Serious effort needed to ‘save’ public healthcare

The responsibility for the lack of progress in restoring the Intensive Care Unit of the Sultanah Aminah Hospital rests with the Pakatan Harapan government.

The sad truth is that this is just an example of the many tragedies being faced by our public healthcare system.

Prior to Dr Mahathir Mohamad’s privatisation drive in the mid-1980s, our public healthcare system was among the best in the world – where rich and poor received the same commitment and access to healthcare facilities.

Mahathir hailed privatisation as a victory in efficiency and cost reduction but, in reality, it only benefited government-linked political elites.

For example, his promotion of for-profit hospitals has created a brain drain that continues to erode the specialist core of our public healthcare system. It has also created conflicts of interest between the finance ministry (MoF) and health ministry (MoH) because of GLCs getting involved in private hospital operations, and the privatisation of certain support services in 1997 created a new rent-seeker class and increased costs all around.

Despite these “improvements”, Malaysia’s public health expenditure in relation to the country’s gross domestic product (GDP) remained around 2% in 2018. This falls short of Pakatan Harapan’s own promise of 4% in its manifesto.

In comparison, Singapore spends 4.9% of GDP on health, Australia 9.4%, Japan 10.2% and South Korea 7.2%.

Malaysia lacks doctors, as our ratio is only at 1.6:1,000.

Although the World Health Organisation prescribes a doctor-population ratio of 1:1,000, many developed countries maintain a higher ratio. France has a ratio of 3.227:1,000, Germany 4.125:1,000, United States 2.554:1,000 and Singapore 2.2:1,000.

Earlier this year, an audit report by the National Audit Department revealed that our hospitals, especially the emergency and trauma department (ETD) at Malaysian hospitals, are understaffed, overcrowded, under-funded and do not have enough equipment to provide proper levels of care.

MoH director-general Noor Hisham Abdullah echoed this statement on his Facebook page:

“We are currently under-funded, understaffed, underpaid, overworked, overstretched and with facilities overcrowded with patients. We all need… to improve the public healthcare system..; all of which are beyond the control of MOH.”

Budget 2020 offered some hope of change – RM 1.6 billion was allocated to improve public infrastructure. However recent headlines are cause for worry.

On Nov 18, the Malaysian Medical Association (MMA) warned the government that our public healthcare system may face a burnout.

The reason? Increasing patient load and, more disappointingly, a government-mandated hiring freeze – where the federal government had rejected over 21,741 job positions for our public healthcare system.

Why does the government continue to play “doctor” with our public healthcare system – even under the “reform” government of Pakatan Harapan?

We need to break from the old-status quo. We need to expand our public facilities and we need to do it fast. Our public healthcare system continues to suffer while certain private providers continue to walk away with another year of “supernormal” profits.

Susan Ooi is an FMT reader.