Health care in Malaysia is divided into public and private sectors.
Public health care, which is available to the majority of Malaysians, is funded through taxpayers’ money. Public health care is more affordable and accessible to all, but lacking in amenities, is overcrowded, and patients are subjected to longer waiting times for procedures.
Given that public health care caters to a large volume of patients, there are still many areas requiring immediate attention.
Firstly, a recent news report highlighting that more than 200,000 will be left in the lurch due to inaccessible palliative care by 2030 is indeed worrying. Palliative care is defined as the approach that improves the quality of life of patients facing life-threatening illnesses by providing relief through pain and symptom management.
Malaysia is on the way to becoming an ageing nation, with more than 15 per cent of the people above 60 years old by 2030. The question is whether our public hospitals are equipped with the necessary equipment, trained specialists, knowledge experts, and staff to oversee palliative care.
The National Palliative Care Policy and Strategic Plan (NPCPSP) 2019-2030 has highlighted that Malaysia lacks effective palliative care services to meet the needs of an increasing population.
Palliative care is not limited to the hospital setting alone, but also exists within community-based care centres, home-based approaches, and hospice centres.
A palliative care specialist at a private medical centre revealed that the cost may go up to RM5,000 per day, a figure beyond the reach of many. So, the question is how prepared is Malaysia to integrate palliative care within the health care system by 2030?
That brings to my next point, facilities in public hospital wards. It has been reported that many VIPs and T20 groups are now turning to public hospitals for treatment, due to insurance premium hikes and soaring private health care costs.
But in which wards are they assigned to? How many ministers and government officials are staying in third-class wards?
Most third-class wards lack basic facilities, with rusty fans, rundown toilets, inadequate water supply and shower facilities, filthy shelves, dilapidated buildings, leaking pipes, and a stuffy environment.
Take a walk around the oncology wards, respiratory wards, and palliative care units. These places often paint a gloomy picture.
In April 2024, the Prime Minister said that the government will expedite the third-class ward facilities in Hospital Kuala Lumpur. Can the Ministry of Health (MOH) provide data on what has been done to improve conditions in these wards?
The term “third class” itself is degrading and condescending. Generally, the first-class and second-class wards are allocated to the higher-ranking civil servants.
For most people who cannot afford to pay for the higher-class wards, third-class wards are the only option left. Surely, the government can channel taxpayers’ money to revamp the facilities in these wards to improve the well-being of the patients.
Thirdly, it is common knowledge that there is a longer waiting time for patients to undergo medical procedures, surgeries, and scans in public hospitals. To get an appointment with a specialist would take much time, sometimes a couple of months.
Then, if there is a need for a biopsy or an MRI scan, there is another waiting period. In situations requiring immediate diagnosis, every minute delayed may only worsen the condition of the patient.
There are patients from Ipoh and Kota Kinabalu who have come to private hospitals in the Klang Valley to get their scans (MRI, PET, etc.) done, due to inadequate accessibility in their own cities.
This is one area of health care that requires the cooperation of all stakeholders. Building partnerships between the MOH and the private sector would speed up the diagnosis, consultation, and medical procedures for patients.
Patients with referral letters from private specialists need to go to the nearest klinik kesihatan first to get the medical officer in charge to rewrite the letter, failing which the patient would have to pay higher fees in a public hospital for specialist treatment.
Accordingly, specialist clinics in government hospitals are accessible to civil servants. The rest of us must get a letter from the klinik kesihatan. Are we all not Malaysians? Why is there the hassle of getting a medical officer to reproduce a private specialist letter?
If a patient bears a letter from a private specialist, a digital assessment of their MyKad is sufficient to prove that the patient is a Malaysian citizen, entitled to the right to seek specialist consultation in public hospitals.
Undoubtedly, the number of nursing homes and elderly care centres in Malaysia is increasing, especially in the Klang Valley, with fees ranging from RM3,000 to Rm8,000 per month, depending on the needs of the patient.
However, according to one of the operators of a nursing home in Petaling Jaya, there are only a few with proper licensing and complying with the regulated laws. The rest are without proper licensing, and this may lead to the compromise of the quality of care provided, as they may not be fully accountable to their clients.
This is a major area which requires serious attention, as many families who are working depend on these nursing homes to care for their elderly loved ones. Regulating nursing homes under a ministry with a proper binding agreement and health care act would do much to restore the public’s confidence.
If you walk into the lobbies of most private hospitals, you will be forgiven for mistaking them for five-star hotels. One can find a large aquarium, a grand piano, and opulent furnishings. It goes without saying that the operational costs will be passed down to the patients, increasing their bills and insurance claims.
The gap between public and private health care is poles apart. But let us not forget that both systems exist to cater to the health care needs of the country’s population. Integrating a holistic, comprehensive health care framework which utilises a whole-of-society approach and strategic partnerships between the two systems will help to meet the country’s health care needs.
After all, isn’t health care the basic right of every Malaysian?
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
