Kuala Lumpur, 07 October 2022 — “The health allocation under the Federal Budget 2023 tabled in Parliament today is arguably not a game changer for healthcare, despite the significant increase in allocation. However, it seeks to begin to address long and teething institutional problems caused by previous underinvestment such as aging infrastructure and retaining skilled healthcare workers,” said Azrul Mohd Khalib, Chief Executive of the Galen Centre for Health & Social Policy, when commenting on the tabling of the budget bill this evening.

“In terms of allocation, at RM 36.14 billion, the health under the proposed budget is 11.5 percent higher than this year’s portion, and is both the highest increase in percentage and absolute amounts in the past five years. It is 9.8 percent of the total Federal Budget of RM 369.34 billion.”

“When the budget 2023 document is reviewed, the breakdown for that allocation gives a mixed impression of being part of a responsive budget and being business as usual. 

There are positive elements which focus on investing in modernising Malaysia’s healthcare infrastructure and services and increasing its capacity and coverage especially in East Malaysia, and the resiliency to respond to issues such as mental health,” he said. “Retaining staff is also a main priority.”

“It is encouraging that though the Government has allocated RM 1.8 billion towards the building of new hospitals, clinics and healthcare facilities, it has also provided RM 420 million towards the repair, maintenance and upgrading of existing structures. This is an important point as over the past five years, there have been several fires at aging facilities including one in 2020 at the Sultanah Aminah Hospital in Johor, which saw six fatalities due to a fire in 2016. Out of Malaysia’s 156 public hospitals, 45 are over 100 years old,” Azrul pointed out.

“The government also wants to address the contract doctor issue by increasing the line item for contract recruitments, but seems to not have increased permanent positions despite large increases in emoluments across the board. This is obviously intended to fund the promotion of existing staff and increase salaries to support retention of skilled healthcare workers.”

However, what does not appear clearly is of concern.

“While the establishment of the National Centre of Excellence for Mental Health is welcome, it would have been better for the allocation to go fully towards investing in ensuring that we have more psychiatrists, psychologists, and other mental health professionals for mental health. We need to increase availability and coverage of mental health services, which currently are inadequate. We need more service providers, or at least means for people to access both public and private mental health services. This will require long term investment and commitment.”

“Despite the Finance Minister recognising that Malaysia is still in pole position among countries in this region with a high population who are obese or living with non-communicable diseases, there seems to be little to address this situation,” Azrul said.

“The National Health and Morbidity Survey (NHMS) 2019 highlighted that 1 in 5 people live with diabetes; 3 in 10 with hypertension; 3.4 million currently live with at least two NCDs; and half of the adult population are either overweight or obese. Yet allocations for health education and PekaB40 have been reduced while Agenda Nasional Malaysia Sihat was provided with RM 16 million.”

“While the government has been Willing to give RM 150 for kids regardless of household income under the Bantuan Awal Persekolahan (BAP) programme, it is still unwilling to introduce a nutritious food programme in schools for all children to address malnutrition among our kids. Stunting and obesity are both affecting a significant proportion of Malaysia’s children, regardless of economic backgrounds. When are we going to invest in addressing the problem of childhood malnutrition?”

“We are still unable to see what the allocations for drugs and treatments are under specific disease areas as they continue to be clumped together under broad line items which prevent an understanding and transparency of funding priorities for therapies.”

Finally, it is disappointing that there is no mention of any commitment to address the issue of healthcare financing and investing in a sustainable long-term solution. In order to ensure that Malaysia’s healthcare system is able to continue to provide quality, affordable and accessible health services for all in the decades to come and tackle the challenges of preventing and treating NCDs, of mental health and an aging population, the government must summon the will and commitment to invest now in a new sustainable approach to funding health. We did not hear that today.”

“More than ever before we need to invest in future-proofing and increasing the resilience and sustainability of the public healthcare system. We cannot take it for granted,” Azrul emphasised.