Greater investment needed for public healthcare

The quality and quantity of healthcare professionals in the public sector needs to be increased, so they can serve the community better

by S BIRRUNTHA / pic by ARIF KARTONO

THE Malaysian public healthcare system needs bigger investment and a stronger institution to ensure that the people in the country always have access to efficient and high-quality healthcare services, said University of Malaya medicine and infectious diseases Prof Datuk Dr Adeeba Kamarulzaman.

She added that although the Ministry of Health provides clinics and hospitals nationwide, there is still a shortage of quality healthcare centres, especially in remote parts of the country.

“There is an imbalance in terms of private and public healthcare systems in the country, where too much resources and attention are always given to the private healthcare system as an acute care hospital in the hope of medical tourism and so on.

“However, I think we have an ample room to strengthen our public healthcare system as well.

“There is of course a role to the private healthcare system in the country, but in the current state, there is no doubt that there has to be a bigger investment into the public healthcare system and to strengthen them because there are many things that we can improve in terms of preventive healthcare, aged and community-based care, and many more.”

She said this during a webinar on “Social Market Economy Perspectives: Public or Private? — Equity, Efficiency and Quality in Malaysia’s Healthcare” organised by Konrad-Adenauer-Stiftung and Futures Malaysia yesterday.

Dr Adeeba noted that the current budget allocation to the public healthcare system is simply not enough and the allocation needs to be increased to at least 3% to 4% in order for the country to join the list of developed nations.

Dr Adeeba stressed that the quality and quantity of healthcare professionals working in the public sector needs to be increased, so that they can serve the community better and avoid shortages in terms of number of staff.

“As a trainer myself for not just medical graduates but also postgraduates, we can’t seem to produce specialists quickly enough for the consumption of both public and private healthcare systems.

“As soon as we train them, we lose them to the private system. So, that’s been a constant source of frustration for all of us. We are still working to ensure that we have a robust and strong public health system,” she said.

Dr Adeeba highlighted that “medical brain drain” among health professionals is very common, where many of them migrate from one country to other developed and industrialised nations in search of better opportunities.

She noted that it is also prevalent in the country’s public healthcare system, where many health professionals seek to join the private health system for their career advancement.

On that note, she also urged the government to have a serious look in terms of salary packages to medical professionals and health staff in the public healthcare system.

“I am told that the salary in the public system is less attractive. So, this is another reason why many of them leave the country to work in other gulf states or even in Singapore due to the huge disparity in terms of their income,” she said.

In terms of costs, Dr Adeeba said it is also important to look at whether the healthcare system is increasingly geared towards profit versus its true role of providing care to Malaysians.

She added that it is indeed the country leads a good public healthcare system, whether it is in delivering public health in its true form or in terms of prevention health measures, disease surveillance and all these activities related to the Covid-19 outbreak.

However, she said the concern lies on the increased privatisation of healthcare in the country, where it should learn by taking example of the Covid-19 surge in India.

“I recently read a commentary that because of the increase in privatisation of the Indian healthcare system, the public healthcare system has been severely underinvested and they are not able to cope with the current crisis that they are facing.

“Although we are not to that level, I think it is a very important lesson for our country’s healthcare system to learn from this pandemic that we need to strengthen our public health system, as they are the one that are currently providing the services to overcome this pandemic, whether in terms of intervention, prevention or even in providing direct care to Covid-19 patients,” she added.

Dr Adeeba noted that whether by enhancing direct taxation or by having a separate health financing system, the question on how and what the government can do to implement a good public healthcare system will always remain.