Let’s start building humans as well as hospitals

A new year is always a reason to be optimistic. It signifies new hope and new beginnings.

And for the more jaded amongst us a chance to perhaps restart and do things better this time around.

Politically the country has had a new beginning, with the first unity government in decades getting off the ground and settling in (for the long haul hopefully). Ministers and ministries seem to have started working, and overall the country looks to be geared to face the new year, with its attendant challenges and opportunities.

But Murphy (of the infamous Murphy’s Law) is already hard at work to usher in the new year as well. Dark clouds are gathering over the health horizon with yet another new Covid-19 Omicron strain, this time named BF-7.

Coming hard on the heels of the decision of the Chinese government to finally reopen their borders and concerns that this could cause Covid-positive tourists coming into the country and driving another round of Covid-19 shutdowns, things do look to be a little bleak for most Malaysians.

The past few weeks have been quite concerning for the healthcare landscape for some other reasons as well.

First, the issue of overcrowding and congestion in emergency departments of public hospitals. Across the country, many departments are reporting that they are ‘full up’ at the hospital gateways i.e. the Emergency Departments because they are unable to admit patients to wards for the comprehensive care needed.

This, of course, is a phenomenon that has been ongoing for years, and has already received much publicity due to the Auditor-General’s Report in 2018. But with the onset of Covid, nothing much has been done to address the systemic issues leading to these conditions. With more than two thirds of Malaysians depending on the public healthcare system for inpatient care i.e. getting admitted for their illnesses; and less than 25% of the population actually having private health insurance – there is not going to be any reduction in terms of demand in the foreseeable future. That’s a reality that’s not going to go away.

But the situation is not exactly hunky dory in the private hospital landscape either. Patients being treated in the private hospital landscape continue to wait for a long time before getting into the wards- and the problem in this case seems to be due to a lack of allied healthcare professionals especially nursing staff.

We are ‘bleeding’ nursing staff to so many other countries including Singapore and the Middle East as fast as we are training them; and even within the country we are losing staff to a host of other reasons including those healthcare professionals leaving the healthcare sector entirely for other, more rewarding, better-paying jobs.

The concerns for healthcare are perhaps most acute when it comes to the ‘cream’ of the healthcare service- its doctors. Also in the news this past week is the ongoing plight of young doctors, many of whom are either quitting the health landscape or moving to greener pastures abroad. With uncertainty about their careers and no clear solutions ahead for many of these doctors, especially those on contract, it should come as no surprise to us that they are making a choice to not be in the Malaysian healthcare system.

For most individuals and organisations in the healthcare landscape, this is not news. Most of us have been talking about this for years. In 2021, for example, NCD Malaysia, the National Cancer Society of Malaysia and the Malaysian Medical Association Public Health Society together published a report on Healthcare Workers in Malaysia and a summary.

However nothing has changed. The system remains damaged and the damage seems to be getting worse.

The end loser, unfortunately, is no one but ourselves. The loss of each of these individual healthcare professionals represents a loss of capacity to the healthcare system – fewer and fewer trained personnel who can help manage things when things go wrong, as they did in 2020.

Our healthcare situation is as bad as it was in 2020 when Covid-19 first struck us. Today, with the worsened cracks in the healthcare system, it is highly doubtful whether we could weather a similar health emergency.

This year, with a new united government, it is perhaps time (and hopefully enough political will) to fix the perennial healthcare problem. Top of the list is how to build and maintain our healthcare human capacity.

Let’s start ‘building’ humans as well as hospitals. Both are needed for our healthcare system to stay healthy. - FMT

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