a day ago
‘Healthcare professionals in Malaysia's national health services see no future'
A consultant paediatrician says he is compelled to speak out about the state of Malaysia's health services, following the limited solutions offered by Putrajaya and what he describes as the government's apparent ignorance of the demoralisation among healthcare professionals.
Datuk Dr Amar-Singh HSS took issue with the government's move towards a fee-for-service model, describing it as 'not good for the poor and middle class'.
In an email to newsrooms, Dr Amar said: 'I do not agree with private practice being a model for healthcare. It is expensive and no longer controlled by doctors, but by large corporations whose primary goal is profit.'
'Private healthcare only serves those who can afford it. I have friends and colleagues in the private sector. Many do good work, but they are unable to control the fee structures, which are determined by private hospitals and corporations.'
He said the Health Ministry's recent 'Rakan KKM' initiative, announced by Health Minister Datuk Seri Dzulkefly Ahmad, was yet another attempt at implementing a fee-for-service model.
The programme, which introduces an 'express lane' for elective procedures in government hospitals, has drawn criticism from various quarters. Some claim it will create a two-tier system, diverting resources to patients who can pay.
Dzulkefly recently clarified that the initiative is not a form of privatisation and does not apply to emergency cases. He said it is instead a transformative effort aimed at improving access to elective procedures in public healthcare facilities.
'Past fee-for-service models include allowing ministry specialists to work in part-time private practice, the full-paying patient scheme, and private wings. All of these take away experience and expertise from those who need them most,' Dr Amar said.
'They further widen the inequality of care within the national health service. It's suggested that specialists have extra time to work under the Rakan KKM scheme, but most of us in the ministry already put in 10 to 12-hour working days, excluding on-call duties.'
He said the Health Ministry seems unaware of the demoralisation and exhaustion plaguing its healthcare professionals.
'Healthcare professionals in our national health services currently see no future. I am unsure who is advising our good Health Minister, but the advice is poor.
'We do not pay taxes so that our national health services can be turned into a fee-for-service or corporatised model – or whatever term we choose to use. Private health insurance and social health insurance are not good solutions.'
He acknowledged there were no easy fixes to resurrect Malaysia's national health services, which have been ailing for decades.
'But perhaps it's important to identify what plagues our system. Why have we reached this low point, where many specialists want to leave the service?
'Why do new graduates and young doctors prefer to work overseas or in the private sector instead of joining the Health Ministry? Why do we have such a low number of nursing staff and allied healthcare professionals? Why is our hospital and healthcare infrastructure so poor?'
Dr Amar said Malaysia has historically spent too little on health services.
'Meanwhile, successive governments have spent lavishly on mega projects. Preterm babies, ill children, and adults have died due to the lack of intensive care services.
'The decades-long failure to resolve overcrowded emergency departments, outpatient clinics, and primary care services reflects a long-standing neglect of public health.
'The Pakatan Harapan government had pledged to 'rebuild Malaysia from the rubble of devastation brought about by overlapping crises across multiple sectors, including healthcare...' But it has failed to live up to its manifesto promises on health.'
Dr Amar said corrupt practices have also taken a toll on Malaysia's healthcare system, especially in terms of spending and development.
'A lack of meritocracy in the civil service is stunting the development of the health sector, and we are haemorrhaging good professionals to the private sector and overseas.
'Meanwhile, we've failed to improve the quality of medical undergraduate training, leading to increased medical errors and incompetency.'
He noted that Singapore, among others, has been actively recruiting Malaysian healthcare professionals.
Dr Amar said Malaysia must first acknowledge the extent of the crisis in order to move forward.
'We cannot make progress without a candid assessment and public admission of our dire healthcare crisis.
'Next, we must revisit some of the promises made in the October 2022 Harapan Manifesto, such as: Healthcare reform must be done immediately before it is too late; Increasing public healthcare expenditure to 5 per cent of the nation's Gross Domestic Product within five years to keep up with population growth, lifespan increases and current needs; and shifting from sick care to healthcare and wellness, including addressing the social determinants of health such as poverty, and providing health education and equal access for all.'
'Although the Pakatan Harapan government has failed to fulfil most of these promises over the past two years, the ideas remain sound and should be pursued.
'We need to increase public healthcare spending and prioritise preventive health measures. Workable funding solutions must be developed.
'I urge the government to return to its healthcare promises and reflect on what it once stood for. Any meaningful health reform must be transparent, accessible to the public, and involve all Malaysians in its development,' he added.
