How new Health Minister wants everyone to get good healthcare

POLITICS and social activism has been a big part of Dr Dzulkefly Ahmad’s life, since his university days in Britain when he was a student leader.

“I was always campaigning with friends for a political cause then. I was a student leader and seen as a critic,” says the newly-appointed Health Minister.

None of his parents or siblings were in politics, he adds. His father was a police in Singapore and he had his primary and lower secondary education there but returned to Rembau, Negri Sembilan, his hometown, to do his O Levels in 1973.

Dr Dzulkefly received a scholarship to do his A Levels in Britain and went on to pursue a Bachelor of Science from the University of Birmingham. He graduated with a Master of Science from the University of Surrey and a doctorate in Medical Science (Toxicology) from the Imperial College (St Mary’s Hospital Medical School) in 1993.

When he returned to Malaysia he became a pharmacology and toxicology lecturer at the Faculty of Medical Sciences, Universiti Sains Malaysia, and Universiti Sains Malaysia Hospital.

“I was teaching until the raging days of Reformasi 1998 when I felt the calling to join politics.

“At that time, the late PAS president Datuk Ustaz Fadzil Noor (Muhammad Noor) wanted an injection of professionals, academics and intellectuals, and I felt the calling to be part of that and bring PAS into mainstream politics,” says the 62-year-old former PAS member, who is now Parti Amanah Negara’s strategic director.

His first experience of contesting in a general election was for the Kapar seat in 1999 but he lost. He then helmed the Research Centre for PAS for many years. He also studied finance and investment as part of an asset management company.

Dr Dzulkefly, who is Kuala Selangor MP, first won the seat in the 2008 general election but lost it in the 2013 elections before regaining it on May 9. He has a wife and seven children.

Q: Since the Pakatan Harapan coalition’s win, how are you finding life on the other side of the aisle?

A: I have always been in opposition in Parliament, opposing the government of the day then, more in light of check-and-balance in a vibrant democracy. The cardinal principle of democracy – you have contestation of policies and programmes.

Now that I am on this side, it is very exciting for me. For the first time, we have a chance to realise our vision, aspirations and idealism of what it takes to run a government, uphold good governance, accountability and still receive a lot of contest from the other side and civil society.

I believe we will always be in check for any excesses that Pakatan may commit. That is essential in democracy. It should be mature and it should be allowing the space for dissent.

I, for one, will ensure that it will be a viable and vibrant democracy (in the country). It is important that the government of the day is constantly checked, not just by political parties, but also civil society and individuals.

> What are your plans for the ministry?

The Health Ministry is one that touches on ascertaining the real index of happiness of the nation – where the health and welfare of the people will be ascertained through healthcare and how it will be delivered to the entire class of society, including the B40 and top 20.

We have expressed our concerns and targets in our manifesto. I am here to provide the stewardship and political leadership over a massive ministry and ensure the delivery of affordable, good quality and safe health system.

While I understand there are some shortcomings and issues that I have to address in the ministry, I feel that the ministry is being managed by professionals and I am here to enhance the potential talent pool.

I look forward to be a significant contributor in this.

> You have mentioned that you will roll out the Peduli Sihat and Voluntary Health Insurance (VHI) schemes, and form a Health Advisory Council within 100 days from Pakatan’s win. How does the mechanism for Peduli Sihat work?

Under the scheme, RM500 assistance will be granted to the B40 class (Malaysian households earning RM3,900 a month or less) to provide them access to healthcare services at registered private medical institutions.

It is one of our 10 promises for 100 days. There are no two ways about it. Although given the tough times, in terms of finance and the fiscal space left for the Government because we are burdened by the debt left by the previous government, I will be realistic and practical.

The Peduli Sihat scheme will see the light of day. At least within 100 days, we will embark on a soft launch or something like that.

For now, I can see that the ministry is quite ready because they have been talking about their own health insurance scheme.

I have had discussions with the National Health Financing section and I think the scheme can be implemented by looking at the mechanims and funding.

> How does the VHI scheme work? Medical and private practitioners’ associations said there have not been enough discussions with stakeholders.

Perhaps we can reverse the process a bit if you need that kind of townhall discussion or more engagements with the private sector. I am more than willing to hear from them.

We are not obliged to take on VHI. We will visit VHI as it was already there when I came in.

I will have a brainstorming session with my think tank and then present an alternative or a hybrid scheme. We are commited to something like this, not by brand or name, but the concept. It could well be a different name. I do not want to say anything prematurely.

> So, the VHI is not necessarily achieved within 100 days as you mentioned recently in a press conference?

No, this is something else. We haven’t promised VHI. We only promised Peduli Sihat.

I think I was talking about VHI as a platform for Peduli Sihat.

Peduli Sihat is borne by the Government, while VHI is a voluntary scheme. As far as the financing is concerned, it is borne by whoever the segment that is engaged in the programme.

(Dr Dzulkefly had earlier clarified that the ministry was already thinking along the lines of VHI before he came on board).

In short, there is reason to further discuss this and see if it can finally be implemented, and see whether it could be a merger. I will review it or enhance it, and if it is good, there is no reason to reject it.

> Is Peduli Sihat directed towards a national health insurance? Or we should maintain the current tax-based system for financing healthcare?

I don’t think so. Peduli Sihat is a stand alone in the sense that it is meant for the B40, not the entire citizenry. I am currently busy with Peduli Sihat. Give me more time to address other schemes and approaches later.

> Has anyone been made members of the Health Advisory Council? Any particular areas that you will be seeking their advice in?

It is work in progress. I have received some CVs. People are excited to come forward. This is a good thing that I see here in the “new Malaysia”. People are voluntarily stepping forward. And these can be big names, especially from the private sector.

Some people say that the ministry cannot have (someone from) the private sector because it’s a conflict of interest.

> Are they not the stakeholders?

I understand but in the new Malaysia, the relationship has to change. People are not simply driven by interest. They are driven by more altruistic interests.

> But don’t private enterprises inherently have their own interests to take care of?

Oh, don’t worry. They are advisory and supervisory at best.

> Why can’t they be treated as stakeholders instead of advisers? You consult them to see what areas they can contribute in, rather than giving advice on how the ministry should be run?

It is a combination of both. They can come up with something novel. We can also throw at them problems that they can troubleshoot.

I am very conscious about this and Pakatan would be more conscious, and you know well that the very last thing for us is to do anything wrong.

> The Pakatan’s manifesto has targeted for the Government to spend 4% of the Gross Domestic Product on healthcare (and up to 6% or 7% of the GDP, including the private sector, as you have announced recently). With this move, the public sector is expected to improve, which is commendable. But the Government also has a high stake in private hospitals (inherited from the previous administration). How are you going to balance the two conflicting interests?

Well, it is something that has been narrated and we are only two weeks old. We certainly would address that.

We want the private sector to contribute to nation-building and the GDP. We don’t want to spend for them to invest, so we must create the space and room for them to grow.

I am coming from the Pakatan government that wants to have a public-private collaboration in the positive sense of nation-rebuilding.

I don’t look at the private sector in that (negative) sense, that they are always coming to secure their interests and looking at their bottom line. But, at the same time, we are not going to be so naive. We are here for stewardship and leadership. And we want to make sure that there is a balance, engagement and partaking of nation-rebuilding.

I, for one, want to see the health sector a sector that requires the synergy of the public and private, and together we can make a more meaningful performance in healthcare delivery. I have friends in the private sector as well as talents in the public sector.

> How are you going to address the housemanship issue? The issue of too many medical graduates and too few training hospitals has snowballed through the years despite some measures being taken. And some have to wait up to a year for housemanship postings.

There is no overnight or instantaneous solution to this. All these are consequential to the lack of hospitals that could provide housemanship training.

Admittedly, the ministry is in deficit of 16,000 beds and that will take more time. But we have nine hospitals to be built in various stages.

We have to address this more creatively and we can have a number of solutions. Perhaps cut down on the duration of training to 18 months, for instance?

We have 5,000 medical graduates a year. Admittedly, we have too many medical schools. We have 32 medical schools for a 31 million population. That means, we have one medical school to one million population and that is way too many for the population.

I will have more discussions with the Health director-general and heads of departments and divisions so that we can address this issue.

> Will you look into measures to reduce the brain drain in the public healthcare sector as this is affecting patients’ access to needful, swifter treatments?

We want to reverse the (brain drain) process. TalentCorp Malaysia is doing well in bringing back specialists from Britain. But the terms and conditions of work need to be re-looked. We need to be creative in solving the problems.

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