Healthcare allocation heavily scrutinised

Medical budget slashed by 20.5%, resulting in cuts across almost all healthcare services, including 74% decrease for pharmacy and supplies


SIGNIFICANT cuts in the budget allocations for almost all health services, including funds for public healthcare workers, health programmes and treatment for chronic illnesses such as cancer and kidney diseases are raising concerns among healthcare practitioners.

Osel Group chief clinical and innovative scientist Dr Kris See said, while the increased of overall allocation for the Ministry of Health (MoH) in Budget 2021 is welcomed, it would still be wiser for the government to spend more in public health.

“Despite a slight 4% increase of MoH’s allocation from last year to RM31.9 billion in Budget 2021, the government had reduced its medical budget by 20.5% from RM14.2 billion in 2020 to RM11.3 billion in 2021.

“This resulted in wide-ranging cuts across almost all healthcare services, including a massive 74% decrease for pharmacy and supplies, which includes drugs and other non-pharmaceutical items such as personal protective equipment, intravenous drips, syringes, and among others,” he told The Malaysian Reserve (TMR) in a phone interview.

He said there is also an 11.7% decrease in MoH’s public health budget to RM5 billion in 2021 compared to RM5.7 billion in 2020, despite the Covid-19 pandemic which could be the worst public health crisis in history.

Dr See said budgets for respiratory medicine and general medicine departments have been cut by 10.5% and 14.3% respectively, which does not really gel well with the current needs due to Covid-19.

The government had also cut funds for hospital support services under MoH’s special programmes from RM1.93 billion to RM98.36 million.

“Today, there’s an increasing number of Covid-19 patients being treated in the intensive care unit (ICU), including more than 35% of them on ventilator support. These do not include non-Covid-19 patients in the ICU or on ventilator support,” he said.

Dr See said the additional RM3 billion of allocation for Covid-19 vaccine is also inconclusive, as all the details are still unclear.

He added that budget cuts for non-communicable diseases (NCDs), such as cancer, kidney diseases, diabetes, and cardiovascular ailments are made despite data by the National Health and Morbidity Survey 2019 data, which highlighted the insidious nature and risk factors of such diseases and the impact on Malaysian healthcare system and society as a whole.

“With public measures to reduce risk of Covid-19 transmission such as the Movement Control Order, the incidences of various NCDs have and are expected to worsen and increase, as many patients have missed their appointments and even treatment.

This is another area of concern that the government must be aware of,” Dr See said and added that the government only allocated RM30 million or 9.1% of the MoH’s budget for mental health, despite recent news reports which suggest an increase in cases of depression, anxiety and attempted suicides.

He also said there is also no mention about long-term plans for medical frontliners’ position within the government settings.

Malaysian Medical Association president Professor Datuk Dr Subramaniam Muniandy said healthcare workers who are contributing towards the battle against Covid-19 may be left out, since they may not fulfil the strict criteria set by the administration.

Dr Subramaniam also said the short-term Employment Programme lacks clarity on who exactly will benefit from this programme or if there will be new positions created for existing contract staff.

Galen Centre for Health and Social Policy CEO Azrul Mohd Khalib said a review of the allocations for health under Budget 2021 should be made.

He added that while it is clear that Covid-19 remains the priority, the diversion of resources and cuts to fund the pandemic’s response would have a significant negative impact on NCDs.

“More than ever before, we need to protect the public healthcare system which provides high quality, accessible and affordable services. We cannot take it for granted,” Azrul told TMR.

Former Health Minister Dr Dzulkefly Ahmad had mentioned in a tweet that the Budget 2021 should focus on restoring the wellbeing of people, saving lives, maintaining health and strengthening the health sector.

“Next year’s allocation was the smallest raise for MoH, compared to 6.6% and 7.8% increases in its allocations in Budget 2020 and Budget 2019 respectively.

“The government should spend. Don’t worry too much about the fiscal deficit, especially in health,” he wrote on his tweet.

Bandar Kuching MP Dr Kelvin Yii had described the 2021 budget as a “short-sighted health budget”, as he had expected a lot from this budget for healthcare, particularly amid the pandemic.

“We do not want to see an increase in suffering and for non-Covid-19 cases as well due to insufficient resources for treatment and good quality of care, which shows lack of support and preparation to handle the entire healthcare ecosystem other than Covid-19 itself,” he wrote.

Nevertheless, Finance Minister Tengku Datuk Seri Zafrul Tengku Abdul Aziz had refuted all the claims that the government has drastically reduced its public health allocation in Budget 2021.

In a Facebook posting on Saturday night, Tengku Zafrul said the government will not compromise in its efforts to safeguard the lives and health of Malaysians.