Integrated electronic health records, such as through the MySejahtera app, would help ensure care continuity between government clinics and hospitals. — YAP CHEE HONG/The Star
Strengthening Malaysia’s healthcare system requires practical, coordinated reforms across primary care, workforce, financing, governance and patient-centred care.
If the Health White Paper explained why Malaysia must reform its healthcare system, and Reset outlined how reforms could begin, the urgent question now is: Where do we go from here?
The Covid-19 pandemic revealed both the extraordinary strengths and deep vulnerabilities of our system.
We witnessed healthcare professionals stepping up heroically, yet hospitals became overcrowded, staff stretched beyond capacity, career pathways remained unclear, and costs escalated.
The decisions made today will determine whether the next generation inherits a resilient healthcare system or one perpetually under strain.
Rebuilding primary care
Malaysia remains overwhelmingly hospital-centric.
Hospitals excel at acute care, but they cannot sustain the nation’s health alone.
Patients often bypass clinics, perceiving them as underresourced and head straight to hospitals, thus worsening congestion and inefficiency.
Primary care needs to be rebuilt as the first line of defence when it comes to health.
Strengthening primary care requires more than technical upgrades, however; it demands a philosophical shift:
- Upgrade Klinik Kesihatan (Health Clinics) and community clinics with adequate staffing, diagnostics, extended hours and integrated digital records.
- Foster public–private collaboration, enabling general practitioners (GPs) and government clinics to operate seamlessly, rather than in silos.
- Expand preventive care through early screenings, lifestyle interventions and chronic disease management to address issues before complications arise.
Prevention is both economical and humane.
Treating diabetes complications or kidney failure after hospitalisation costs far more financially and in human terms than early interventions.
Yet, preventive systems remain underdeveloped, leaving hospitals to shoulder preventable burdens.
Fixing the workforce crisis
Malaysia faces acute staffing shortages: over 20,000 nurses, 8,000 medical officers and 11,000 specialists are needed.
Burnout is widespread, junior doctors often remain on short-term contracts, and many leave for better conditions abroad.
A sustainable system cannot rely on passion alone.
Workforce reforms must be bold, comprehensive and implemented urgently by:
- Establishing permanent, transparent career pathways for all health professionals.
- Offering competitive remuneration reflecting risk, responsibility and expertise.
- Ensuring safer working conditions, psychological support and zero tolerance for toxic culture.
- Expanding postgraduate training, structured mentorship and equitable selection processes.
Healthcare workers were the backbone of the Covid-19 pandemic response.
Failing to invest in them now will cost far more in the future, both in human lives and economic efficiency alike.
A community nurse and midwife assesses a baby’s health during a post-delivery home visit in Semenyih, Selangor. Nurses are the backbone of the health system, but Malaysia currently faces a shortage of over 20,000 nurses. — World Health Organization
Confront financing challenges honestly
Malaysia is spending less on healthcare when compared to nations with similar economic status.
Minimal outpatient fees have created public expectations that are misaligned with rising costs.
Sustainable financing is politically sensitive, but unavoidable. Some options include:
- Exploring multi-source funding, e.g. dedicated contributions, insurance innovations and public–private partnerships.
- Establishing a ring-fenced national health fund to insulate healthcare from political cycles.
- Piloting well-governed partnerships to expand capacity without compromising affordability.
Without transparent dialogue and decisive action, financial bottlenecks will continue to undermine reforms, regardless of how strong other policies are.
Strengthen governance, trust and coordination
The Health Ministry’s mandate is vast, spanning procurement, service delivery, training and regulation.
This creates chronic coordination challenges.
Weak governance erodes trust, blurs accountability and allows inefficiencies to persist.
Robust governance requires:
- Clear accountability structures, so that the public and healthcare professionals know who is responsible for outcomes.
- Strong inter-agency collaboration between the Health Ministry, Higher Education Ministry, Public Services Department, state governments and private providers.
- Transparent engagement with healthcare professionals, patient groups and civil society.
- Policy continuity regardless of leadership changes.
“Kami sedia membantu (We stand ready to help)” must be backed by clarity, resources and organisation, not just goodwill.
Centring patients and data
Healthcare is ultimately about people.
A truly patient-centred system requires accessible, respectful and coordinated care.
This can be accomplished by:
- Implementing national integrated electronic health records to ensure continuity between clinics and hospitals.
- Reducing duplication, improving safety, and preserving time and resources for both patients and staff.
- Engaging communities meaningfully to ensure policies reflect real needs, not assumptions.
Neglecting data integration or community input risks perpetuating inequities and inefficiencies.
Key takeaways
The future of Malaysian healthcare depends on deliberate and sustained choices.
Primary care must be strengthened, the workforce protected, financing made sustainable, governance clarified and patients placed at the centre.
These are not easy tasks as each faces operational, political and social hurdles.
But inaction risks a system that is perpetually reactive, overburdened and inequitable.
The Health White Paper provides long-term vision; Reset translates that vision into immediate action.
But documents alone do not reform systems.
Real change requires leadership, continuity and courage across governments, ministries and generations.
Reforms must survive political cycles; Malaysia cannot afford healthcare tied to personalities alone.
It must be a national mission.
Our next article shifts the focus to Malaysians themselves.
Policymakers set the framework, but citizens, patients and communities play an essential role in shaping, monitoring and sustaining reforms.
Engagement, informed discourse and collective responsibility will determine whether Malaysia achieves a resilient, inclusive and world-class healthcare system.
Dr Eugene Chooi is the president of the Private Medical Practitioners’ Association Of Selangor And Kuala Lumpur (PMPASKL), Dr Carollyn Kek Chee Yen is the president-elect, and Dr Chang Chee Seong is the honorary secretary. This is the fourth in a five-part series on healthcare reform that will be published weekly. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
