Health Minister Khairy Jamaluddin admitted in Parliament that the nation’s public healthcare system was chronically underfunded.
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Malaysia’s public healthcare system is critically ill.
In March 2022, Health Minister Khairy Jamaluddin admitted in Parliament that the nation’s public healthcare system is chronically underfunded — which is no real surprise…
Between the sudden influx of patients needing care during the peak of the pandemic, economic slowdowns and calls for reforms from civil service doctors and medical workers who feel that they are overworked and underpaid — the public saw first-hand how the nation’s healthcare system is struggling under the enormous weight of underinvestment.
In his address, Khairy confessed that compared to other middle-income countries that spend upwards of 4% of their Gross Domestic Product (GDP) on healthcare, Malaysia was only spending about 2.6% of ours in 2020.
Meanwhile, the World Health Organisation (WHO) and other experts suggest that nations should be spending between 5% to 8% of their GDP on public healthcare.
Referencing the 2018 Auditor-General’s report, the Minister acknowledged that this underinvestment caused “insufficiencies” within government health facilities including clinics and hospitals:
- Weaknesses within the emergency and trauma (A&E) departments
- Staff shortages due to high patient traffic
- Insufficient funding
- Inadequate medical equipment
The government wants to address these problems with more financial allocation and reforms to our public healthcare system, but no clear plans have been put forward yet.
Call for reforms
In 2019, Health Director-General Tan Sri Dr Noor Hisham Abdullah exclaimed that our public healthcare system was underfunded, understaffed with underpaid, overworked and overstretched employees, and facilities that are overcrowded with patients.
We are currently underfunded, understaffed, underpaid, overworked, overstretched and with facilities overcrowded with patients.— Noor Hisham Abdullah (@DGHisham) July 17, 2019
He asserted the statement again in 2020, saying that our public healthcare expenditure was too low and that “we have been underfunded for years”.
The same was mentioned by WHO Science Council member Prof Dr Adeeba Kamarulzaman who highlighted the importance of investing in healthcare as Malaysia struggles to deal with both non-communicable diseases and communicable diseases like Covid-19.
The collision of a high burden of non-communicable diseases, particularly obesity and diabetes, hypertension and end-stage renal failure, with a highly infectious disease, unfortunately, triggered the hyper inflammation that led to severe diseases.WHO Science Council member Prof Dr Adeeba Kamarulzaman via CodeBlue
Universiti Kebangsaan Malaysia (UKM) Faculty of Medicine Professor Dr Sharifa Ezat Wan Puteh elaborated that our public health system carries a “double burden” and needs to be improved.
This is because our burdens are not only communicable diseases due to Covid, we have a double burden, a huge amount of problems with non-communicable diseases as well. We have a high number of people with diabetes, hypertension, stroke, heart problems and so on, so we need to tackle this in a holistic manner.UKM Faculty of Medicine Professor Dr Sharifa Ezat Wan Puteh via BFM
In an interview with BFM, she explained that Malaysia’s public healthcare system can be divided into two categories: the primary healthcare system such as clinics, and hospitals where patients are being admitted.
Dr Sharifa said that although our primary care systems are well set up, they can still be improved in order to cater to issues relating to mental health and lifestyle diseases resulting from bad habits like smoking, drinking, unhealthy diets and the lack of physical activity.
She also specified that improvements can be made to how Malaysia acquires drugs and medicine.
If we talk about drug spending, most of the drug funding in Malaysia comes from government purchases. An example would be oncology drugs, they are very expensive and we need to purchase this because a huge number of our patients suffer from cancer, they need treatment.UKM Faculty of Medicine Professor Dr Sharifa Ezat Wan Puteh via BFM
Gopeng Member of Parliament and former Deputy Health Minister Dr Lee Boon Chye justified that in order to fix problems in our public healthcare system and make it future proof, we must:
- Determine the source of financial funding — either from general taxation or other alternative sources.
- Improve the quality of healthcare delivery and services.
- Make healthcare affordable.
- Make healthcare services accessible — especially for marginalised groups and those in rural areas.
During the same interview with BFM, he added that with Malaysia’s ageing population, there is an increased demand for healthcare services, especially in cases of non-communicable diseases.
He asserted that the country needs to strengthen our:
- Geriatric care or elderly care facilities such as old folks’ homes
- Ambulatory care or outpatient care where patients receive treatment at home.
Inequalities on the ground
In an opinion piece published by Malaysiakini, author and former journalist Christine YP revealed that there exists a clear gap between rich and poor in terms of getting healthcare services here in the country.
She explained that there’s a lack of access to new treatments and therapies for people in the low-income bracket — especially when it comes to non-communicable diseases like cancer.
The treatment gap between the T20 and B40 is real. Cancer Research Malaysia reported that while high-income breast cancer patients in Malaysia have a survival rate of over 90%, low-income patients have a less than 65% chance of surviving the disease.Christine YP via Malaysiakini
Although this is disheartening, Christine says that there’s definitely room for improvements to make universal healthcare available for all.
Inequality exists in every fabric of society and while our coffers may not be able to provide state-of-the-art treatment for all, there is potential to strategically plan, purchase and implement science-backed targeted therapies for the most common cancers to narrow the treatment gap.Christine YP via Malaysiakini
She suggested that the country could do more to bring advanced, lifesaving medicine to all quarters of the population.
If targeted therapies for breast cancer can be introduced to suburban and rural hospitals in the country, the overall survival for cancer patients can be prolonged. The European Society for Medical Oncology 2021 congress highlighted that targeted therapies for breast cancer such as Ribociclib (CDK 4/6 inhibitor) showed a median overall survival of more than five years for metastatic breast cancer, which is one year more than hormone therapy treatment.Christine YP via Malaysiakini
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