Make allocations for health more transparent

 

I wish to refer to the explanation by the finance minister on the allocations for health yesterday. He basically claimed that there were no reductions but only reclassification of certain expenditures under a cluster called “Program Khusus”, among others.

This opens up few questions that need further clarification. Why is there a need to reclassify it and put it under a consolidated “area” instead of dividing them and specifically channelling them to the individual departments or disciplines?

This is less transparent and we do not exactly know whether there is a reduction or increase for each department. We will not be able to gauge if it is sufficient and adequate.

Classifying it under a consolidated “Program Khusus” is also not a good idea. How does each department obtain its share from this allocation? Do they need to apply for it? Who makes the decision to approve?

What it actually does is that it adds more layers of bureaucracy which may delay the funds even if it is a matter of urgency. Imagine how much extra paperwork will be involved in this new process.

In healthcare, there is always a need to obtain funds as quickly as possible as it may mean a matter of life or death. Who then decides who gets the funds as everyone will fight for it since the “Program Khusus” appears to be a highly discretionary one.

I wonder who will get the funds first — the one with a bigger “cable” or will the loudest voice win? How can the clinical departments in the country plan ahead, especially when it comes to patient care when they don’t even know how much they are truly getting?

Without a clear budget now, how will clinicians know how many patients they can treat in a year?

I fear this move will adversely affect the timing of clinical plans too because when hospitals run out of drugs, which is frequent these days, they usually turn to pharmacies to help replenish.

However, the budget for pharmacies has been cut drastically, which means they will now have to go through the whole process of applying for it from “Program Khusus”.

This will impact the work of the clinician which in turn will affect the patients and the quality of care.

If there is no planning, I foresee patients getting the short end of the stick. Imagine being told by your clinician that they cannot treat you because they are waiting for the funds to be approved.

It is imperative that allocations are made transparently so that each clinical department can then plan ahead and will know how best to utilise it.

The core issue here is that the 4.3% growth in health budget is highly insufficient, especially at a time when we are facing Covid-19 and also other prevalent diseases. In addition, we need to address the systemic gaps in our healthcare due to decades of under-investment.

Such an increase is expected due to expenditure for Covid-19, but it also shows there is no growth for other disciplines and little investment to address systemic shortcomings. We need to do more.

To build a resilient healthcare system, we need to invest to make sure it has sufficient infrastructure and human resources to handle not just a pandemic, but also the challenges faced by public hospitals to provide quality care for all patients.

Dr Kelvin Yii Lee Wuen is MP for Bandar Kuching. - FMT

The views expressed are those of the author and do not necessarily reflect those of MMKtT.