PETALING JAYA: Beds at public hospitals should be increased in view of the high usage by the population, says a public health expert.
Universiti Kebangsaan Malaysia health economics and public health specialist Prof Dr Sharifa Ezat Wan Puteh said the government must also look into increasing hospital beds under Budget 2024.
“Our public hospitals have high bed occupancy ratios in general, but palliative care and geriatric care are generally overlooked in medical specialties.
“We need to work aggressively towards preparing for an ageing population. This would include home care for the elderly and also the additional number of beds for the elderly,” she said.
Dr Sharifa said the government could consider transition beds for chronic cases involving elderly patients, and the budget too must include some sort of national social care programme.
However, she said increasing the number of beds alone will not do the trick, adding that the government must concentrate on elderly care needs, which will prolong their ability to remain well and mobile.
Meanwhile, healthcare groups have called for more permanent positions for contract healthcare workers and upgrades to healthcare facilities in Budget 2024.
Although the Health Ministry was the second largest recipient under Budget 2023 with RM36.3bil, stakeholders said a higher allocation is needed to ensure that the country’s healthcare spending is at 5-7% of the gross domestic product (GDP), which is on par with other countries and the World Health Organization’s recommendation.
Malaysian Medical Association (MMA) president Dr Azizan Abdul Aziz said the group is looking forward to a Health Budget that is reflective of the government’s serious commitment to healthcare reforms and is in line with the Health White Paper.
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“We hope to see an increase that is significantly closer to the target of 5% of the nation’s GDP for Budget 2024,” she said.
As the bulk of the health budget is to cover operational expenses, MMA hopes to see a higher budget allocated for development. In the 2023 Budget for Health, only RM4.8bil out of RM36.3bil was allocated for development, while the remainder RM31.5bil was for operational expenses,” she added.
Planning and development of the healthcare workforce should be prioritised in Budget 2024 through the creation of more permanent positions, contract positions, allocations for long-overdue promotions, and training.
“This allocation should also include positions created for nurses, allied healthcare personnel, medical assistants and other support staff in public healthcare,” said Dr Azizan.
“We hope that following the statement made by the Prime Minister on the government’s plans to raise the salaries of civil servants in Budget 2024, public healthcare workers’ wages will also be substantially increased.”
Promotions and increments in remuneration are important as a motivating factor and as part of efforts to retain the services of healthcare workers in the system,” she added.
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Dr Azizan hopes for a substantial amount of the budget to be allocated for public-private initiatives as part of efforts to “decongest” the public healthcare system.
“The Madani Medical Scheme (SPM) is a good initiative that should be expanded to include non-communicable diseases (NCD) management by the private general practitioners’ (GP) clinics. The government should leverage the 13,000 private GPs nationwide in these efforts. Involving all key stakeholders in the planning stages must be emphasised for the successful implementation of any public-private initiatives,” she said.
She also called for more allocation to improve healthcare infrastructure and services in rural areas, adding that telehealth should be expanded to these areas.
She said the government should also channel allocation towards encouraging digitalisation of services in both public and private healthcare.
“In efforts to prevent NCDs, allocations should be set aside for health education programmes and awareness campaigns for the public – in schools and at the community level,” she said.
“Corresponding with national efforts to prevent cases of obesity and diabetes, taxes on high-sugar food and beverage products should be raised, with revenue collected channelled towards the treatment of diseases associated with high sugar intake.”
“Lastly, the MMA hopes that the government will reveal in Budget 2024 the amount collected in taxes from the sale of vape products.
“The Prime Minister had stated that half of the taxes from vaping nicotine products would be channelled to the Health Ministry. So we would like to know how much from these taxes will be channelled into the 2024 Health Budget?” she asked.
Hartal Doktor Kontrak, on the other hand, is asking for at least 4,000 permanent positions for contract healthcare workers under Budget 2024, up from the 1,500 announced under the last budget.The group is also proposing for private specialists and medical officers to do locum with the Health Ministry to ease the workload of government doctors.
“District hospitals should be upgraded so that more people can benefit, instead of just upgrading the main hospitals in the country,” said a spokesperson for the pressure group.
As for upgrades of facilities, HDK said cluster hospitals and district hospitals should be upgraded with computed tomography (CT scan) services, while health clinics should have laboratory services.
The group also wants national health insurance, which is subsidised by the government, to be introduced for the target populations, mainly the M40 group, as well as making healthcare insurance compulsory for foreign workers as a pre-requisite for renewal of work visas and permits.
Prime Minister Datuk Seri Anwar Ibrahim is slated to table the government’s spending plan for 2024 on Oct 13.
