NEW STRAITS TIMES MALAYSIA
Medical experts weigh in on 2021 Budget
KUALA LUMPUR: While medical experts and frontliners welcomed the 2021 Budget’s overall goals in terms of health expenditure, they felt it missed out on several key points.
Health systems and policies specialist, Dr Khor Swee Kheng said there were three main takeaways from the budget in terms of health spending.
“Firstly, the entire Covid-19 support is too small, both in health and non-health terms.
“For example, the allocation for vaccines is only RM3 billion, which may not cover the likely scenario of two vaccine doses of approximately RM80 per dose for at least 60 per cent of Malaysia’s population, including the logistics of a nationwide vaccination program.
“Additionally, the RM17 billion Covid-19 Fund for wage support and social assistance is too small to sustain an entire year’s worth of job losses and under-employment, which will impact nutrition, mental health and health outcomes.
“Secondly, the overall allocation to the Health Ministry increased from RM30.6 billion to RM31.9 billion, which is only a 4.3 per cent increase year-on-year. This reduces the ministry’s ability to deliver the needed Covid and non-Covid care, and reduces the ability to achieve universal health coverage and long-term health reforms.
“There is also no mention of more permanent posts for frontliners, something that nearly all of Malaysia supports.”
However, Dr Khor said there were a series of small decisions that reflected a greater willingness to embrace health insurance.
“There is an expansion of the MySalam benefits, providing tax breaks for some insurance purchases and introduction of vouchers for the B40. This is a positive trend that allows for a more sustainable and diversified funding sources for healthcare in Malaysia.”
Medical lecturer, Dr Aidalina Mahmud said frontliners appreciated the continuation of the special allowance of RM600 per month and a one-off payment of RM500.
“It is a gesture that I’m sure they will appreciate. Perhaps there should be other gestures of gratitude that can be given administratively by the top management such as special days off or achievement awards.
“Rather surprisingly, there is no explicit mention about the creation of new posts or absorption of contract medical personnel into permanent posts, particularly involving doctors.”
The Universiti Putra Malaysia (UPM) hospital management expert said there was a lack of allocation for infrastructure as compared to last year’s budget.
However, she said this is understandable because resources were expected to be pumped into Covid-19 prevention and control programs.
“However, it is intriguing there is no specific mention about improving information and communication technology/electronic medical records (ICT/EMR), compared to last year’s RM30 million allocation.
“Are last year’s allocations enough to cater to ICT/ EMR and virtual clinics next year? Or was it because the allocation for virtual clinics was included in the RM1.8 billion overall budget for Covid-19?”
Public Health specialist Dr Maznah Dahlui said the RM24 million carved out for mental health, prevention of violence and substance abuse was a good move.
However, she decried a lack of funds for health promotion and prevention campaigns for non-communicable diseases (NCD).
Although the focus was more on treatment rather than prevention, she said NCDs were the leading cause of death in Malaysia and this required an additional RM5 billion allocation next year for treatment, early intervention and awareness campaigns.
Malaysia records RM8.91 billion in losses in productivity annually from NCDs such as cancer, diabetes, heart disease and hypertension.
Dr Maznah stressed upon a need to protect groups at risk of NCDs as there is a risk of a national health crisis following a surge in NCD cases when the pandemic is over.
“We can already see how the pandemic has taken a toll (on the wellbeing of NCD patients), with delayed appointments, infrequent hospital visits and disrupted treatments.
“These affect the elderly and B40 groups who can’t afford to go to private facilities,” said the Social and Preventive Medicine Department professor from Universiti Malaya.
Meanwhile, Association of Private Hospitals Malaysia president, Datuk Dr Kuljit Singh was happy that the budget focused on further containment and control of Covid-19, including getting vaccines when they are available.
“There is a lot of support and appreciation to the frontliners.
“However, we hope the government will allocate a budget for patients waiting to get treatment in public hospitals to receive treatment at private hospitals, which allows for early intervention and treatment.”
He said this was vital as the fight against Covid-19 is being carried out at government hospitals.
THE STAR ONLINE
PETALING JAYA: The RM1bil allocation to combat the Covid-19 pandemic is heartening, but it’s disappointing that the long-standing issue regarding permanent and contract positions for junior healthcare workers was not addressed in the Budget, says the Malaysian Medical Association (MMA).
Its president Datuk Dr Subramaniam Muniandy (pic) said the announcement of further contract positions for nursing and other healthcare support staff did not bode well for the welfare of the staff.
Nonetheless it was important to ensure that the positions were made available quickly, he said.
Dr Subramaniam added that the job opportunities under the government’s Short Term Employment Programme lacked clarity as to who exactly would benefit or if there would be new positions for existing contract staff.
“We would have expected that seeing the need for enhanced public healthcare to deal with the pandemic, there would be allocations for increased healthcare positions.
“Disappointingly, we don’t see any major allocations for the much-needed boost in our healthcare workforce.
“We hope that once the finer details are released that the government will address these urgent issues,” he said in a statement Friday (Nov 6).
Dr Subramaniam added that general practitioners (GPs) were also forgotten as calls for tax breaks and incentives to be extended to the 7,000 GPs in the pandemic fight were not heeded.
“Overall, we agree that the budget is focused on rejuvenating the economy, but to the medical profession, it does seem that despite the applause given to the frontliners, more could be done to address the needs of our fraternity.
“It is hoped that the government will be clearer on the employment of new doctors in permanent positions.
“The GPs are also going through a tough time during this period. They should be supported by allowing tax relief from indemnity insurance,” he said.
He said the RM600 bonus for all civil servants, including the frontliners, as well as the RM500 one-off payment for almost 100,000 frontliners were welcomed, but said there would be disparities as many healthcare workers contributing in the battle against Covid-19 were left out as they might not fulfil the strict criteria set by the government.
Apart from the RM1bil allocation, Dr Subramaniam said the RM90mil allocation to ensure that the long-awaited pneumococcal vaccination programme was also welcomed.
He added that the number of tax relief initiatives to promote preventive health, the attention given to mental health as well as the extension of the My Salam programme were also laudable.
Meanwhile, Association of Private Hospitals Malaysia (APHM) president Datuk Dr Kuljit Singh said it was encouraging that the government prioritised funding vaccine production.
“The government has given a lot of attention to vaccine research and manufacturing in Malaysia, ” he said.
He added that it was also good that there was a RM35mil allocation to help boost medical tourism in the country once the borders were open.
However, he said a special budget should be set aside for non-Covid-19 public hospital patients who were waiting for treatment for them to be transferred to private hospitals instead.