As an aspiring hub for health care in Asia, Malaysia should invest more money and resources in its health care system. Recently, we heard a pledge by Health Minister Khairy Jamaluddin, who advocates allocating 5 per cent of the country’s GDP for health care.
As the nation grows, its health care system should match its development strategies and goals. Allocation for health care should be scrutinised to ensure equitable access to quality health care in the country.
As the President of SCAN, Chris Cheng strongly hopes the government will not overlook health care needs in East Malaysia and the cancer community.
With 95.3 per cent the size of Peninsular Malaysia, Sarawak is the largest state in Malaysia, although it lacks transportation infrastructure. The health minister has stated that the Ministry of Health (MOH) is overly centralised, which results in excessive bureaucracy and the neglect of regions in the periphery during a recent town hall meeting in Kuching.
The top decision-makers in the MOH may not fully comprehend the difficulties in Sarawak, which makes matters more complicated. Decentralising our health care system to the state level with the appropriate institutions and resources is a significant priority.
Decentralisation and the autonomy that comes with it will enable local decision-makers to better handle the problems faced locally, resulting in a health care system that is more equitable, effective, and resilient.
One of the more pressing issues in Sarawak is the ageing infrastructure. Wards, operating theatres, treatment rooms, and even consultation rooms are always packed and not conducive for cancer patients. The building that houses the oncology unit is over 30 years old.
Deputy Premier Dr Sim Kui Hian has proposed a cancer hospital in Sarawak to solve this obstacle. We hope that in this budget, the necessary allocations have been made to make this hospital a reality. This must be not only the physical building but also the proper equipment and sufficient maintenance budget.
Infrastructure is only one part. The allocation of human resources must not be overlooked. The government must also train more oncologists, especially those from East Malaysia.
Currently, there are only seven oncologists under the MOH in Sarawak for a population of 2.56 million. This is far from the recommended number of one oncologist per 100,000 population. Other health care professionals will also be needed to have an adequately run hospital.
Cancer treatments can be costly. Advanced targeted therapy drugs like Osimertinib (for lung cancer) and Palbociclib (for breast cancer) can have six-figure prices, and these drugs are not yet covered by our government. They must be paid for by the patients. These medications are financially out of reach for B40 patients, and even those in the M40 because they are so expensive.
SCAN urges the government to find ways to deliver newer drugs to patients who need them, especially with the increase in health care funding that has been promised.
Even though demanding that all medical procedures are fully subsidised may be impractical, other measures such as the implementation of value-based reimbursement/pricing, the creation of a cancer fund, or even special national cancer insurance should be considered.
Technology should also be leveraged in its application and research to increase the accessibility to care. In Sarawak, the seven oncologists serving in the public hospital system are all based in Kuching. Telemedicine will allow the oncologists to do telementoring, guiding the medical officers in the district hospitals with cancer patients.
Telemedicine will also increase the pool of oncologists available as we will not be limited by those living in the state. Research is also another critical area. More funding for research such as clinical trials and drug development will also help get the necessary treatments for our cancer patients in Sarawak.
The government must make many difficult decisions about budget allocation, but we genuinely hope that this budget, as well as upcoming ones, will divide the pie fairly and holistically.
Do not overlook those living outside the centre of power. Let’s not abandon anyone.
The Society for Cancer Advocacy and Awareness Kuching (SCAN) is a registered society and a UICC member. It was established to become the unified voice for all cancer patients to improve access to high-quality public health care and to create cancer awareness to the general public to increase survival.
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