KUALA LUMPUR, Dec 24 — In a reflection on his past two years of office, Health Minister Dzulkefly Ahmad compared Malaysia’s public health service to the United Kingdom’s NHS.
He wrote that he received, with an open heart, criticisms by “sceptics” about how the public health care system under the Ministry of Health (MOH) was a “sinking ship” or “trapped in the last century”.
“Although the criticism is sometimes painful, it is an important wake-up call,” Dzulkefly wrote in a foreword for a booklet released by his office that documented the health minister’s initiatives over the past 24 months.
“However, it must be emphasised that our system continues to demonstrate remarkable resilience; at a time when giant systems such as the UK’s NHS are grappling with the risk of paralysis, our public facilities remain the final bulwark where the people can seek refuge.”
Dzulkefly, who replaced Dr Zaliha Mustafa as health minister in December 2023, said he was building a “future-ready, future-focused, and future-proof” health care ecosystem.
“Through the approach of five Strategic Clusters, we are shifting the system’s centre of gravity from sick care to health care. This involves strengthening primary care to reduce congestion in secondary and tertiary hospitals, while also ensuring that the welfare of health care workers, as the central lifeblood of the system, is safeguarded through a fairer and more sustainable working environment.”
The UK government released last July a 10 Year Health Plan for England that touts three big shifts to how the NHS works: from hospital to community, from analogue to digital, and from sickness to prevention.
Malaysia’s Parliament adopted a Health White Paper (HWP) in June 2023, when Dr Zaliha was health minister, that touted a 15-year plan to future-proof Malaysia’s health care system.
However, the 47-page booklet on Dzulkefly’s 50 initiatives over the past two years doesn’t explain how these initiatives fit in the HWP that is only mentioned once – as being under the MOH’s Health Transformation Office (HTO).
The five Strategic Clusters in Madani’s health reforms are health care delivery; health human resources; institutional governance; health care financing; and public health, safety, and prevention.
Health Care Delivery
Under health care delivery, the minister’s office touted the implementation of a cloud-based clinic management system (CCMS) in 309 primary health care facilities, where 70 per cent of patients were attended to within 30 minutes.
MOH’s Hospital Services Outsourcing Programme (HSOP), which outsourced 66,023 patients to private hospitals, reduced waiting times by 75 per cent. The booklet does not specify how many months or years the waitlists are for various procedures.
A total of 880 dilapidated clinics nationwide, focusing on Sabah, Sarawak, and the interiors, were upgraded for RM960 million. About RM2.86 billion was allocated for 25 new constructions, upgrades, and additional buildings for hospitals in 12 states.
Health Human Resources
Under health human resources, the registration of specialist doctors under the parallel pathway was resolved with amendments to the Medical Act 1971. The Bayaran Insentif Pakar Pra-Warta (BIPPW) was implemented, where this allowance – at the same rate as Bayaran Insentif Pakar (BIP) – will be paid to doctors when they begin supervised working experience.
Dzulkefly’s office boasted the highest number of permanent appointments from 2024 to 2025, during which 10,994 medical, pharmacy, and dental officers were given permanent appointments. A total of 4,328 nurses have been given permanent appointments since 2024.
Medical and dental officers also received an approximately 43 per cent increase in their on-call (ETAP) allowance, the first raise in 14 years, while a 42-hour work week was retained for more than 82,000 health care workers in five critical schemes.
Dzulkefly’s office further touted the ePlacement 2.0 system for medical officer postings, as well as the Suka Sama Suka Platform (P3S) that has benefited 52 nurses in its first phase. The mutual posting swap system will be expanded to doctors, assistant medical officers, dentists, and pharmacists next year.
Institutional Governance
Under institutional governance, the MOH created a digital health division; Health deputy director-general positions for dental, pharmacy, and food quality; and the HTO.
There is also a National Centre for Food Safety, while the National Transplant Resource Centre (NTRC) was restructured from being under Kuala Lumpur Hospital to the MOH’s medical development division.
Health Care Financing
Under health care financing, Dzulkefly’s office touted the Reset initiative by Bank Negara Malaysia, the Ministry of Finance (MOF), and the MOH to curb medical inflation. This includes the development of a base medical and health insurance/takaful (MHIT) product and transitioning private hospitals to the diagnosis-related groups (DRG) reimbursement system.
The minister’s office said Rakan KKM will be implemented by the first quarter of 2026. The MOH’s private wing programme is currently facing regulatory barriers from the Private Healthcare Facilities and Services Act 1998 (Act 586).
The drug price display mandate, which is legally under the Domestic Trade and Cost of Living Ministry’s (KPDN) jurisdiction, was also highlighted. However, the High Court yesterday granted a temporary stay of the price transparency policy until February 4, 2026, in a judicial review application by doctors’ groups.
Dzulkefly’s office touted an increase of private general practitioners’ (GPs) consultation fee to RM80, while maintaining an RM10 floor, describing this as the “biggest reform” in 30 years to strengthen primary care while ensuring an affordable minimum fee.
“The increase will instead encourage doctors to provide more efficient and responsible services,” Dzulkefly was quoted as saying.
Doctors’ associations previously condemned the government’s decision to retain an RM10 floor, saying that this would allow third-party administrators (TPAs) to continue undercutting GPs. The doctors’ groups want a minimum RM50 consultation fee.
Public Health
Under public health reform, Dzulkefly stressed the importance of preventive care to curb non-communicable diseases (NCDs), citing the enactment of the Control of Smoking Products for Public Health Act 2024 (Act 852) that prohibits the sale of tobacco and vape products to minors aged under 18.
A total of 147,326 compound notices have been issued under Act 852. Dzulkefly was also quoted as saying that banning vape was “only a question of when and how”.
Anti-tobacco groups, however, now describe Act 852, the country’s first standalone tobacco control Act, as a law “tainted” by corruption, following a bombshell revelation from Dr Zaliha’s former political secretary, G. Sivamalar, that she had personally witnessed the health minister rejecting an RM50 million bribe to kill the tobacco generational end game (GEG) policy.
Sivamalar told CodeBlue last Saturday that neither she nor Dr Zaliha had reported the RM50 million bribe offer to the authorities. But the PKR deputy secretary-general then claimed in a press statement yesterday – after lodging a report with the Malaysian Anti-Corruption Commission (MACC) – that she did not report an “implied” offer when it occurred two years ago because she found no “serious or explicit” bribery offer that “met the threshold requiring immediate reporting”.
The booklet by Dzulkefly’s office touted the MOH’s War on Sugar, Smoke, Salt, Stigma, Sedentary, as well as the Lung Health Initiative, under which 4,692 lung screenings have been conducted nationwide since May this year.
Free influenza shots were given to 165,000 senior citizens aged 60 years and older, with an RM2.5 million allocation.
The MOH also has a Senior Citizen Health Service Action Plan 2023-2030 and a Dementia Action Plan 2023-2030 that focus on healthy ageing, nutrition, and holistic health care services by expanding primary care access.
Mission For 2026
“We acknowledge that human resource challenges can no longer be managed manually or through a one-size-fits-all approach,” said the booklet by Dzulkefly’s office.
“Talent attrition rates and issues of task distribution require solutions supported by accurate and granular data.”
By 2026, the MOH will operationalise a centralised human resource (HR) dashboard that provides a comprehensive and detailed overview of the “health” of its workforce. This will enable strategic decisions to be made based on three key data pillars:
- Capacity Expansion (Supply): Monitoring projected workforce needs against current supply to enable more precise appointment and recruitment planning.
- Equitable Distribution (Maldistribution): Identifying placement gaps in real time to ensure that no critical facility experiences staff shortages relative to others.
- Retention and Development (Attrition and Retention): Analysing resignation trends and the effectiveness of incentives and career development, allowing for early interventions before critical talent exits the service.
To manage congestion in public health care facilities, the MOH touted real-time monitoring of capacity at each clinic and hospital, enabling proactive planning of maintenance, upgrades, and management and procurement of assets.
“We will leverage big data to implement more aggressive decanting projects—transferring stable patients to district hospitals or procuring private services (outsourcing) at the right locations. This approach not only reduces waiting times but also alleviates overcrowding in major hospitals, thereby improving comfort and the overall patient experience,” said the booklet.
For public health, the MOH plans an integrated dashboard to monitor the implementation status of electronic medical records (EMR) and digitalisation at each facility.
“Most critically, we will leverage big data to monitor the effectiveness of NCD management programmes at the community level. By analysing treatment outcome data at a granular level, we can design more targeted public health interventions (precision public health), shifting from reactive treatment to more focused, proactive, and high-impact prevention,” said the booklet.
Dzulkefly wrote in his closing remarks that his work from 2023 to 2025 wasn’t the end, but a critical “structural correction”.
“We have laid a strong foundation. Now is the time to build a solid structure upon it to ensure that every citizen, regardless of background, can enjoy dignified health care services.”
