An equitable distribution between primary care, preventive medicine and curative services should be prioritise rather than allocating the majority to the latter
by AZALEA AZUAR / pic BLOOMBERG
STAKEHOLDERS in the medical field are calling for the government to increase the allocation for healthcare to at least 3% of the GDP in the upcoming Budget 2024.
Consultant paediatrician and child disability activist Datuk Dr Amar Singh HSS said MoH’s budget has remained stagnant at 9.53% despite the Health Ministry (MoH) getting the second highest allocation (RM36.3 billion) after the Education Ministry.
“This is not in line with the promises made in the political party manifestos of Pakatan Harapan (PH), Barisan Nasional (BN) or even Perikatan Nasional (PN).
“All of them promised an increase in the public healthcare expenditure to 5% of GDP within five years,” he told The Malaysian Reserve (TMR).
He said these promises are not being fulfilled while the Health White Paper also has the similar target of 5% of the GDP spent on healthcare.
“If the MoH budget does not increase then we cannot expect our ailing health services to improve, let alone reach the indigenous, rural Sabah and inner-city poor, all of whom currently have limited healthcare access and services.
“Hence, Budget 2024 needs to allocate 3% of the GDP (at least 15% of total budget expenditure) to healthcare and increase this by 1% of the GDP annually over the next three years,” he warned.

Dr Amar is hoping that Budget 2024 will focus on community care enabling the public to manage their own health (Pic courtesy of Dr Amar)
Dr Amar also voiced his concern that Budget 2023 has reduced the allocation for paediatric healthcare to 1.7% compared to 2% in 2013.
“This is reflected in all our child mortality indicators that have been stagnant for the past 20 years.
“It is critical that we spend more on children as this will impact adult care and services,” he said.
Dr Amar hoped that Budget 2024 will focus on community care which could enable the public to manage their own health.
Currently, the system is focusing on treating illnesses through a curative, specialist and drug-based system.
“Community health services should be mobile rather than static (building-base), they should be decentralised; utilise adequate community health (nursing-based trained) and trans-disciplinary workers (trained in disability, elderly, adolescent-mental health), and use NGOs better.
“The focus should be on empowering the community for self-care and training or supporting care partners,” he added.
Dr Amar also urged the government to revise its annual budget for healthcare since 60% to 70% is allocated towards curative services.
“We will never be able to deal with the adolescent mental health crisis, the non-communicable disease (NCD) epidemic, the poor services for the disabled and elderly, the inadequate indigenous and inner-city services, and the weak child and maternal services by spending more on hospitals,” he said.
Similarly, Perak’s Health Department Consultant Public Health Physician and Deputy Director (public health) Dr Feisul Idzwan Mustapha observed that Malaysia’s healthcare budget is mainly allocated towards curative hospital care rather than primary care and preventive medicine.
“The burden of Malaysians living with NCDs is high and continues to increase.
“Prevention, early detection and effective treatment at the primary care level can prevent complications, which are more costly to manage,” he told TMR.

The transformation of the healthcare system will meet both current and future populations, Dr Feisul says (Pic courtesy of Dr Feisul)
Dr Feisul also called for fiscal measures to increase healthier food availability, reduce tobacco, alcohol and support positive health behaviours like physical activity and health screening.
Additionally, the 2023 budget for repairing and replacing debilitated health clinics should be sustained and increased in 2024 to improve the quality of care for healthcare workers amid their immense stress.
“Working in a comfortable and well-equipped infrastructure increases healthcare workers’ morale and improves their well-being — translating into improvement in quality of care.
“Looking at the main determinants of health, any additional budget and fiscal initiatives addressing poverty, food security and education (basically the United Nations’ Sustainable Development Goals 1, 2 and 4) will also have a positive impact on health and wellbeing of the populations, especially the vulnerable groups,” he shared.
Dr Feisul said Malaysia’s expenditure on healthcare is not enough.
He added that the transformation of the healthcare system will meet both current and future populations as the country is facing many public health challenges.
“The Health White Paper is, therefore, a crucial effort in ensuring that the additional investment in health can be translated into the best health outcomes,” he said.
The Health White Paper was released on the Parliament’s website in June this year which proposes systemic and structural reforms to improve health and wellbeing in the country.
It also seeks to ensure greater equitability, sustainability and resilience by addressing issues on ageing, chronic diseases, infectious diseases, mental health impacts, climate change, biodiversity decline and imbalance fees in hospitals and clinics.
The paper engages stakeholders to collect data on healthcare system issues.
- This article first appeared in The Malaysian Reserve weekly print edition
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