Health sector challenges

A FRIEND from United Kingdom was mocking my friends and I on the eve of the general election saying that Malaysians are passive and seem contented to choose the same party to be the government for close to six decades. We accepted what he said and then reminded him that nothing was certain since the election had not taken place yet. When the results were announced on May 10, my UK friend called up to convey his utmost respect to all Malaysians for making history and sending a clear message that the power to choose the government lies with the rakyat.
We dared to take a gamble and put our trust in a new government. I was a proud Malaysian that day and I know that the new government will do well as we have Tun Dr Mahathir Mohamad at the helm to put the country back on track, assisted by coalition partners, many of whom have huge doses of enthusiasm, resilience, passion and grit. We all love our country and need to show the world that we now have a government which will institutionalise good governance, transparency, integrity, accountability, fairness and justice to all. Our country is blessed and with a responsible government, we will surely soar and reclaim our title as one of the tigers in Asia.
I would like to remind the new government that there are many challenges facing the health sector including the changing pattern of diseases, the ageing population, rising costs, increasing demand for quality services, patient safety, public-private dichotomy, inequitable distribution of resources and a highly subsidised government healthcare service resulting in heavy workload and long waiting, all of which could compromise quality of services. Advances are pushing us to offer even better services but at great cost. Failing to accommodate these advances will make our healthcare services obsolete.
Financing health care is fraught with challenges. Currently finance sources are direct taxes, insurance premiums, out-of-pocket payments, contributions to EPF and Socso and indirect taxes. New drugs and new methods in healthcare delivery have led to higher costs. The allocation for the Ministry of Health for 2018 is RM26.58 billion which is 9.5% or 1.7 billion increase compared to 2017. The increase in allocation keeps pace with the rising healthcare costs. There is just not enough money in public hospitals for most things. There is even greater inequity in the private sector in terms of resources, equipment and healthcare costs.
To improve further equity, accessibility, quality, integration and regulation of healthcare services, it is time to introduce an integrated healthcare system, strengthen primary care, shift it closer to the community and introduce some form of healthcare financing. Private primary care physicians or family physicians should be invited to enforce wellness paradigm initiatives and bring health information closer to the people so that they can be responsible for their health. We are an overweight nation. There is no time for slogans and traditional educational programmes. What we need is an innovative way of disseminating health messages to the masses so that, armed with knowledge, they can indulge in responsible self-care and only visit clinics and hospitals if required. Although some work has been done in this area, more needs to be done. Information and communication technology can be employed to do this.
As Malaysia strives to become a high-income developed nation, we must upgrade and adapt our health system. We need to enhance universal coverage, improve quality of care and health outcomes, ensure good financial protection for those who fall ill, strengthen governance and make certain that Malaysia's health system remains viable and sustainable.
Tan Sri Dr Mohd Ismail Merican
Former director-general of Health