‘Underfunded for years’

Medical practitioners wish for bigger allocation for healthcare

PUTRAJAYA: With Covid-19 hitting Malaysia’s economy hard, Budget 2021 is expected to focus on the country’s recovery measures.

But as pointed out by the Health Ministry (MOH), its battle on the ground against the pandemic is equally important for economic rejuvenation.

“We hope the ministry will be given more allocation to fight the war on Covid-19. We have been underfunded for years.

“The public funding for healthcare is only 2.2% of the country’s GDP (Gross Domestic Product).

“That is among the lowest,” Health director-general Tan Sri Dr Noor Hisham Abdullah told The Star.

During Budget 2020, the ministry was allocated RM30.6bil, which was an increase from RM28.7bil the year before.

Dr Noor Hisham said 4% of the country’s GDP would be an ideal quantum for the ministry’s allocation from the government.

Former health minister Datuk Seri Dr Dzulkefly Ahmad concurred, saying that health is a macro-critical economic, social and political imperative.

He said that more must be allocated to employ doctors, nurses and pharmacists, with a need to correct the huge disparities of medical staff between Peninsular Malaysia and that of Sabah and Sarawak.

“There is a need to correct this deficit and the inequitable distribution,” he said, adding that while there is one doctor to every 500 Malaysians, the ratio in Sabah is one doctor to 900.

Dzulkefly said he had applied to the Public Service Department for an additional 10,675 medical posts last year, but was not sure of the outcome of this.

He also stressed on the importance of allocating a budget for the Covid-19 vaccine, which is expected to be out next year.

Another former health minister Datuk Dr S. Subramaniam said the upcoming Budget should empower the ministry to manage the pandemic effectively.

Better allocations for frontliners, strengthening medical services and allocation for emergency purchases should be provided, he said.

He also called for a transparent and effective procurement process.

“Greater flexibility should be provided for the creation of contract posts to the MOH. Likewise, recognition for all frontliners across the government with sufficient remunerations and appreciation should be announced,” he said.

Malaysian Public Health Physicians Association president Datuk Dr Zainal Ariffin Omar hoped there would be incentives for healthcare frontliners.

There should be a special allowance for PPE as well as childcare incentives for frontliners even during non-critical times, he said.

Dr Zainal hoped there would be a special prevention and disease control team formed to focus on global health issues and provide suggestions to the government on protecting public health and well-being.

Medical Practitioners Coalition Association of Malaysia president Dr Raj Kumar Maharajah said emphasis should be placed on efficient use of resources, prevention of diseases, as well as the recovery phase of the pandemic.

“The situation is fluid so we need a budget for effective vaccines and treatments for the coronavirus.

“Due to the pandemic, the government may have to increase its allocation for the public healthcare system, advocating an increase of 20% to both operating expenditure and staffing levels over the next two years for Covid-19 screening and treatment,” he added.

Malaysian Medical Association (MMA) president Prof Datuk Dr M. Subramaniam said the pandemic and its aftermath was predicted to continue for another one to two years.

During this time, there will be certain ministries with decreased activities or lower needs.

“We propose that some of the budgets from these ministries be repurposed to meet the needs in healthcare,” he said.

He said there was a shortage in positions for junior doctors, nurses and paramedic staff.

“Many new and existing facilities and departments are unable to operate due to lack of human capital.

“MMA hopes that the government will also provide a 10-year extended contract for medical officers to allow for specialisation in the masters programme.

“Once they are qualified as a specialist, permanent post at U054 can be offered.

“In the long term, investing in homegrown specialists would save the government on expenditure as there will be no need to hire from abroad,” he said.

Caring Pharmacy chairperson Datin Seri Sunita Rajakumar said there were many consumer-friendly initiatives which the government could consider implementing in Budget 2021.

She said insurance companies and third-party administrators, for example, should allow policy holders to refill their medicines at pharmacies, not just at hospitals and clinics.

Another suggestion, she said, was the separation of dispensing rights and printing recommended retail prices on medicines.