By Amar-Singh HSS
I have a lot of respect for Health Minister Dr Dzulkefly Ahmad.
The minister is a good man and is trying his best to fix our public health services under the Ministry of Health (MoH). He genuinely cares for the service and the staff.
It appears the government does not plan to invest a lot more in the public health services, ie there is not going to be any major increase in health spending in the Budget or in the near future. We see no concrete plans for a meaningful solution to improve the conditions and remuneration of healthcare professionals who serve the people.
This ties up our health minister’s hands. Hence, the health minister is looking for alternatives to support our healthcare professionals. The “full-paying patients” scheme is one such suggestion.
The minister and all of us in the health profession are acutely aware that healthcare professionals in the MoH are demoralised and exhausted. There is an enormous drain of human resources from the public to the private sector and abroad – not just of specialists and doctors, but also of nurses, pharmacists and other allied health professionals. The nursing shortage is at a crisis level. Healthcare professionals in the public health service see no future.
That said, the full-paying patients scheme is not a good one.
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First, most of us who serve in the public health service do so because we want to make a difference in the lives of the people – especially a difference in the lives of those who cannot afford the private sector.
Second, most of us who work in the public health service have no time at work for anything else. From the time we arrive to the time we leave, it is a non-stop rollercoaster of work. If specialists used their time for the full-paying patients’ wing, it would mean other patients would not be cared for, and younger colleagues would have to shoulder that burden. Hence, care for these patients may be compromised.
Third, who will benefit from the full-paying patients scheme? It will be the upper and perhaps the middle segments of the middle class – not the poor, not our sizable 60% of the people who desperately need and depend on the public health services for healthcare. It would worsen the dichotomy that private health services have already created. Those who have money can easily access healthcare while the poor are further marginalised.
Fourth, who are the specialists who are likely to take up full-paying patients? The hardworking ones will think many times before they use the scheme, if at all. But there are some specialists who do not pull their weight in the public health service. They come late to work, they do not see that many patients and they leave right on time. These are probably the specialists who will grab the opportunity of the full-paying patients scheme. Some others who are thinking of private practice will also use the scheme to ‘test the waters’.
We need better, more sustainable and reformation-based changes to our public health services. We need a progressive improvement in the conditions and remuneration for our health staff. We cannot allow them to continue demoralised without any hope for the future. They work long hours with more and more demands placed on them. The Covid pandemic unmasked how poorly we supported them and their families.
Private health insurance and social health insurance are not good solutions. See the excellent commentary and insightful discussion by Jomo Kwame Sundaram and Nazihah Noor.
We need increased spending on our public health services with greater focus on preventive health efforts. This can come from improving tax-funded healthcare.
For far too long, we have allowed our public health services to decay. There are no easy fixes, no easy solutions.
But we can salvage our dying public health services and keep all categories of our healthcare professionals in public services. They should be given better conditions, an improved working environment and stronger support to allow them to focus fully on their jobs and not worry about resources for patients or their family’s needs.
Basic health is a human right – not something people should have to pay to receive.
Dato’ Dr Amar-Singh HSS is a consultant paediatrician and child-disability activist.
- Tegakkan maruah serta kualiti kehidupan rakyat
- Galakkan pembangunan saksama, lestari serta tangani krisis alam sekitar
- Raikan kerencaman dan keterangkuman
- Selamatkan demokrasi dan angkatkan keluhuran undang-undang
- Lawan rasuah dan kronisme
