Galen: All Coalitions Making Empty Promises On 5% Of GDP For Health

The Galen Centre says it’s not enough to cut wastage or corruption to boost health care funding; PH, BN, and PN show business-as-usual for health financing without commitments to reform.

KUALA LUMPUR, Nov 10 – The Galen Centre for Health and Social Policy today criticised Pakatan Harapan (PH), Barisan Nasional (BN), and Perikatan Nasional (PN) for unrealistically pledging to raise public health care spending to 5 per cent of Malaysia’s gross domestic product (GDP).

Galen Centre chief executive Azrul Mohd Khalib noted that although PH’s manifesto for the 15th general election mentioned health care financing reform, the coalition did not make specific commitments, such as earmarking revenue from sin taxes, introducing social health insurance, or proposing other methods of securing new funding for health care.

The GE15 manifestos by BN and PN made no mention of health care financing reform whatsoever.

“Unfortunately, in the area of health care financing, although all three political coalitions indicated commitments to increasing public health expenditure to at least 5 per cent of GDP over the next five years, these targets appear to be empty promises,” Azrul said in a statement. 

“It is simply impossible to increase funding to those targets without reforms.

“It simply isn’t enough to cut wastage, crack down on corruption, and hope that it is enough to bridge the gap between what we have today and these ambitious targets. This missing commitment implies business-as-usual for health care financing.”

The Galen Centre previously identified four critical issues currently affecting the sustainability and resilience of Malaysia’s health care system, namely health care financing, non-communicable diseases (NCDs), mental health, and ageing population.  

“Political parties needed to respond to at least three to indicate that they are serious about health. Both PH and PN meet this requirement,” said Azrul.

Azrul said the pledges contained within the election manifestos reflect the level of respective political coalitions’ understanding, appreciation and commitment to addressing serious systemic health issues from the catastrophic health burden of NCDs, new and emerging diseases like polio and Covid-19, an ageing population, and increasingly complex and diverse health needs, including mental health.

“Overall, only Pakatan Harapan and Perikatan Nasional seem to get the urgency, while Barisan Nasional appears to want health issues to be in the rearview mirror, a bad dream needing to be forgotten.”

The Galen Centre noted that BN’s PADU manifesto omitted crucial issues identified through the Health White Paper process, such as dealing with the ongoing NCD crisis. 

The Health White Paper project was initiated by Khairy Jamaluddin when he was health minister, but the paper was never published or tabled in the Dewan Rakyat before the dissolution of Parliament.

“If taken at face value, Barisan Nasional’s approach to health would be disastrous,” said the Galen Centre.

“The manifesto is missing many of the proposed necessary reforms championed by former health minister Khairy Jamaluddin, which ironically seem to have been adopted into the PH edition.”

Azrul said BN’s 2022 manifesto does not even meet the standards of its previous 2018 manifesto.

“One glaring problem: It has delegated aged care to non-government organisations by providing RM105 million over five years, which is not only incredibly insufficient but also improper to expect NGOs (non-governmental organisations) to deliver essential care services to a population of millions. This is a government responsibility.”

The Galen Centre welcomed pledges on aged care in the manifestos by all three major political coalitions, noting that by 2030, at least one in 10 people will be aged 65 or older or surpassing 15 per cent of the total population. 

“Very little has been done to prepare, coordinate and provide essential support and specialised services for the aged such as disability and care, social and financial security systems, welfare services, and realistic retirement schemes,” said the think tank.

“PH’s extensive pledges on aged care and the care economy overall demonstrate understanding of the urgency and gravity of the problem.”

On mental health, the Galen Centre noted that although this was mentioned in the manifestos by both PH and PN, their proposals were light on specifics.

“Mental health services need more investment to train and increase the number of health care professionals and support personnel in this field, not new buildings,” Azrul said.

According to the “staggering” findings from the National Health and Morbidity Survey 2019, one in three people in Malaysia were suffering from at least one type of mental health disorder. 

Nearly one in 10 children aged between 10 and 15 years, and 8.4 per cent of girls had mental health issues. As many as a quarter of adults experienced functional difficulties. 

“The impact of the Covid-19 crisis on mental health in this country has not been properly understood or described,” Azrul said.

He said many questions remain about health pledges in the election manifestos by PH, BN, and PN.

“Government hospitals, clinics and health facilities under continuous strain from increasing public demand and dependency, are encountering problems of decreasing numbers of healthcare workers, ageing infrastructure and equipment, insufficient funding, and public and political fatigue caused by the Covid -19 public health crisis. 

“The quality and coverage of health care in Sabah and Sarawak remain inadequate for a landmass larger than Peninsular Malaysia. There is no mention of improving health care for the disabled.”

Azrul called for a change in public belief that health should not be “politicised”, noting that health care has rarely, if ever, been the focus of political debate in election campaigns.

“We must avoid taking our healthcare system for granted and expecting it to somehow sort itself out. This coming general election provides an opportunity for Malaysians to ask those running for office, not only their fixes for existing problems, but also their plans for the future of the country’s health care.”

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