THE HEALTH Ministry received one of the biggest increases in allocation in Budget 2024 with RM41.2 billion , an increase from RM36.3 billion last year . The significant increase shows that the government is serious and acknowledges that healthcare costs have increased .

Of the total allocated , RM5.5 billion will be used to procure medicine supplies , consumables , reagents , and vaccines . Several new development projects will begin next year , including the Universiti Sains Islam Malaysia ( USIM ) Teaching Hospital Complex Phase 1 in Kota Tinggi and preliminary work for the construction of Sultanah Aminah Hospital 2 , Johor Baru in Johor . Budget 2024 was tabled in Parliament on Oct 13 by Prime Minister Datuk Seri Anwar Ibrahim who is also Finance Minister .

Funds are also allocated to upgrade the Ministry of Health ’ s ( MoH ’ s ) quarters and mobile clinics . To upgrade dilapidated clinics , a total of RM300 million is allocated for 400 clinics that still have wooden structures and outdated wiring . An amount of RM766mil is allocated for procuring medicines in Health Ministry hospitals and replacing equipment that is beyond repair .

Apparently , only three per cent of health clinics in the country are equipped with digital health records , essential for quick patient data access . For now , the government has allocated RM150 million to maintain the information technology system .

The government is also keen on shifting from treating the sick to intensifying disease prevention activities to ensure people stay healthy . New programmes related to primary and preventive health , namely the Madani Medical Scheme and Agenda Nasional Malaysia Sihat 2.0 , with allocations of RM100 million and RM23 million respectively , are being initiated . It is hoped that the Madani Medical Scheme would include non-communicable disease management as it would encourage higher participation from private general practitioners and , as a result , significantly reduce overcrowding at public healthcare facilities .

To address the overcrowding at government hospitals , the government has allocated RM200 million for outsourcing of patients to other hospitals including military , university and private hospitals . The private hospitals have stated that the methodology in transferring patients must be seamless so that public patients can be quickly treated in private hospitals only after the public healthcare capacity is exhausted . The budget must help the patients immediately and not to wait for new healthcare facilities to be built , which will be the long-term solution .

IS THE EXCISE DUTY ON SUGARY DRINKS MEANINGFUL ENOUGH ?

As part of the efforts to curb health risks , an

Prime Minister Datuk Seri Anwar Ibrahim

The current excise duty on sugary drinks has been increased from 40 sen per litre to 50 sen per litre . The revenue from this tax will be used to treat diabetes and support dialysis centres .”

excise duty on chewing tobacco products at the rate of five per cent plus RM27 per kilogramme was imposed .

The current excise duty on sugary drinks has been increased from 40 sen per litre to 50 sen per litre . The revenue from this tax will be used to treat diabetes and support dialysis centres .

While this is a good move to manage diabetes , there are rumblings that this will not help much as restaurants are getting subsidised sugar that Malaysians consume when drinking “ teh tarik ” and like . With food being the favourite indulgence of Malaysians , this increase of 10 sen is not going to be meaningful enough to make a difference .

Apart from discouraging high sugar consumption , the government should also encourage healthy lifestyle behaviour through policies to comprehensively address the concern over the increasing number of cases of non-communicable diseases among the population .

The government also allocated RM24.6 million for the National Centre of Excellence for Mental Health in Cyberjaya that was launched in October last year . Mental health is becoming a major concern , with some statistics showing that half of Malaysian teenagers are affected by it .

One key concern that has been raised is that the budget did not appear to address human resource planning and development in the healthcare sector , amid rising attrition rates among doctors and nurses that lead to immense overwork in severely understaffed health care facilities . This issue is set to be further compounded as the budget listed several new hospital and public health clinic projects , without any mention of the health care professionals needed to staff the new facilities .

FIX THE PROBLEM OF AN UNDERSTAFFED HEALTHCARE WORKFORCE

There were no specified wage reviews for medical officers , with a mere mention that a general salary and fixed allowance review for civil servants across all service schemes will be carried out , slated to be completed by end 2024 . Unfortunately , no consideration seems to have been given to doctors who work far longer hours than other public servants . There is a call by government doctors , who have often complained about 36-hour shifts and being on-call nearly every other day , for the government to raise their weekend on-call claims from RM9 to RM25 per hour .

The government has spent and continues to spend millions of ringgit to train clinical specialists . Their remuneration levels do not commensurate with their workload , giving rise to frustrations , and they ultimately

leave for private hospitals that pay them significantly more . It is a sheer waste of government resources in training and nurturing them only to lose them to the private sector . This should be addressed objectively so that government hospitals don ’ t see doctors leaving in droves to private hospitals .

There is , however an allocation of RM1.5 million for emoluments , which allows for the possibility of new permanent positions , but this may not be enough to fix the problem of an understaffed healthcare workforce .

There was no mention of funding or policies to improve healthcare workers ’ welfare and working environment , amid rising abuse and mental health issues among staff . These are serious issues and funds would be needed to facilitate these issues effectively .

The cost of medical treatment has increased significantly for the rakyat . The addition of incentives for social insurance schemes like the Madani Healthcare and Skim Peduli Kesihatan for the B40 group should be extended to the M40 group as well . Currently , the focus is on the B40 group .

Sadly , the B40 group keeps increasing due to the rising cost of living and medical expenses . It is estimated that about 20 per cent of the M40 group dropped to the B40 category due to the pandemic .

There are suggestions for introducing an exemption for medical cards to ease the burden of the middle-income group . Social insurance needs to be given additional focus in the future so that the lower- and middle-income groups will have suitable insurance .

Whilst there have been no reductions of personal income tax or corporate income tax rates , there are a number of tweaks to some of the tax reliefs available to Malaysian resident individuals .

To support the National Dental Health Policy in promoting dental care among the rakyat , the budget proposes that the scope of the income tax relief of RM10,000 for medical expenses be expanded to cover dental examination and treatment expense from dental practitioners registered with the Malaysian Dental Council up to RM1,000 .

Further , to increase the level of awareness among taxpayers on parent ’ s health , the scope of the tax relief of RM8,000 for medical treatment , special needs and carer expenses for parents is to be expanded to include fees paid for full medical examination , limited to RM1,000 as well . – The Health

Harvindar Singh is a Council Member of the Chartered Tax Institute of Malaysia and Managing Partner at Harvey & Associates