PETALING JAYA: Keeping manpower and upgrading public health facilities should be among the top priorities in the government’s spending plan for next year, say members the medical fraternity.

Referring to next month’s tabling of Budget 2025, they said that Malaysia’s public healthcare spending should be at 5% of gross domestic product (GDP) in accordance to the World Health Organisation’s yardstick.

Malaysian Medical Association (MMA) president Datuk Dr Kalwinder Singh Khaira said about 70% of Malaysians rely on public healthcare services, which means that urgent steps need to be taken to retain the services of healthcare workers by improving their work-life balance, benefits and overall efficiency.

“The brain drain and resignations of both junior and senior doctors which are occurring at an alarming rate need to be addressed,” he said.

If introducing more new positions within the system is a challenge, he said the government should look into creating “Khas Untuk Penyandang (KUP) Gred Khas C” positions for specialists who have been stagnating at the UD56 scale.

“There are a few hundred doctors in this category across all specialisations. Up to 100 are senior doctors who got their UD56 (grade) in 2017 and have since been stagnating at this scale,” he said.MMA is expecting the government to announce new on-call rates under Budget 2025.

“We hope the government will accept MMA’s proposal of increasing the hourly active on-call rate for medical officers to RM25 an hour (from the current rate of RM9.16 an hour for weekend active calls),” he said.

“Similarly, we hope that the government will increase the specialists’ hourly active on-call allowance rate to RM30 an hour (from RM10.40 currently),” he added.

MMA also called for allocation for the purchase of Automated External Defibrillator (AED) machines in view of the increasing reports of cardiac arrest cases.

“Corporate organisations and privately-owned gymnasiums as well as sports centres should be given tax relief for purchasing this life-saving equipment,” he said.

Senator Dr RA Lingeshwaran, who is the former director of Hospital Sungai Bakap, suggested that hospitals be given a certain percentage of revenue collected from sin taxes derived from cigarettes, alcohol and also sugar- sweetened beverages (SSB) tax.

“This is so that they can replace their ageing equipment and upgrade dated facilities,” he said.

Former Health Ministry’s disease control division deputy director Datuk Dr Zainal Ariffin Omar said hospitals and clinics, especially those which serve as the first point of contact such as the outpatient department, should be upgraded and equipped with the required manpower, particularly specialists.

He also proposed that the Peka B40 scheme be expanded to cover follow-up care for non-communicable diseases (NCD) after diagnosis.

Dr Ginsky Chan, Access Director at Angsana Health, said Budget 2025 should focus on strengthening the health system to meet the evolving needs of Malaysians.

“This includes addressing the challenges posed by an ageing population, rising rates of NCD and ensuring equitable access to healthcare services for all.”

“Specific areas of focus could include strengthening primary healthcare services to prevent and manage chronic conditions more effectively and promoting the use of health technology and digital health to improve screening, diagnosis and patient care,” Chan said.

He cited international benchmarks which showed that upper middle-income country’s spend about 6% to 8% of GDP on healthcare.

“However, it is crucial to prioritise efficiency over simply increasing the budget. By addressing inefficiencies within the existing system, we can maximise the impact of our healthcare spending,” he added.

He said this could involve reforms such as streamlining administrative processes, increasing public-private partnerships and promoting preventive care.

The Health Ministry was allocated RM41.2bil in Budget 2024, making it the second highest recipient.

https://www.thestar.com.my/news/nation/2024/09/25/call-to-set-spending-at-5-of-gdp