Kuala Lumpur, 22 April 2019 – The Galen Centre for Health & Social Policy conducted a review of selected health related programmes, policy actions and announcements after 1 year of the Pakatan Harapan government. It looked at nine areas: Strengthening Health Infrastructure & Improving Service Delivery; Healthcare Financing; Insurance/ Health Schemes; Human Resources; East Malaysia; Disease Specific Interventions; Mental Health; Children; and Vulnerable Populations. The areas were graded individually based on selected activities and programmes.
Commenting on the report card, Chief Executive Azrul Mohd Khalib said “There has been progress and a few setbacks but overall an encouraging year so far. Healthcare has been challenging as the government must balance demands, expectations and aspirations amidst a challenging financial climate and competing priorities. It has had to deal with fire-fighting on diverse issues including sexual harassment, rising vaccine hesitancy numbers and an ongoing rabies epidemic. The overall grade given of C+ reflects a work in progress.”
“The introduction of the smoke-free air regulation in eateries is arguably, the most prominent health-related achievement for the Pakatan Harapan government in its first year. At least 40% of Malaysians are exposed to second-hand smoke and an estimated RM 2.9b is attributed to the treatment of tobacco-related diseases such as lung cancer, cardiovascular disease and chronic obstructive pulmonary disease.”
“The experience of other countries have shown that the smoke-free regulation and the sugar tax when combined, have the potential to be a game-changer for prevention and control of non-communicable diseases in Malaysia. The challenge will be to persevere and maintain the political will and commitment to imposing these measures.”
“The development of Peka B40, the Ministry of Health’s current flagship programme to tackle non-communicable disease, is a major achievement. It has the potential to succeed where other similar initiatives have failed. However, it needs to be better funded, include people below the age of 50, and have clear mechanisms linking people with treatment.”
“Under this government, doctors doing their housemenship will see long-awaited reforms. They are no longer permitted to work more than 14 continuous hours, no back-to-back shifts, work hours reduced from 65 to 75 hours per week, to 60 to 62 hours a week, and the term reduced from two years to 18 months. Though placement continues to be a problem, these changes will improve the overall conditions for this group of healhcare workers at this early stage of their professional lives.”
“The state of healthcare in Sarawak and Sabah needs to be urgently addressed by the government. Many long standing issues such as maternal health coverage remains woefully inadequate. More than a third in these states continue to live beyond 5km of any kind of health facility and may have to travel for hours to seek treatment. There needs to be a separate action plan to urgently begin upgrading the healthcare infrastructure. People in these two states are being left behind,” Azrul emphasised.
“Mental health needs continue to be dependent largely on private sector players including for profit, not-for-profit and non-governmental organisations. The 2019 budget for mental health was actually reduced compared to the previous year. Despite mental illness expected to be the second biggest health problem affecting Malaysians in the coming years, Malaysia remains inadequately equipped and positioned to meet current and future mental health needs.”
“A major push to contain the escalating cost of healthcare saw the introduction of containment measures such as central pool procurement and a price control mechanism for medicines. It is too soon to tell whether these actions will actually lead to cheaper drugs and improved coverage. The mySalam insurance scheme, introduced by the Ministry of Finance, assisting individuals struck by critical illness, is a critical step in the right direction towards eventually introducing a national social health insurance scheme. However, it is too soon to tell whether this income replacement assistance plan for the B40 will actually help the intended beneficiaries at the intended scale as approval rates are still low. “
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The Summary can be read here and the Report Card is available for download.