Think tank gives PH government C+ for healthcare during its 1st year

The Galen Centre for Health and Social Policy says healthcare in Sarawak and Sabah, particularly for the rural population, remains basic. (Bernama pic)

PETALING JAYA: The Galen Centre for Health and Social Policy has given the Pakatan Harapan government a C+ grade in its stewardship of the health agenda and commitment to reforms.

In a “report card” in connection with the first-year anniversary of PH coming into power, the independent public policy research and advocacy organisation said although there had been some achievements, there were still some “failings”, with the results of other projects “too soon to tell”.

Galen said the introduction and upcoming enforcement of the smoke-free air regulation in eateries is arguably the most prominent health-related achievement for the government in its first year.

Considering that at least 40% of Malaysians are exposed to second-hand smoke and an estimated RM2.9 billion is attributed to the treatment of tobacco-related diseases such as lung cancer, cardiovascular disease and chronic obstructive pulmonary disease, this move will be seen as a watershed moment, it said.

“If the government stays firm in the face of criticism, this move will pay dividends in reduction in airborne nicotine, better respiratory symptoms, better air quality, increased well-being and a massive drop in societal healthcare costs,” the report said.

Galen also praised the government’s reforms on the housemanship programme, noting that fresh doctors will no longer have to work more than 14 continuous hours and back-to-back shifts.

The doctors’ work hours have also been reduced from 65-75 hours a week to 60-62 hours a week.

It said although the length of housemanship has been cut from two years to 18 months, placement will continue to be a problem.

Galen said another significant development is the Peka B40 programme, aimed at tackling the rise of non-communicable diseases (NCDs) such as diabetes, high blood pressure and high cholesterol, through the strengthening of primary care services.

It said the plan has the potential to succeed where similar initiatives have failed.

“However, it needs to be better funded, include people below the age of 50 and have clear mechanisms linking people with treatment,” it said.

Failings

Galen said the state of healthcare in Sarawak and Sabah, particularly for the rural population, remains generally basic and underserved in terms of access to facilities.

“More than a third of the population continues to live beyond 5km of any kind of health facility and may have to travel for hours to seek treatment.

“Longstanding issues such as maternal health remain unresolved. There needs to be a separate action plan to upgrade the healthcare infrastructure in these two states which is fully funded and has political support,” it said.

The centre said that despite one in three persons in Malaysia suffering from depression and anxiety disorders, the framework to respond to mental health needs continues to be dependent on private sector players, including for-profit, not-for-profit and non-governmental organisations.

It said the allocation comprises only 1.17% of the total health budget, adding that the budget allocation for the health ministry’s psychiatric and mental health department was actually reduced by RM7.93 million this year, compared to 2018.

“By 2020, mental illness is expected to be the second biggest health problem affecting Malaysians.

“High price mark-ups for treatment-related costs and services by private hospitals (a large number are owned by government-linked corporations) have contributed towards double-digit medical inflation,” it said.

Too soon to tell

Galen said the mySalam insurance scheme assisting individuals struck by critical illness is a critical step in the right direction towards eventually introducing a national social health insurance scheme.

“However, it is too soon to tell whether this income replacement assistance plan will actually help the intended beneficiaries, the B40 group, at the intended scale.

“The exclusions and lack of customisation to reflect the actual needs of this population potentially compromise its value and impact.

“Introducing cost containment measures such as central pool procurement and a price control mechanism for medicines will contribute towards managing healthcare cost, particularly for the public health sector.

“The stated objective is to ensure access to medicine at an appropriate price, as well as to encourage innovation and healthy competition for industry growth.

“Though it is too soon to tell whether these actions will actually lead to cheaper drugs and improved coverage for diseases, it is a major initiative,” it said. - FMT