Malaysia Healthcare system
Malaysia healthcare system is dual-tiered, public sector and the private sector. These two sectors have their own operational principles and cater for the different social group of patient. It is encouraged that both these sector can be unified in future and reason is will be discussed in the following article.
Public healthcare, as commonly known is much more affordable than private healthcare sector due to subsidisation from the government. Firstly, from the perspective of rural health care, there is a growth in the number of rural clinics and district hospital. It is expected that distribution of healthcare staff should be based on certain region population medical demand. However, distribution of healthcare staff is not even compared to urban area to rural area. Obviously, because of the geographical features of rural area- more mountainous, remote and less accessible causes majority of staff do not want to apply to rural healthcare centre, especially better-trained and educated staff would rather stay at urban medical centre or private healthcare sector than stay in a rural area because they find this is very unrewarding and not getting paid much. This leads to a problem that most of the staff at rural health sector is not sufficiently trained and unable to provide quality medical care to the rural citizen, which causes unfair treatment to the citizen. In order to overcome this issue, the government should promote staff to apply to rural healthcare sector by offering incentives like hardship allowance, tax break, promised preferential selection for training and development after the service at rural area. If this step is not done, this would cause healthcare staff working in the rural area feel that they are neglected by the government and taking care of their welfare. However, so far, the rural health sector is still providing effective primary healthcare, and if the case is more serious, rural healthcare will send the patient to tertiary healthcare centre through a unique system of referral, which brings to another perspective of the public healthcare sector. Past these few decades, our public tertiary healthcare service has grown tremendously and provided wider coverage. Every state and capital city to have a large hospital to refer to. Besides, government hospital also provides adequately ambulance, including airlift capacities. Malaysia tertiary health service is excellent, for example, National Health Institute (IJN) provide outstanding service in several specialities like cardiology, nephrology, neurology and others. However, understaffing is still a problem that has not been completely solved yet, especially for some of the specialist will opt for serving in the private healthcare sector due to higher wage paid. Statistics have shown that 300 doctors and 50 specialists left public healthcare sector annually. This causes expertise retention is one of the issues that occur until today. Besides, some of the problems of public healthcare system include poor maintenance and planning leads to condemnation of the whole wing of Kota Kinabalu Queen Elizabeth General Hospital. This causes the hospital have to shut down the intensive care unit and surgical operating unit.
In public healthcare sector, there is also purchase private of corporate sector expertise. Clearly, like stated before, due to the migration of doctors and specialists to the private healthcare sector, sometimes causes understaffing in certain specialities when there is high in demand. For example, Kota Kinabalu cardiology and cardiac surgical services are purchased from IJN, which is another great expenditure and burden of government. Having partnership with private healthcare sector actually do yield a lot of benefits included IJN staff would not turnover more often because of the well paid, and also able to provide quality healthcare service to citizen, thus it is hoped that one day public and private healthcare sector will be unified at one day for the good of Malaysian citizen. However, partnership with IJN does not last long due to its high cost and lead to existence of government-linked co-operation (GLC) with private sector like Sime Darby, KPJ in order to modernise and extend the reach of private healthcare service to public at an affordable price, which sound a little bit unbelievable , but at least to a win-win scenario. In public healthcare sector, there’s even a period of time where a patient who willing to pay more and enjoy certain priorities like quicker access and shorter waiting time for elective surgeries and some therapies. This is actually to increase government income in order to lessen their financial burden in healthcare, and which in fact the money just does not make a significant changes actually, Eventually, due to customer pressure and some of the citizen complain that this is penalising the poor and less financially endowed, hence this eventually called for abandonment.
On the other hand, the private healthcare system is the one which is attracted by general and family medicine. Most of the specialist join because of better paying, especially in an urban big private hospital. During Mahathir premiership, private sector hospital bed increased 10 fold, which is a proof that private healthcare sector is growing tremendously. Firstly, from the perspective of general practitioner clinics. This is catered for the fee-for-service and self-paying citizen. That patient who rather opt for private clinic than a public clinic because of the simple registration, shorter waiting time and easier access than government clinic, which is good for relieving Ministry of Health. The private clinic also able to provide greater continuity of care and give more personal attention to the patient, improving population health. The private clinic does provide care for the common ailment and simple trauma, especially those clinics at outside urban area like KL, do really alleviate the patient to prevent patient crush during peak hour. It is recommended that private clinic and public clinic should have a crossover for the good of the patient. Patient able to seek second advice and redistributing patient to the private clinic so that every patient would get adequate medical care and nobody is neglected. This is also a good solution, at the times of mushrooming clinics, some of the clinics are facing the financial problem, hence through this step, there is a win-win solution if having a partnership with the public clinic.
From the point of view of private medical centre and hospital, undeniable, private hospital grows massively and for example, the emergency department used to be available at large government hospital only but it is offered at the private hospital. Obviously, people who go to the private hospital isn’t only because wanting to get better and personal medical care, and also the luxurious environment and attentive healthcare staff. That is the reason for those who are able to afford would definitely go to a private hospital because they could have a recover faster in a situation that is well taken care of. Especially now, the times of mushrooming of the private hospital, more and more hospital strive to cater for public even better healthcare service. Not only this, some of the foreign private hospitals also flowing and growing in Malaysia like KPJ, Parkway Holdings. These foreign private hospitals able to provide sophisticated amenities and high technology treatment, which again, definitely beneficial to the citizen and improve overall population health.
In conclusion, both sectors do play a huge role in improving population health but catering for different social group of patient generally, however, both sectors sometimes do face problem that another sector do n’t, for example, some private clinic is not often visited by patient but in government clinic there’s always patient, hence, by promoting private-public partnership able to resolve the problem and most importantly, all of our Malaysian citizen able to access to quality and excellent medical service at an affordable price.