budgeted under relevant ministries such as the Housing and Local Government Ministry.
Medicine security is even more crucial now as evidenced by the current prolonged disruption of medical supply in the country. Attention will need to be given to this important area in the planning of the 2023 health care budget.
The Health Ministry must also look into investments in research and development to enable us to reduce dependency on foreign pharmaceuticals.
In line with the ministry’s plan to give workers an additional day of leave to undergo health screening, the government could also increase the current tax incentives for working adults to further encourage them to go for such screenings.
We hope there will also be allocations to enhance primary care delivery in government health care facilities and in the private sector through public-private collaborations.
The more-than-8,000 private general practitioners nationwide have an important role in the county’s health care system, as witnessed during the pandemic. The government should take advantage of this wide distribution of GP clinics in the delivery of health care through programmes for the communities.
More allocations are also needed for public health for the prevention of communicable diseases and non-communicable diseases, and also for health promotion and enforcement under the Health Ministry’s Inspectorate Unit.
MMA is deeply concerned over the rising cases of NCDs. To encourage Malaysians to adopt healthy lifestyles, the government should increase the tax incentives for those regularly engaging in sports and fitness activities, as well as for purchases of sports equipment.
Dr Muruga Raj Rajathurai is president of the Malaysian Medical Association.
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