YB MR. LIM GUAN ENG
MINISTER OF FINANCE
2020 BUDGET FOCUS GROUP MEETING
THE 3R APPROACH OF REPAIRS, REPLACE AND RESTORE IN
GOVERNMENT MEDICAL EQUIPMENT AND FACILITIES
PUBLISHED ON SEPTEMBER 2019
Yang Berhormat Datuk Seri Dr Dzulkefly Ahmad
The Minister of Health
Yang Berbahagia Dato' Seri Dr Chen Chaw Min
Secretary General, Ministry of Health
Yang Berusaha Encik Ahmad Shariff Bin Hambali
Chief Executive Officer, Medical Device Authority
Ladies and gentlemen,
Good morning and Salam Harapan,
1. The Government is organising a series of 12 focus group discussions to obtain views and recommendations for the 2020 Budget, which will be tabled on 11 October 2019. These focus groups will deliberate on specific issues highlighted during the Budget Consultation Day held on 27 June 2019, as well as from memorandums submitted by industry players, think tanks, academia and NGOs.
2. One of the most important issues raised relates to the provision of quality health services that is accessible to all Malaysians, particularly among the B40. Indeed, quality health service is important towards fulfilling the “Shared Prosperity” agenda.
HEALTH SPENDING IN MALAYSIA
3. Between 2010 and 2018, the Government of Malaysia has allocated RM193.6 billion for the provision of healthcare services.
4. As tabled during the 2019 budget, the Health Ministry received a total allocation of RM28.7 billion, or approximately 9% of the total budget spending. The RM28.7 billion allocation is about 8% higher than it was in 2017. This made the Ministry among the largest ministries in terms of spending.
5. The money was spent for primary public healthcare services such as sanitation, food safety and vaccination that had raised our life expectancy. According to the Department of Statistics Malaysia, in 2019 a Malaysian has a life expectancy of 74.5 years.
6. Allocation to the Health Ministry is part of the RM107 billion social expenditure provided in 2019 across various ministries. This formed about 34% of the total 2019 Budget spending.
7. In 2018, the Government operated 2,881 health and community clinics nationwide, as well as 144 hospitals. In addition, there were a total of 2.6 million admissions to government hospitals, compared to 1.1 million admissions to private hospitals. These numbers reflect the dependency of Malaysians on our public healthcare services.
8. Acknowledging the importance of quality public healthcare, several measures were introduced by the Government in the 2019 Budget. These included RM10.8 billion worth of medical supplies and upgrade in the quality of health services at public clinics and hospitals.
9. The Government has also provided RM100 million through nationwide health screening programme, Skim Perlindungan Kesihatan (PEKA) for 800,000 individuals aged 50 and above in B40 households.
10. Furthermore, RM50 million has been allocated this year for the treatment of rare diseases, treating Hepatitis C, addressing stunting among children, providing more haemodialysis screening and treatments, and expanding the Enhanced Primary Healthcare (EnPHC) programme.
11. The Government also introduced the mySalam scheme beginning this year. It is a free national health protection program covering 3.8 million Malaysians aged between 18 and 55 years old in the B40 group. The scheme provides a RM8,000 one-off lumpsum payment for those diagnosed with any one of 36 critical illness. Furthermore, the scheme also provides income replacement payment of RM50 daily to those receiving treatment at any government hospital for a maximum of 14 days, or RM700 annually.
12. The mySalam program will help reduce out-of-pocket healthcare spending among Malaysians. According the World Bank, 38% of healthcare spending in Malaysia came directly from individual Malaysians. This is higher than some of our neighbouring countries. For instance, outof-pocket healthcare spending in Singapore and Thailand were 31% and 12% respectively.
CHALLENGES IN THE PROVISION OF HEALTH SERVICES
13. Lifestyle changes have an impact on the needs for and the delivery of health services. On top of these changes, the public health system also has to manage rising healthcare cost. This is especially as Malaysia’s demographic profile is getting older. In 2020, it is projected that 7% of Malaysians will be 65 years old or older. By 2045, it is projected to hit 14%.
14. The Government is also concerned with monopoly power over the provision of drugs and its effects on healthcare cost. We are currently studying the existing contact between the Government and Pharmaniaga to find the best way forward to address the problem. At the moment, the monopoly is costing the Government more than RM1.1 billion yearly.
15. I call on the Health Ministry to carry out administrative reforms so that savings could be made and health services could be delivered more efficiently. The Ministry of Finance has a new policy of returning all savings made by any ministry through such administrative reforms to the same ministry. This is to encourage all ministries to double its reform efforts through creative and innovative approach, and would not simply request for additional allocation. I believe the public health system will be able to spend more efficiently and help address the problem of rising living costs, if we are able to introduce healthy competition within the drugs supply market.
16. The focus of the Federal Government now is to ensure all existing medical equipment and facilities function well. What is the point of building new facilities if the existing ones are not taken care off and deteriorate in quality? In my visits throughout the country, I have observed that this trend has persisted over the past 15 years. To solve this, we need the 3R approach of Repairs, Replace and Restore towards all government medical equipment and facilities. It would involve a high cost and it would be impossible to carry it out within a period of one year. Yet, we need to start now.