Kuala Lumpur, 13 October 2023 — The proposed allocation for health under the Federal Budget 2024 tabled in Parliament today by the Finance Minister, represents the largest increase for this line item over the past decade. It appears that no other area, including Education, has had a similar boost to its allocation.

“MOH will have RM35.2 billion for its operating expenditure and RM6.1 billion for development expenditure. Just three years ago, the total allocation for health under the 2020 budget was RM 30.84 billion. This demonstrates not only how rapid the increase has been in health expenditure, but also the increasing demands on Malaysia’s healthcare system,” 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.

“At RM 41.2 billion, health under the proposed 2024 budget is 13.5 percent higher than this year’s, and is both the highest increase in percentage and absolute amounts in the past five years. Health now represents 10.5  percent of the total Federal Budget of RM 393.8 billion.”

“This strong and clear commitment by the Federal Government to improve Malaysia’s healthcare delivery system can be seen in the hundreds of millions allocated to building and modernising clinics, hospitals, and replacing ageing and obsolete infrastructure. However, what is not that clear, is how the Government intends to address the problem of recruiting, retaining and preventing the haemorhagge of skilled healthcare workers such as nurses, doctors and specialists from the public to private sector, and the loss of these same professionals to other countries such as Australia. The Finance Minister pointed out that Malaysia still falls short of the target of one doctor for 400 patients. The Government must also *demonstrate commitment to not only recruit new personnel but fund the promotion of existing staff and increase salaries to support retention of skilled healthcare workers. This was not made clear.”

“I am glad that the Budget proposed to increase the excise duties on sugar sweetened beverages (SSB). However, the revenue should instead be channeled to investing in improving health communications, preventive health interventions, and healthy breakfast programmes for school children as was originally intended when the tax was first imposed in 2019. We need to invest more in this area if we are to seriously commit to moving from sick care to health care.”

“Every year, nearly one million Malaysians fall sick, either with diabetes, hypertension, high cholesterol or various other diseases. We must want to keep people healthy. It is the only effective and sustainable way to manage non-communicable diseases and reduce the burden of care in the long run. With 3.9 million people living with diabetes and around 9,000 kidney patients annually newly registered and needing dialysis treatment, this budget and future editions will never be enough to meet the demand. We must do things differently.”

“The RM100 million allocated to the Skim Perubatan Madani or Madani Medical Scheme is welcomed. This scheme is potentially a game changer, which could reduce the congestion in government clinics and hospitals. We have seen the proven public-private partnership models from Selangor and ProtectHealth. By providing those who qualify to be enrolled in the scheme particularly those from lower income households, with subsidised access to private general practitioners (GP) clinics at a national level, this scheme could significantly relieve the pressure and burden on congested Emergency departments at public hospitals across the country. However, based on the Selangor experience, I believe that RM 100 million is too low for such an ambitious coverage target. It should be twice the amount and given the necessary resources to succeed,” Azrul emphasised.

“Though the Health White Paper was mentioned, there was no indication of any commitment to addressing the issue of sustainable 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 commit itself to finding a way forward on this question.”