by NURUL SUHAIDI
BUDGET 2024 announcement saw a substantial increase in funding and allocation for the health sector that showcases government commitment in enhancing the healthcare services.
Out of the total budget amount, RM41.2 billion is for healthcare, which represents 13.5% increase in comparison to RM36.3 billion for this year, 2023; RM 32.4 billion in 2022; RM31.9 billion in 2021; and RM30.6 billion in 2020 previously.
A significant portion of the increased budget has been directed towards the expansion and upgrading of healthcare infrastructure across the country, addressing the overcrowding at ministry hospitals, construction of new hospitals, clinics, and healthcare centres in both urban and rural areas.
Furthermore, a large chunk allocation of RM5.5 billion will go to the procurement of medicine supplies, consumable materials, reagents and vaccines. Among the focus is also to enhance digital health aspects such as improving the system across public and community clinics for a better efficiency.
To reduce overcrowding in government hospitals, RM200 million of the allotted funds would be channelled towards enhancing collaboration with hospitals that outsource patients to other facilities, including as military hospitals, academic institutions and private enterprises.
Many factors that have influenced changes in healthcare budget allocation this year are the current crisis in the healthcare services such as the overflow of patients, lack of medical professionals or support groups, as well as the issue of contract doctors.
I-Medic VP Prof Dr Rafidah Hanim Mokhtar said the primary drivers for the increase also includes intention of sharing burden among the government and private sectors.
“I think we are moving in that direction. While this is a positive step in which private hospitals share the healthcare burden, it requires a careful regulatory mechanism to ensure that capitalism does not take precedence over welfare,” Dr Rafidah Hanim told The Malaysian Reserve (TMR).
Upgrading Infrastructure
Investing in healthcare infrastructure can result in long-term cost savings by enhancing efficiency, convenience, addressing health emergencies and disaster preparedness, and consequently reducing overall healthcare costs.
In the Budget 2024, Prime Minister (PM) Datuk Seri Anwar Ibrahim has emphasised the priority for upgrading efforts, allocating a total of RM300 million for the renovation of 400 old clinics with wooden structures and outdated wiring.
Several developments also would commence to expand the infrastructure including the Phase 1 of the Universiti Sains Islam Malaysia (USIM) Teaching Hospital Complex in Kota Tinggi, Johor, with a cost of RM938 million.
By allocating RM175 million, the development also included Hospi- tal Johor Baru with the initial works for the construction of Sultanah Aminah 2 and an additional patholog y block at Raja Perempuan Zainab II Hospital in Kelantan.
Other projects include a RM150 million expansion of the Emergency and Trauma Department at Sultan Abdul Aziz Shah Hospital, Universiti Putra Malaysia; and five new health clinics in Rantau (Negri Sembilan), Kuala Tahan (Jerantut, Pahang), Kuala Jengal (Dungun, Terengganu), and Pulau Mantanani (Kota Belud, Sabah).
The budget also aims to address the healthcare gap in East Malay-Sia as it backs up the government of Sarawak’s mission to establish a cancer institute in the state.
“We hope more information will be provided on the government’s plans to support the setting up of a cancer institute in Sarawak, as well as its plans on equipping the centre with the expertise needed as this may involve long-term human resource planning and developing of specialists,” The Malaysian Medical Association (MMA) president Dr Azizan Abdul Aziz said in the recent statement on Budget 2024.
Applauding the moves, she said apart from Sarawak, the northern region in Peninsular Malaysia is also in need of a cancer institute since there are gaps in healthcare infrastructure in the northern peninsular.
Investing In Public Health
Through Budget 2024, the government shows a proactive approach aimed to strengthen the public health system, ensuring accessible, affordable and high-quality healthcare services for all Malaysians.
This boost in funding is a testament to the government’s dedication to improve the overall health and wellbeing of its citizens.
Among the expansion is the implementation of Madani Medical Scheme to accommodate the health needs among bottom 40% income group (B40) for acute primary care services.
In the budget, the PM said with an allocation of RM100 million, the Madani Medical Scheme will now be expanded to the entire country and is expected to benefit 700,000 rakyat.
The MySalam Scheme will also be continued for another two years, and another RM50 million is provided for medical device cost claims such as stents for the heart.
In investing in the facilities, a total of RM766 million is also allocated for the procurement of medical equipment at Ministry of Health (MoH) facilities to replace equipment that has reached Beyond Economic Repair (BER), as well as meeting the requirements of various new service disciplines.
This includes RM200 million for procurement to guarantee that health services are ready to respond to emergency calls.
We hope more information will be provided on the govt’s plans to support the setting up of a cancer institute in Sarawak, says Dr Azizan (Source: drazizan.com)
Focus on Preventive Healthcare
Budget 2024 also emphasises the importance of preventive healthcare measures. Funds have been allocated to public awareness campaigns, vaccination drives and screening programmes aimed at preventing the onset of diseases.
The approaches in budget enhancement this time are more geared toward promoting healthy lifestyles and early detection, as the government aims to reduce the overall burden on the healthcare system and improve the overall health of the population under the National Health Agenda.
Among the efforts is an allocation of at least RM130 million for the purpose of health screening, early screening of newborns and providing vaccines to pregnant women.
Meanwhile, in tackling the risk and reducing the consumption of tobacco, the government also will be imposing excise duty on chewing tobacco products at a rate of 5% plus RM27 per kg, same as the excise duty imposed on snuff tobacco.
Not only that, the current excise duty rate for sugary drinks is increased from 40 cents to 50 cents per litre. This excise duty revenue will be redistributed specifically to treat diabetes including support for dialysis centres.
For Kuala Langat MP Datuk Dr Ahmad Yunus Hairi, who is also the shadow health minister of the Opposition party Perikatan Nasional (PN), this issue will become even more significant as the MoH aims to shift towards more preventive measures rather than solely focusing on treating illnesses.
“In the next few years, we expect more health initiatives that touch on aspects of lifestyle and preventive measures as we see an increased awareness among policymakers on the increase of non-communicable disease (NCD) among the public,” Dr Ahmad Yunus said.
“We also welcome the government’s move to introduce a new tax on chewing tobacco products and increase the current excise duty rate on sugary drinks,” he told TMR.
Supporting Healthcare Professionals
Recognising the crucial role played by healthcare professionals, the government has allocated funds to support and uplift the healthcare workforce. This is especially important to prevent the country from losing more civil servants who leave the healthcare service.
This initiative includes providing specialised training, and continuous education and skill development programmes for doctors, nurses and other healthcare practitioners.
Additionally, the government emphasises the importance of competitive salaries and incentives to retain and attract talented healthcare professionals, ensuring the sector’s sustainability.
Under a new policy, an extra RM1.7 billion was earmarked for the absorption of contract doctors into permanent positions.
“This additional emolument is very necessary to protect the welfare and continuity of our medical officers as the most important heart of the health system,” Dr Ahmad Yunus added.
As we progress toward modern healthcare and embrace digitalisation, digital records are essential to provide a comprehensive overview of patients’ health needs. Technology will allow an increase in efficiency in healthcare settings and quickly enable data to be shared with all government health infrastructure.
Unfortunately, in Malaysia only 3 % of the country’s health clinics are equipped with digital health records. Realising this, the government has provided RM150 million for the maintenance of IT systems under the MoH, including by providing a Clinic Subscription Management System (CCMS) in 100 health clinics.
In the next few years, Dr Ahmad Yunus expects more health initiatives that touch on aspects of lifestyle and preventive measures (Source: Dr Ahmad Yunus’ Facebook)
These are some of the budget’s improvements to address systemic issues and strengthen the healthcare system.
Nonetheless, the government must also be prepared for any future advancements based on the health needs of the people, while focusing on giving citizens a good quality of life.
In response to this, Dr Rafidah Hanim stated that one necessary improvement pertains to inter- nal control over funding. This is to ensure that medical workers are not required to use their own funds for expenses like travel or overtime claims during instances of funding shortages and inadequate medical supplies, especially in health centres.
She emphasised that the government should wholeheartedly implement genuine preventive measures and take into account religious and cultural values to support the healthcare sector’s transition from a focus on treating the sick to emphasising preventive activities.
“For example, religions have positions against alcoholism, drugs, smoking, anal sex and multiple sex partners; all these are behavioural factors that are modifiable. So, when we mean prevention, let’s go all out for it,” she said.
Meanwhile, Dr Ahmad Yunus said the situation was worsened by the increasing cost of living which forced many patients to choose public clinics and hospitals to save expenses and cause significant congestion in the public service sector.
He said with the increased allocation, he also hopes to see reduction in the number of patients with NCD and more advocacy and health programmes being implemented to prevent the disease.
While he agrees the allocation is satisfactory and a good start, to achieve an overall reform, the health services also require a constant increase of allocation every year to achieve the optimal service and address all of the underlying problems.
“In general, there have been only minor changes to the budget allocation for the health sector in recent years, which is due to the increase in population and health workers.
“Public and private health services should be jointly managed under the MoH to minimise the impact on healthcare workers and patients,” Dr Ahmad Yunus said.
He added that a health financing system needs to be established to ease the costs borne by patients.
“The main focus should be on advocating for prevention and health education to create healthier citizens and reduce healthcare expenses,” he concluded.