Health White Paper: Investments into public healthcare to be increased to 5% of GDP in stages, says Dr Zaliha

KUALA LUMPUR: Investments into public healthcare will be increased in phases to 5% of the Gross Domestic Product, said Health Minister Dr Zaliha Mustafa.

While tabling the White Paper on Health, she said this will be done in accordance with the government’s fiscal position. It will also include cross-sectoral strategic cooperation and the pooling of resources and assets among stakeholders.

“The current fee structure at public healthcare facilities will also be reviewed so that the targeted healthcare subsidies will be channeled in a good and systematic manner.

“The Health Ministry will study the appropriate option to pool healthcare funding sources such as a more progressive healthcare financing scheme to ensure the sustainability of healthcare funding,” she said.

Dr Zaliha acknowledged that expenditure on public healthcare has remained low for a long time.

This has hampered the government’s efforts to fulfill manpower, infrastructure and equipment needs and to optimise healthcare resources effectively and efficiently.

The dichotomous and unintegrated nature of the healthcare sector has contributed to imbalances in the service distribution and resource allocation.

To illustrate this point, Dr Zaliha said the primary healthcare facilities in the public sector only made up 28% of the total primary healthcare facility in the country—but it accommodates 64% of outpatient visits.

“This has led to facilities and personnel in the public sector being burdened, especially at the height of the Covid-19 pandemic,” she said.

The 2018 Auditor-General’s report revealed congestions in the Emergency and Trauma departments of hospitals which stemmed from shortage of staff, high patient volume, lack of funding and shortage of equipment to provide the necessary care.

“The shortcomings are not limited to the Emergency and Trauma Department of hospitals but it reflects the situation in many government healthcare facilities comprising clinics and hospitals. The long wait time and the congestion have affected the quality of service,” she said.

Citing the latest ministry data, she said the wait time for cardiothoracic, cataract, neurological and other surgeries could be from three to 15 months.

Nevertheless, she said the Health Ministry had ensured that immediate intervention and surgery were prioritised for emergency cases.

“At the same time, a lot of healthcare facilities and equipment in the public sector are dilapidated,” she said, adding that some 1,200 healthcare facilities were run down or badly damaged.

Some even had safety hazards such as cracks in the building or fire hazards.

She also noted that there is also geographic disparity in the locations of healthcare facilities as most private facilities are concentrated in urban and suburban areas, leaving government facilities in rural areas under pressure.