Doctors want to fix our healthcare system - here's their prescription

Doctors have launched a campaign pushing to overhaul the national healthcare system into one that is more efficient, accessible, inclusive and sustainable.

An effort led by the Malaysian Medical Association (MMA), they will spend the next 100 days compiling public support and recommendations for the Health Ministry on how the system can better address primary healthcare needs.

Primary healthcare is usually undertaken by general practitioners (GPs) or family doctors and includes preventive, curative, rehabilitative and palliative care.

The campaign, entitled the "Titiwangsa Declaration 2019", also calls for quality healthcare to be made available to all, including those who are unable to afford it. 

The campaign focuses on two areas of reform - strengthening primary healthcare and building a more sustainable health financing system that leaves no one behind.

This means more better-trained primary healthcare doctors, explained MMA president Mohamed Namazie Ibrahim at a press conference launching the declaration on Saturday.

This would help ensure that the basic health of every family in Malaysia was cared for.

“We have been asking the government to play a greater role in seeing that we have adequately trained GPs and family practitioners. As well as an adequate number of family physicians.

“This is low-cost [...] what we need is a low-cost healthcare system and I think this is where the concept of family physicians (is good) - one physician for one family who will look after the patients from 'womb to tomb',” Namazie said at a hotel in Titiwangsa, Kuala Lumpur.

Leaving no one behind

The system should also be able to accommodate the poor as well as the undocumented, stressed Malaysian Medical Council representative Dr Abu Hassan Asaari Abdullah.

“When we say leaving no one (behind), we don’t just address healthcare coverage for Malaysians, for example.

“There are people who are in Sabah and Sarawak (who are undocumented).

“We are talking about having to serve them regardless of whether they have money or not [...] our system must capture the need of those who are not,   somehow or someway, in the system (now),” he explained.

Not only did doctors have a responsibility to serve all regardless of status, but primary care was also more effective when accessible to everyone - both in terms of cost and the prevention of epidemics, said MMA national health policy committee chairperson Dr Teoh Siang Chin.

“It is better to do preventive care at a primary level rather than at an intensive care unit (ICU) level,” he said during the press conference.

Public healthcare facilities presently charge refugees and undocumented migrants full foreigner rates.

Presenting at a public forum afterwards, Federation of Malaysian Consumers Association (Fomca) president Paul Selvaraj commented that many Malaysians were choosing private healthcare because the public system was overcrowded and had long waiting periods.

“Private healthcare is expensive but people go anyway because they have to,” he said.

A large chunk of these patients was paying their medical bills using credit cards or from their savings, resulting in “serious financial problems” for some.

High medical bills have remained as one of the top reasons cited by the Credit Counselling and Debt Management Agency (AKPK) for bankruptcy among Malaysians. 

To address this, Paul mooted partnerships between public and private healthcare facilities to ease congestion as well as to lower medical expenses.

Funding the new system

Like the Fomca president, public policy and healthcare consultant Dr Chua Hong Teck (photo) told the forum that private facilities could be engaged to serve public healthcare needs, provided they were regulated well.

Moving forward, he suggested further increasing the health budget to four percent of the total federal expenditure, as promised by Pakatan Harapan in its election manifesto. 

Lauding the recently introduced MySalam and Peka B40 schemes, Chua believed the next step was to redistribute existing resources.

“The resources are there, you just need to redistribute them,” he said.

For example, he compared overcrowded urban public healthcare facilities to “underutilised” rural ones and suggested that the government provide transport facilities to allow patients to travel to available hospitals.

The forum was held in conjunction with MMA’s launch of the campaign.

The Titiwangsa Declaration 2019 is in support of the Health Ministry’s move to sign the World Health Organisation’s (WHO) Astana Declaration, which stressed a commitment to Universal Health Coverage. 

Universal Health Coverage means health services should be able to be accessible to all who need them, not just those who can pay for them; the quality of health services ought to be good enough to improve a patient’s health; and the cost of such health services should not put people at the risk of financial harm.  -Mkini