There has been major reorganization of health care services in Malaysia since 1957. Where once the health care services in the country were largely led by the government and funded by the public service enterprise since the time of independence, it has now changed into a dual-tiered parallel system over the decades. However, the country does not have a unified system that is a declared national health care policy of offering universal access to every citizen.
Malaysian citizens paid for public healthcare through the general taxation of income. Public healthcare is a cheaper option compared to the private sector as it is funded and subsidised by the government. The quality of doctors, surgeons and other medical staff do not differ from one another as both sectors employ trained medical professionals. Not only that, both sectors use high quality equipment which had undergone standards inspections from governmental overseers. Malaysia has become a destination for medical tourism for those looking for treatments for various ailments because of the excellence of medical facilities provided in the country’s health care services.
Rural health service is one of the largest sectors in the services department where almost all the infrastructure and human resources are provided by the government. Minister of Health employed and deployed healthcare workers to various healthcare centres, such as from rural clinics to district hospitals and to tertiary specialist hospitals throughout the country. The size, need and population of the districts and states greatly affect the distribution of these resources. However, there is still a lack of health care services in the rural and remote regions in the nation.
The rural health service only provides primary healthcare coverage but they are connected to large hospitals in each state and capital city through a unique system called referral. Government-managed ambulances which also includes airlift capacities for remote sites are provided for medical and surgical emergencies.
One of the problems faced by the public health sector today is the migration of trained medical staffs, especially specialists, to the private health care system. This is not only because of the deployment to rural sites that some of them view as ‘unrewarding’, but also because of the better financial gain in the private sector. The loss of these trained staff would hinder the progress in the public sector and they also have to buy the services of private specialists, especially during emergencies.
While the private sector often attracts doctors and other medical staff due to its higher wages compared to working in the public sector, it is still preferable and sought for by the citizens despite its fee-for-service system and the generally expensive price. This is no doubt because of the faster waiting time and a more comfortable or luxurious medical care, among other benefits.
Health insurance has also worked to offer more premium benefits to their clients using this system. Despite charging more than the public sector, the private sector actually helps to ease the burden faced by the public sector. Many public hospitals face the problem of overcrowding from higher number of patients with not enough doctors to attend to them. On the other hand, the private sector has a smaller number of patients compared to the public sector and they also have more doctors due to the higher salaries offered within the private sphere, thus offering faster services for their patients as the ratio of doctors to the patient is higher.
Besides general health care services, there is also a special facility for the aged. There is an estimation in Malaysian population among aged citizens which would increase from 7.4% to 10% by the year 2020. So, it is also crucial to improve aged care facilities and also nursing home facilities to ensure their comfort and well-being. Many people would think that senior citizens should not be sent to old folks home, as it would be seen that their children does not love them or are too busy with their career until they have no time to take care of their folks. However, nursing homes are the best way to provide good health care services especially for them as their well-being would be maintained and managed every single day by professional nurses with legit nursing skills. It is for those who do not need hospital services but cannot be cared for adequately and safely at home. Plus, these aged citizens would be able to find new friends with the same age to spend time with.
Nevertheless, Malaysia is still in need for improvement of nursing homes. This is because there is still no minimum standard on how an adequate and effective nursing homes should be. According to a research in Universiti Malaysia Kelantan, old folk’s home in Malaysia still uses dorms to accommodate the senior citizens. These type of accommodation should be banished because most of them would need privacy for their living, unless they are willing to share a room. Still, we should not treat them like children in boarding schools. That is why the need for improvement is emphasized on their accommodation, from their bedroom, dining room, to a special mobility services like wheelchairs. All of these are essential for the nursing homes’ residents.
It is true indeed that Malaysian health care services are improving time by time, ranging in both public and private sectors, from new-borns to the aged, and from general to chronic conditions. Nonetheless, these improvements should never stop to maintain Malaysia as a place for medical tourism, and to make Malaysia a developed country by the year 2020.
This article was contributed by Nur Shahira binti Ahmad and Nadhrah Athirah binti Johan, Department of English, Faculty of Arts and Social Sciences, University of Malaya as part of their social engagement project with Challenges Media.