Harapan: Public Health Spending 5% Of GDP In 5 Years

PH pledges to raise public health care spending to 5% of GDP in 5 years, as well as to introduce a National Health Services Commission to manage health care professionals’ human resources and a Health Commission to monitor a National Health Reform Plan.

KLANG, Nov 2 – Pakatan Harapan (PH) has pledged to increase public health care expenditure to 5 per cent of Malaysia’s gross domestic product (GDP) within five years in a single term.

PH’s election manifesto for the 15th general election, titled “Kita Boleh! Harapan GE15 Action Plan”, stated that its target to double Malaysia’s public health spending to “5% in 5 years” – or by late 2027 – was necessary to keep up with national population growth, longer lifespans, and current needs.

PH’s prime minister candidate Anwar Ibrahim said that government revenue to fund a bigger public health care budget could be obtained from cost-cutting measures, such as a smaller Cabinet and by plugging leakages in public spending.

“That’s why I said, we’ll do it by looking at the state of the economy and gradually implement these reforms, but the commitment stands,” Anwar told a press conference at the launch of PH’s GE15 manifesto here today, when CodeBlue asked how PH plans to fund items like increased public health expenditure and allowances for caregivers of the elderly or incapacitated.

“I am more optimistic. Having some limited experience both with the World Bank and IMF (International Monetary Fund), and also the Treasury, we can start by ensuring that we adhere to the rules – no abscondment of funds, no corruption – you can save 30 to 40 billion ringgit.”

Then-Health Minister Khairy Jamaluddin, under then-Prime Minister Ismail Sabri Yaakob’s administration, told a town hall session in Kuching, Sarawak, last September that he targeted eight years, or the year 2030, to double Malaysia’s public health care budget to 5 per cent of GDP.

Despite the Ministry of Health (MOH) receiving an 11.5 per cent increase in Budget 2023 tabled last October 7 to RM36.14 billion, critics have pointed out that the public health budget remained stagnant against the GDP at 1.98 per cent, the same share as in 2022. Parliament was dissolved before the 14th Parliament could pass the federal budget.

Contract doctors and health care workers’ welfare are among 10 priorities of the Harapan Action Plan that PH promised to embark on immediately if it is elected into federal government in the upcoming November 19 poll.

“Harapan will develop local specialists, which includes addressing the issue of contract health care workers in order to deepen the capacity of the public health care system,” PH said in a press release.

“At the same time, we can work to guarantee the continued welfare of health care workers, while acknowledging their role as the fulcrum to our collective efforts at improving the quality of national health care delivery.”

Among other health care reforms proposed in its GE15 manifesto, PH also pledged to introduce a shift system in public hospitals to safeguard the welfare of doctors and other health care workers.

“This is similar to other countries and it is done to ensure specialised services are available to all segments of society and also to optimise usage of public health care and medical facilities.”

PH plans to reform public health care service delivery as well.

“The national health service delivery reform will cover reduction of waiting periods for procuring health services, modernising health facilities, and establishing flexible operating hours at clinics located in high population areas.”

The coalition further aims to establish two commissions related to health.

One is a National Health Services Commission that will specifically manage human resources, staffing, training, and career growth of health care staff, in a bid to resolve contract doctor issues amid insufficient permanent posts.

Currently, human resources and staffing of health care professionals in the public sector across MOH, university hospitals in the Ministry of Higher Education, and military hospitals in the Defence Ministry, are managed along with other civil servants by the Public Service Department (JPA), instead of by a separate service commission.

The other commission proposed by PH is a Health Commission to tabulate and monitor the execution of a National Health Reform Plan with the Economic Planning Unit (EPU), the Ministry of Finance, MOH, and the Ministry of Education.

PH’s election manifesto used a different term for a proposed document of health care reform – “National Health Reform Plan” – as opposed to the “Health White Paper” name that Khairy had used to describe his proposals for long-term health care reform spanning 15 years.

PH said that its National Health Reform Plan would tackle systemic health care issues, including health care financing, decentralisation of power, and public and private partnership (PPP).

The coalition highlighted Malaysia’s non-communicable disease (NCD) crisis in its GE15 manifesto, pledging to focus on primary care, health screening, health education, welfare, public health, and also to reduce harmful habits like smoking.

PH did not explicitly cite Khairy’s proposed generational end game (GEG), his controversial plan to ban smoking and vaping for anyone born from 2007 that had received bipartisan objection from MPs in the 14th Parliament.

The Harapan Action Plan also proposed shifting from sick care to health care and wellness, including addressing the social determinants for health, such as poverty, and preparing health education and equal access to health care for all.

This was another proposal that Khairy previously talked about in his communications of the Health White Paper and health care reform.

PH pledged to expand coverage of the mySalam health protection scheme and the Peka B40 health screening programme from the bottom 40 per cent (B40) to the middle 40 per cent (M40) of income earners.

The coalition also promised to expedite amendment of Section 309 of the Penal Code to decriminalise attempted suicide and to expand insurance coverage of mental health services.

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