THE HEALTH | MARCH-APRIL , 2023

BY HARVINDAR SINGH

DURING the tabling of the revised Budget 2023 , Prime Minister and Finance Minister Datuk Seri Anwar Ibrahim announced the Health Ministry would be allocated RM36.3 billion . This is the secondhighest allocation in Budget 2023 .

It is also slightly higher than the RM36.1 billion allocated under the spending plan tabled by the previous government in October last year and RM32.4 billion under Budget 2022 . The Health Ministry also received the highest jump in allocation compared to Budget 2022 .

The main component of the allocation will be used for procuring medicines , reagents , vaccines and disposables . At the same time , RM3 billion will be allocated to appoint 1,500 medical officers , dentists and pharmacists for permanent and contract positions .

Several measures to address congestion at government hospitals are planned . Public health capacity will be optimised by outsourcing patients from congested hospitals to universities , army and private hospitals .

Private hospitals have been assisting the public healthcare system , and reasonable reimbursements must be negotiated to make treatment outsourcing sustainable . Private hospitals successfully managed many outsourced patients during the Covid- 19 pandemic . However , the outsourcing of treatment from public to private hospitals should be based on the private healthcare system ’ s capacity , which is overstretched too .

A total of RM700mil was allocated for constructing women ’ s and children ’ s wings with a capacity of 476 beds at the Melaka Hospital . At the same time , older hospitals such as the Kuala Kangsar , Jelebu , and Pontian hospitals will be upgraded and refurbished .

HUMAN CAPITAL DEVELOPMENT NEEDED

Health industry players agree that building more infrastructure and improving it would benefit public healthcare , but human capital development and retention needed the most attention . The budget must address the specific needs of public healthcare remuneration and training . An announcement on extra posts , both permanent and contract , may not be the answer to the problem .

There has been a positive increase in mental health funding under the budget , but there is always room for improvement to adequately address the growing “ mental health pandemic ” in Malaysia . There is an urgent need to ensure investment is prioritised so that Malaysia has adequate capacity to manage both the immediate post-Covid-19 pandemic mental health issues and to stay vigilant in preparation for possible future mental health crises .

There is still much to be done in terms of greater investment in mental health , especially the need to increase mental health professionals in the public system , upgrade infrastructure and increase accessibility .

According to the Malaysian Medics International ( MMI ) in its policy brief titled “ Improving Accessibility and Availability of Mental Health Services in Malaysia ”, Malaysia should ideally have 3,000 psychiatrists evenly distributed across the country , based on recommendations by the American Psychiatric Association and World Health Organisation of a ratio of one psychiatrist to 10,000 people .

The seriousness of the current government to repeal Section 309 of the Penal Code to decriminalise attempted suicide and to strengthen the Mental Health Act 2001 to ensure those who make suicide attempts receive necessary support and psychotherapy rather than being treated as criminals is lauded .

The impact of mental health conditions is not merely a health situation , but also has potential repercussions on the nation ’ s economy .

GIVE CHARITABLE HOSPITALS COMPREHENSIVE TAX EXEMPTION

Some of the other goodies in the revised Budget 2023 include the following :

• RM120 million for the Madani Health Scheme for the poor to receive treatment at Madani healthcare schemes specifically for the poor . They can obtain medical treatment in private clinics and at private general clinics , as has been done by the Selangor government .

• RM80 million to strengthen the Peka B40 Scheme by including diabetes screening , a scheme first introduced in 2019 for early health screenings for the B40 income group .

• Tax relief for medical expenses for year of assessment 2023 will be increased from RM8,000 to RM10,000 . This tax relief will also be expanded to cover up

The impact of mental health conditions is not merely a health situation , but also has potential repercussions on the nation ’ s economy .” to RM4,000 of the costs of recovery for neurodevelopmental disorders such as Autism , Down Syndrome , and Specific Learning Disabilities .

• The government is proposing for charitable hospitals registered as companies limited by guarantee to be given income tax exemption equivalent to the amount spent for charitable expenses . At the same time , donors to such hospitals will also be given up to 10 per cent in tax relief . The tax exemption announced for the charitable hospitals is welcome as it will help reduce their costs and enable them to continue providing affordable health treatment . However , the exemption given falls short of the expectations of the charitable hospitals .

Firstly , the exemption should not be only to hospitals formed as a company limited by guarantee but also associations registered under the Registrar of Societies .

Secondly , it should cover all surpluses made by charitable hospitals , as no dividends or benefits are paid to any shareholders or members . The surpluses are ploughed back to improve the facilities of the hospitals or to fund the operations . The narrative is that the surpluses made by charitable hospitals should be tax exempted , and the exemption should not be confined to the amount spent for charitable expenses .

Collectively , charitable hospitals serve over an estimated two million patients annually who otherwise may seek treatment from government hospitals , burdening the public healthcare system and services . A comprehensive tax exemption would lead to cost savings for the hospitals , allowing them to continue providing affordable treatment . – The Health

Harvindar Singh is a Tax Consultant and Council Member of the Chartered Tax Institute of Malaysia .