During last Friday’s Budget 2017 address, Prime Minister Dato’ Seri Najib Razak announced that a total of RM25 billion will be allocated for the Ministry of Health (MOH) to boost the health of the people and the quality of healthcare in the country.

This comes after the MOH raised concerns over a possible repeat of this year's budget where it saw a 10% cut.

The allocation for the MOH was for numerous programmes, including building and upgrading of new hospitals and clinics in Perlis, Kuching, Mukah, Jempol, Muar and Johor Bahru.

"A total RM536 million has been allocated for upgrading of hospital facilities.

"This includes provision of cardiology treatment equipment for Serdang Hospital, Penang Hospital and Sultanah Aminah Hospital in Johor Bahru and the purchase of 100 ambulances," he said.

RM4.5 billion is also allocated for the operations of 340 1Malaysia Clinics, 11 1Malaysia mobile Clinics, 959 health clinics and more than 1,800 rural clinics. RM4 billion is allocated for the supply of drugs, consumables, vaccines and reagents to all government hospitals and facilities.

>> Find the infographic here: Breaking down Budget 2017 spending for Malaysia’s healthcare system

Addressing overcrowding, helping underprivileged patients and implementing Kospen

To reduce overcrowding in public hospitals, the government will cooperate with the private sector or non-governmental organisations (NGOs) to operate non-profit charitable hospitals based on negotiated government hospital rates. A total of RM20 million is allocated in the form of loans for the purchase of hospital equipment, he said.

For nearly 10,000 underprivileged patients the government has allocated RM110 million, of which RM70 million is for medical assistance. The establishment of more private haemodialysis centres is also encouraged through one-off grants worth RM200,000 for purchasing of equipment, with a total allocation of RM40 million.

As for contagious diseases such as dengue and Zika, the government plans to implement initiatives to prevent and control these diseases by allocating RM80 million for the National Community Health Empowerment Programme (Kospen).

According to Dr. Noor Hisham Abdullah, the government will introduce a grade 56 between grade 54 and JUSA C for medical and dental specialists to address issues of specialist doctors leaving the public service and delays in promotion. The government will also be making efforts to appoint the first group of doctors, dentists and pharmacists on contract, latest by December 2016 due to constrains tin permanent posts and nearly 2,6000 doctors awaiting housemanship postings.

Taking a closer look

Opposition MP Ong Kian Ming wrote that Najib did not make any mention of a new item in the budget estimates for the MOH, called 'Privatisation of Hospital Support Services' costing RM2.01 billion. What may seem like an increase of the health budget, is actually allocated for the privatisation of support services, which Ong claims that much of it is sub-contracted out now.

Ong also asks why such a large expenditure item made it into the budget without any further clarification and questions how many other such items will be found in the budget.

The cut of RM280 million from the allocation for health programmes in 2016, compared to that in 2015 has caused government hospitals and clinics to run out of reagents needed to carry out health tests. There was RM4.6 billion allocated for the supply of medicines, consumables, vaccines and reagents to all government hospitals and clinics.

However, the budget for next year actually sees a cut of RM600 million for the same supply, therefore the problem may resurface. Another opposition MP Teo Nie Ching, recently highlighted a circular from the Pathology Department at the Tengku Ampuan Rahimah Hospital in Klang on the "temporary halt" in laboratory investigations as the department did not have enough funds to purchase necessary chemical reagents.

At the end of September, the Selayang Hospital also reported not having enough chemical reagents to run creatinine blood tests.

The Director-General of Health, Noor Hisham Abdullah said that RM4 billion is sufficient for now and that cutting the wastage of unnecessary investigations and consumables as well as prudent spending, should be the main focus. If by the mid-year budget review an increase is needed, it will be considered, he said in reply to one of the comments in his post on Facebook.

Nurses and pharmacists have few benefits

Many nurses were disappointed at the lack of benefits allocated for them in the 2017 budget. Dr. Noor Hisham only mentioned that, "Nurses going for further studies will be given full scholarships." Highly qualified or long-serving pharmacists were also stumped at not being able to qualify for the new grade 56.

Former deputy prime minister Tan Sri Muhyiddin Yassin was sceptical that the offerings under Budget 2017 would actually be achievable due to Malaysia's weakening financial position.

"On the surface, Budget 2017 seems to make a lot of offerings, but the main issue here is that the nation's source of income is deteriorating. How is he going to settle the country's piling debts?" Muhyiddin asked. MIMS

Read more:
Budget 2018: An extensive overview on the possibility of improving Malaysia’s healthcare system
Malaysia’s Deputy Health Minister: We cannot afford budget cuts for 2017
MMA concerned over quality of Malaysian healthcare due to budget cuts
Is Malaysia spending enough to prevent a healthcare catastrophe in 20 years?