A roller coaster ride in healthcare, with key policy papers and laws that some, however, say under-delivered
KUALA LUMPUR: Even with the worst of Covid-19 over, the Health Ministry and healthcare sector remained in the limelight in 2023 over legacy issues, a controversial provision in the anti-smoking law being snuffed out after pushbacks, the tabling of the Health White Paper, and an eventual change in minister.
One longstanding issue that persisted was permanent placements for contract healthcare workers.
In April, a group called Mogok Doktor Malaysia (Malaysian Doctors Strike) threatened a three-day strike from April 3-5, saying that some 8,000 contract doctors would skip work and paralyse the public healthcare system.
The group demanded that all contract doctors be absorbed into permanent service.
However, the three-day strike did not materialise as planned. Despite claiming that the eventual one-day strike was a success, the organisers deactivated their social media account through which they had been communicating.
Although the strike was a failure, on April 4, Prime Minister Datuk Seri Anwar Ibrahim said 12,800 contract doctors would be absorbed into permanent service over three years.
He told the Dewan Rakyat that more than 4,000 contract doctors would get permanent appointments in 2023, and this was to cost about RM1.7bil.
However, the exercise involving healthcare workers moving from contract to permanent service also had its fair share of challenges, including the absence of a relocation allowance, the workers trying to avoid placements in Sabah and Sarawak, and the relatively short notice periods to report for duty at their newly-assigned places.
This also led to shortage of manpower in some hospitals.
According to reports, contract healthcare workers were also forced to resign before entering permanent service on Dec 18.
Meanwhile, in June, the Health Ministry tabled the much-awaited Health White Paper in the Dewan Rakyat.
The 57-page document detailed the healthcare reforms to be implemented in phases over 15 years.
The policy paper addressed issues such as funding constraints, manpower, facilities and equipment shortages, disease burden, the ageing society, mental health, climate change and the deterioration of the planet, as well as the lack of emphasis on the social determinants of health.
While many lauded the document, there were also criticisms that it under-delivered in terms of concrete solutions for longstanding issues plaguing the healthcare system.
Another much-awaited document was the revised anti-smoking Bill, which was reviewed and revised for the second time in June after it met a similar fate as when it was tabled for the first time in 2022.
When the Bill was finally tabled in November by then health minister Dr Zaliha Mustafa, it was done without the controversial generational endgame (GEG) provision that sought to prohibit smoking among those born in 2007 and onwards.
While this was a huge blow to health advocates who had relentlessly advocated for the GEG, the government maintained that it was removed as per the legal advice of the Attorney General’s Chambers (AGC) over constitutionality concerns.
The AGC had said that the GEG provision contradicts Article 8 of the Federal Constitution as “it creates unequal legal treatment between a person born before Jan 1, 2007 and a person born on and after Jan 1, 2007”.
Rumours were also rife that there were a strong industry lobby working against the Bill.
However, despite the omission of the GEG provision, the Control of Smoking Products for Public Health Bill, which has now been passed by both the upper and lower Houses, prohibits the sale, purchase and use of smoking products including vapes among the underaged.
It also addresses the loopholes from the delisting of nicotine gel from the Poison’s Act 1954 earlier in the year – another move by the ministry that was heavily panned by health advocates.
The year culminated in a change of minister in the Dec 12 Cabinet reshuffle.
Dr Zaliha was moved to the Prime Minister’s Department, where she now handles the Federal Territories portfolio, after a year of manning the Health Ministry.
Datuk Seri Dr Dzulkefly Ahmad, who was the health minister in Tun Dr Mahathir Mohamad’s Pakatan Harapan administration (2018-2020), returned to the helm for a second stint.
In one of his early appearances after his appointment, Dzulkefly said digitalising healthcare and seeing through the implementation of electronic medical records will be among his priorities.
