KUALA LUMPUR, Feb 15 – Bandar Kuching MP Dr Kelvin Yii today told the government to postpone constructing or opening new hospitals or clinics, due to staff shortages in the public health service.
The government backbencher from the DAP said the focus for this year and the near future should be on fixing and improving existing public health care facilities.
“It’s pointless to increase new hospitals or clinics, but we don’t have sufficient manpower. It doesn’t solve the problem, so our focus needs to change,” Dr Yii said in his debate on the motion of thanks on the royal address in the Dewan Rakyat.
An anonymous health care worker wrote to The Star last month that the newly opened Cyberjaya Hospital was not even running at 20 per cent capacity because of severe understaffing, and that no core staff have been identified for both Cyberjaya Hospital and the new Pendang Hospital in Kedah.
Selangor Menteri Besar Amirudin Shari reportedly said last Friday that the federal government plans to build a 300-bed hospital in Kapar, as well as another hospital in Sepang.
“Our focus should be on modernising existing facilities, investing in electronic medical record (EMR) systems plus maintenance, building a social care structure, investing in staff training, and to pay overdue fees as well as to increase the on-call allowance to a fair rate,” Dr Yii told Parliament.
He pointed out that the lack of maintenance and upgrades of digital systems in public hospitals has led to system breakdowns, such as the EMR system in Selayang Hospital, as reported by CodeBlue recently, that was once the country’s flagship paperless hospital in 1999.
The government backbencher suggested forming an inter-ministerial and inter-agency taskforce between MOH, MOF, and the Works Department to identify priority and need for health care facilities, besides monitoring infrastructure spending on procurement to prevent mismanagement and wastage in health spending.
“We know that every year, much funding is allocated to improve, upgrade, or construct health care facilities, especially in rural areas, but in many cases, the projects are delayed and become ‘sick projects’, causing mismanagement, wastage, and increase in costs.”
Revise On-Call Rates, Include MMA And MPS In Selection Process For Permanent Posts
Dr Yii said that while creating new positions in the public health service would be difficult and require cooperation with the Public Service Department (JPA) and the Ministry of Finance (MOF), reviewing on-call allowances for government doctors was “low-lying fruit”.
He pointed out that the on-call rate for government doctors in public hospitals is only RM200 on working days and RM230 on weekends, equivalent to just RM10 per hour, compared to locums in private clinics who can claim between RM60 and RM80 per hour.
“I know that JPA is currently in discussions (over this) and they always compare with other service schemes like teachers and engineers, but we can’t make these comparisons as it’s not an apple-to-apple comparison,” said the Pakatan Harapan (PH) Youth chief.
“We should compare with market rates because that’s the pull factor that will pull health care workers out from public service. If this is not prioritised, brain drain will continue.”
Dr Yii also called for greater transparency in the selection criteria for permanent positions in the health service, a chronic complaint among government doctors.
The Sarawakian legislator suggested prioritising those who serve in rural areas or district hospitals for permanent positions.
He also suggested including representatives from the Malaysian Medical Association (MMA) and the Malaysian Pharmacists Society (MPS) in the selection process with the Public Service Commission (SPA) of permanent doctors and pharmacists respectively.
“This will provide accountability and oversight and more confidence in the selection process.”
Form Inter-Ministerial And Interstate Task Force For Long-Term Health Reform
Dr Yii urged the government to form a task force for long-term health care reforms across ministries, agencies, and states, as he highlighted the social determinants of health.
“Health must no longer only be the business of the MOH, but a core priority for the whole of government, whole of society,” he said.
“Covid-19 has shown that health issues cross nearly all ministries; there must be a paradigm shift in health issues.”
Dr Yii told Prime Minister Anwar Ibrahim today to leave a legacy in difficult but necessary health care reform to stave off the ongoing crisis in the public health service.
The government backbencher from the DAP, citing CodeBlue’s recent survey among government health care workers, highlighted burnout and frustrations in the public health service that is even leading to rumours of a strike.
“There won’t be smoke without a fire,” Dr Yii said.
“I hope the government will admit and take these issues seriously; this doesn’t just involve the Ministry of Health (MOH), but involves nearly all government agencies and ministries. This is not an admission of weakness, but to identify current challenges and to strengthen political will for a paradigm shift in the health care system, or to rethink health care.
“It cannot be business as usual anymore.”
He urged Anwar, the country’s 10th prime minister, to put the health reform agenda as the administration’s top priority to not just improve people’s health, but as a catalyst to increase productivity and expand the economy.
“Why under the PM? Health must no longer be the business of the MOH, but a core priority for the whole of government and the whole of society. Who else is more suitable than the head of government himself?”
Health Financing Reform: Health Bonds, Social Health Insurance, Earmarking Sin Taxes
Dr Yii, who is Pakatan Harapan (PH) Youth chief, called for health financing reform, proposing ideas like payroll-funded social health insurance or the issuance of health bonds (sukuk kesihatan), as proposed by the Galen Centre for Health and Social Policy to raise funds for further investment of the health system and to support urgently needed solutions required in the immediate term.
“Infusion of new funds are urgently needed now to invest in modernisation of health care system such as electronic medical records, payment of outstanding dues to HCWs (health care workers), upgrading of working conditions, investment in capacity building and pay adjustments for qualified staff,” the Galen Centre said in its brief submission paper to the Ministry of Finance (MOF) in a recent consultation for the upcoming Budget 2023.
Dr Yii also suggested in the House to earmark sin taxes, at a rate of 5 per cent of the excise duty on tobacco and alcohol, for the treatment of cancer and other non-communicable diseases (NCDs). This, he said, could bring in about RM290 million in funding annually.
