KUALA LUMPUR, Oct 8 – The government has cut funding to health education, the Peka B40 health screening programme, and psychiatry and mental health services under the Ministry of Health’s (MOH) 2023 budget.
According to the Finance Ministry’s Estimated Federal Expenditure 2023 document, although psychiatry and mental health under MOH’s medical programme received an overall 5.1 per cent increase from RM319.6 million for 2022 to RM336 million for 2023, services and supplies were reduced by RM580,000, or 2 per cent, from RM28.58 million to RM28 million.
Emoluments for psychiatry and mental health were bumped up by 5.8 per cent from RM291 million for 2022 to RM308 million for next year. However, the number of permanent positions in this programme remained the same for 2023 at 6,050, indicating salary raises or promotions for existing staff.
Finance Minister Tengku Zafrul Aziz, when tabling the federal government’s Budget 2023 in Parliament yesterday, announced an RM34 million allocation to establish a new National Centre of Excellence for Mental Health.
Galen Centre for Health and Social Policy chief executive Azrul Mohd Khalib, in his comments on the 2023 budget, said that it would have been better for the allocation to go towards increasing the number of psychiatrists, psychologists, and other mental health professionals, instead of constructing a new building.
Melaka Hospital psychiatrist Dr Gayathri K. Kumarasuriar and Dr Nurulwafa Hussain, head of the psychiatry and mental health department at Melaka Hospital, previously told CodeBlue that public hospitals have insufficient occupational therapists in the management of mental health, especially specialists in child and adolescent care.
They said wait times to see occupational therapists in government hospitals, who multitask with adult patients, can stretch from several weeks to months sometimes.
According to the Malaysian Medics International (MMI) in its policy brief titled “Improving Accessibility and Availability of Mental Health Services in Malaysia”, Malaysia should ideally have 3,000 psychiatrists evenly distributed across the country, based on recommendations by the American Psychiatric Association and World Health Organization of a ratio of one psychiatrist to 10,000 people.
As of February 2022, there were only 479 registered psychiatrists in Malaysia.
15% Budget Cut To Health Education, Peka B40 Loses RM5 Million
The government also made a large budget cut of 14.7 per cent to health education under MOH’s public health programme from RM60.8 million for 2022 to RM51.9 million for 2023, a decrease of RM8.96 million.
Emoluments for health education were cut by 33.5 per cent from RM25.5 million for 2022 to about RM17 million for 2023, although the number of permanent positions in health education remained the same for next year at 324.
The allocation for services and supplies for health education was reduced by about 1 per cent, or RM398,800, from RM35.3 million allocated for 2022 to RM34.9 million for 2023.
MOH cut its health education budget despite repeatedly calling for self-monitoring of one’s personal health, especially after the acute phase of the Covid-19 pandemic.
According to the National Health and Morbidity Survey (NHMS) 2019, one-third of Malaysian adults have poor health literacy.
MOH also cut the budget for its Peka B40 health screening programme by RM5 million, or 6.25 per cent, from RM80 million for 2022 to RM75 million for 2023, according to the Estimated Federal Expenditure document. Tengku Zafrul’s budget speech and Health Minister Khairy Jamaluddin’s press statement both quoted an RM80 million allocation for Peka B40 for next year.
Khairy said last April that only 10 per cent of 5.9 million eligible Malaysians, or 582,746 people, got screened under Peka B40 as of March 31 this year.
Based on Peka B40’s 2021 report, the number of beneficiaries undergoing their first health screening plunged from a peak of 49,422 in December 2019 to 9,864 in November 2021.
The budget cut for Peka B40 occurs even as health experts have repeatedly warned the government of a non-communicable disease (NCD) crisis.
According to the NHMS 2019, one in five people live with diabetes; three in 10 with hypertension; 3.4 million currently live with at least two NCDs; and half of the adult population are either overweight or obese.
However, Tengku Zafrul also announced in his budget speech an allocation of RM15 million for Agenda Nasional Malaysia Sihat (ANMS), a general health communications campaign launched in August 2020 to encourage a healthy and active lifestyle.
The disease control division’s budget under MOH’s public health programme was cut by RM401,800, or 0.04 per cent, from RM932.4 million for 2022 to about RM932 million for next year.
Emoluments for disease control were reduced by RM5.7 million, or 0.8 per cent, from RM741.5 million for 2022 to RM735.7 million for 2023, although the number of permanent positions remained the same at 13,558.
Services and supplies for disease control increased by RM5.3 million, or 2.8 per cent, from RM190.9 million for last year to RM196.2 million for 2023.
Overall, MOH’s 2023 budget increased by a whopping 11.5 per cent, or RM3.7 billion, to RM36.1 billion from RM32.4 billion in this year’s budget. The increment is the largest both in terms of percentage of increase and absolute figures in the past five years.
From the total of RM36.14 billion allocated in its 2023 budget, MOH will use RM31.5 billion for its operating expenditure and RM4.64 billion for development expenditure.