Health sector challenges for new government
A FRIEND from Britain taunted me and my friends on the eve of our 14th General Election, saying sarcastically that we Malaysians are a passive lot and seem content to choose the same party to be the government for close to six decades. We painfully accepted what he said and then reminded him that nothing was certain since the election had not taken place yet.
When the election results were officially announced, my British friend called up to convey his utmost respect to all Malaysians for finally making history and sending a clear message that the power to choose the government lies in the hands of the rakyat.
We dared to take a gamble and put our trust in a new government. I was, of course, a proud Malaysian that day and I know that the new government will do well as we have Tun Dr Mahathir Mohamad at the helm to put the country back on track, assisted by the other coalition partners, many of whom have huge doses of enthusiasm, resilience, passion and grit.
We all love our country and we need to show the world that we now have a government which will institutionalise good governance, transparency, integrity, accountability, fairness and justice to all. Our country is blessed, and with a responsible government, we will surely soar upwards and reclaim our title as one of the formidable tigers in Asia.
I would like to take this opportunity to remind the new government that there are many challenges facing the health sector currently, including the changing pattern of diseases (increasing number of non-communicable diseases or lifestyle diseases), increase in the ageing population, rising healthcare costs, increasing consumer demand for quality services, patient safety, public-private dichotomy, inequitable distribution of resources and a highly subsidised government healthcare service, resulting in a heavy workload and long waiting time, all of which could compromise the quality of the services delivered.
Advances in medical treatment and technology are pushing us to offer even better services but at great costs. Failing to accommodate these advances will soon make our healthcare services irrelevant and obsolete.
Financing healthcare in this country is presently fraught with challenges. Currently, finance sources are direct taxes, private insurance premiums, out-of-pocket payments, contributions to EPF and Socso and indirect taxes.
New drugs and new methods in healthcare delivery have led to higher healthcare costs over the past decade. The allocation for the Health Ministry for 2018 is RM26.58bil, which is a 9.5% increase from the 2017 budget. The increase in allocation for healthcare cannot keep pace with the rising healthcare costs. There is just not enough money in public hospitals for most things. There is even greater inequity in the private sector in terms of resources, equip- ment and healthcare costs. To improve further equity, accessibility, quality, integration and regulation of healthcare services, it is time to introduce an integrated healthcare system, strengthen primary care by shifting it closer to the community, and introduce some form of healthcare financing.
Private primary care physicians or family physicians should be invited to enforce wellness paradigm initiatives and bring health information closer to the people so that they can be responsible for their own health.
We are an overweight and obese nation. There is no time for slogans and traditional educational programmes. What we need is an innovative way of disseminating health messages to the masses so that, armed with knowledge, they can indulge in responsible self-care and only visit clinics and hospitals if required.
Although some work has been done in this area, more needs to be done. Information and communication technology can be employed to do this.
As Malaysia strives to become a high-income, developed nation, we must upgrade and adapt our health system to overcome current and future challenges. We need to enhance universal coverage, improve quality of care and health outcomes of the rakyat, ensure good financial protection for those who fall ill, strengthen governance and make certain that Malaysia’s health system remains viable and sustainable for generations to come.
TAN SRI DR HAJI MOHD ISMAIL MERICAN Former Director General of Health, Malaysia