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LETTER | HSA and our healthcare woes

Arif Bakhtiar

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LETTER | The 2016 fire at the Sultanah Aminah Hospital (HSA) in Johor Baru, Johor should have been the clarion call for better governance and funding for our public healthcare system.

Unfortunately, despite two visits by Tunku Mahkota of Johor, Tunku Ismail Sultan Ibrahim in years following what has become the country’s worst hospital accident alongside numerous rebukes by the Johor Royal Family – not much has been done in the interim, leading to the most recent fire last Sunday.

The reality of the matter is that the continued incidents and status of the HSA ICU ward is another case in the continued negligence of our public healthcare system by governments from both sides.

Malaysian public healthcare infrastructure has seen better days. In a 2018 audit report by the National Audit Department, it was revealed that our hospitals, especially the emergency and trauma department (ETD) at Malaysian hospitals are understaffed, overcrowded, under-funded and do not have enough equipment to provide proper levels of care.

Health Ministry director-general Dr Noor Hisham Abdullah (below) echoed this statement on his Facebook page:

“We are currently under-funded, understaffed, underpaid, overworked, overstretched and with facilities overcrowded with patients. We all need… to improve the public healthcare system..; all of which are beyond the control of MOH.”

Pakatan Harapan had failed in two consecutive budgets to raise healthcare expenditure up to four percent as promised in their manifesto – a modest sum no doubt, but a far cry from the money spent by our regional neighbours such as Singapore (4.9%) and far below the WHO recommendation of seven percent.

These now opposition politicians can clamour for reports and royal commissions all they want, but I do hope they realised that they have messed up their chance to rectify the issues that affect the rakyat the most.

Yet not all blame should go to Harapan after all, they only inherited the system that was produced by Dr Mahathir Mohamad.

Our public healthcare system was among the best in the world – until Mahathir’s great privatisation drive that struck many of our public services in an attempt to create a new class of “bumiputera” capitalists.

Mahathir hailed this move as a victory for the rakyat, bringing in unprecedented efficiency and cost reductions.

In reality, we only saw the creation of a rent-seeker class that continues to monopolise not only health services but all aspects of our healthcare system.

The Malaysian public healthcare system today continues to suffer from conflict of interest due to the presence of GLCs in private hospitals, the mass privatisation of health services and added brain-drain in the competition for specialist talent between public and private hospitals.

Despite these challenges, our healthcare professionals have performed admirably in protecting our country from the Covid-19 epidemic.

What is needed now is for our government to start rectifying any and all shortcomings that prevent our frontliners from doing their jobs to their maximum potential.

According to the MMA, about 3,500 junior doctors from two cohorts may not get permanent positions in government healthcare facilities. A large number of these medical officers on contract are currently serving as frontliners in the fight against Covid-19.

The new government needs to break from the past - we need to lift the moratorium on new positions, expand our public facilities and we need to do that fast.

Given that our government is growing increasingly restless to reopen our borders, it should use this time to ensure that our healthcare infrastructure can cope with any future waves of Covid-19 without compromising existing patients.

It is high time for our politicians to stop visiting tragedy sites such as HSA for political grandstanding, and to start actually ensuring that it does not repeat in the future.  


The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.

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