‘Budget cut misconception due to shift in accounting’

PUTRAJAYA: The misconception of the supposed budget cut for the Health Ministry was due to a shift in the accounting method, says a health expert.

Health systems and policy specialist Dr Khor Swee Kheng said that although the government is not cutting health budgets, it looked that way because “the accounting treatment has changed”.

“It is inaccurate to say that funding is drastically cut. No government is so cruel or foolish to cut health spending to zero overnight. So, where is the money?

“The money is being reallocated from operating expenditure (Opex) to development expenditure (Devex),” he wrote on Twitter yesterday.

However, he noted that such accounting treatments involving a shift between Opex and Devex needed more explanation by the government as it was “unnecessary and confusing”.

“What is the breakdown in Devex, by category? How will you procure services or supply in Devex? Tenders, direct negotiations, direct purchases, treasury instructions?

“The lack of transparency gives way to corruption, wastage and fraud,” said Dr Khor, who also noted that the overall RM31.94bil budget for health was a mere 4.3% increase from the previous one.

“That’s not enough at all,” he added.

The Malaysian Health Coalition concurred, saying that the government should invest more heavily in the public healthcare system.

It said that in the main areas of human capital and infrastructure development, additional funds for the public healthcare system as well as teaching hospitals must be addressed to bring Malaysia closer to international standards.

As the ministry will now decide how the allocation is spent, public health advocate and senior consultant paediatrician Datuk Dr Amar Singh has expressed concern over the disempowerment in the management of local and state health facilities.

“Possibly, the ministry feels this is a better way to manage the pandemic – by pooling funds centrally.

“But how to decide who gets what?” he said, adding that expenditure for public health and paediatric services are important areas that need funding.

“Public health expenditure is grossly underfunded, and paediatric services are limited and poor.

“These are fragile areas that should be boosted because they are vital to health services and for families and children,” he said.

He also added that otherwise it could damage healthcare for vulnerable groups in certain communities and hamper preventative activities.

Public health expert and former deputy Health director-general, Prof Datuk Dr Lokman Hakim Sulaiman, said any underfunding in health activities besides fighting Covid-19 will deprive the people, especially the poor, of equal healthcare access.

“It is a question of priority. Health should continue to receive the same share of the budget cake.

“Although there was an increase in the health budget, it is marginal compared to what is needed.

“And this will continue to happen, year after year, as long as we continue with the current independent dual healthcare financing systems between the public and private healthcare system,” he said.

Dr Lokman noted that the problem of insufficient budgets and widening disparity in equity, as seen in the long waiting time for certain procedures, is a sign of an inadequate healthcare system.

Malaysian leaders, said Dr Lokman, need to have the political will to change, and adopt holistic healthcare financing systems by integrating both the public and private healthcare systems.

Such a move will benefit the people, especially the most vulnerable – the lower middle income, the poor, and the marginalised whose voices may not be heard, he added.

Retiree Mohd Samad Ahmad, 62, from Bukit Baru in Melaka, said he is glad that his cataract surgery scheduled for next year at the general hospital would not be affected even though the government is focusing on Covid-19.

“I have done my left (eye) cataract a few years ago and I have been waiting for my slot for the right eye. The doctor said it is slotted for next year.

“I have been worried since the pandemic began, but during a visit on Friday, doctors have assured me that I will get my cataract surgery regardless of the budget.

“I feel relieved because I cannot afford to pay RM3,000 for the surgery,” he said.

A 70-year-old who only wants to be known as Jenny, from Shah Alam, said she is happy that her monthly medication for hypertension is not affected.

However, she hopes that the waiting time to see a doctor can be reduced as “hours of waiting” seem to be a norm at the public hospital, even with an appointment.

A renal failure patient K. Anand, 52, agreed, saying he was also waiting for a surgical procedure for his dialysis, but was thankful nonetheless that his treatment is all free.

“As a former civil servant, I am thankful that the government is not shrinking its healthcare services.

“Healthcare costs have been rising and the underprivileged group needs the government to help,” said the former janitor from Klang.

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