THE fire at the Sultanah Aminah Hospital in Johor Baru in 2016 should have been a clarion call for better governance and funding for our public healthcare system. And then there was another fire on June 28 this year.
The reality of the matter is Malaysia’s public healthcare infrastructure has seen better days. A 2018 report by the National Audit Department revealed that our hospitals, especially the emergency and trauma departments, are understaffed, overcrowded and underfunded, and do not have enough equipment to provide proper levels of care.
Health Ministry director-general Datuk Dr Noor Hisham Abdullah echoed this in a July 16,2019, Facebook: “We are currently underfunded, understaffed, underpaid, overworked, overstretched and with facilities overcrowded with patients. We all need to try harder to improve the public healthcare system, to increase the funding, to increase the number of healthcare workers, to improve the salary scale and availability of job posts in our health facilities; all of which are beyond the control of MOH (Ministry of Health). I believe when there is a will there is always a way.”
The Pakatan Harapan government failed in two consecutive budgets to raise healthcare expenditure to 4% as promised in its election manifesto – a sum that is still a far cry from the money spent by neighbours like Singapore, which budgets 4.9%, and far below the World Health Organisation recommendation of 7%.
Malaysia’s public healthcare system was among the best in the world – until Tun Dr Mahathir Mohamad’s great privatisation drive during his previous stint as Prime Minister. Dr Mahathir hailed this move as a victory for the rakyat, bringing in unprecedented efficiency and cost reductions. In reality, we only saw the creation of a rent-seeker class that continues to monopolise not only health services but all aspects of public service.
The Malaysian public healthcare system today continues to suffer from a conflict of interest due to the presence of GLCs (government- linked corporations) in private hospitals, the mass privatisation of health services and added brain-drain in the competition for
specialist talent between public and private hospitals. Meanwhile, both Barisan and Pakatan governments continued to make healthcare a matter of “who can pay” with the establishment of private dispensaries and private wings in government hospitals, a near constant push for health tourism in several private hospitals and raising fees for foreign workers.
Despite these challenges, our healthcare professionals have performed admirably in protecting the people during the current Covid-19 pandemic. What is needed now is for the government to start rectifying any and all shortcomings that prevent our frontliners from doing their jobs to their maximum potential.
According to the Malaysian Medical Association, about 3,500 junior doctors from two cohorts may not get permanent positions in government healthcare facilities. A large number of these medical officers on contract are currently serving as frontliners in the fight against Covid-19.
The new government needs to break from the past – we need to lift the moratorium on new positions, expand our public facilities and we need to do that fast. Given that people are growing increasingly restless to reopen our borders, the government should use this time to ensure that our healthcare infrastructure can cope with any future waves of Covid-19 infections without compromising existing patients.
It is high time our politicians stopped visiting sites of tragedies such as the Sultanah Aminah Hospital fire for political grandstanding and start actually ensuring that such incidents are not repeated.
ARIF BAKHTIAR MOHAMMAD