I just managed to read the explanation by the Minister of Finance on the allocations in the Health Budget and how he basically claims that there are no reductions but only reclassification of those expenditure under a different heading called “Program Khusus” among others.

This opens up few questions;

-Why is there a need to reclassify it and put it under a consolidated “area” rather than clearly divide it to each departments/discipline.

– This is less transparent and we do not exactly know whether there is a reduction or increase in each department and we will not be able to gauge if it is sufficient and adequate.

– Classifying it under a consolidated Program Khusus is also not a good idea. How do each department get access into such allocations? Do they need to apply for it? Who makes the decision?

– What it actually does is it ADDS BUREAUCRACY to whole process which may delay the funds even with there is a matter of urgency. Imagine how much extra paperwork will be involved.

-Fact of matter,in healthcare, it is almost always urgent. Who then decides who gets the funds as everyone will fight for it since these Program Khusus are highly discretionary.

-Does the one with bigger ‘cable’ or loudest voice wins?

-How can the clinical departments across hospitals and states plan ahead especially when it comes to patient care when they don’t even know how much they are truly getting?

-Without a clear budget now, how will clinicians know how many patients they can treat in a year?

And it affects the timing of clinical plans too — because when hospitals run out of drugs (which is frequent), they usually turn to Pharmacy to help top up, but the Pharmacy’s budget has been cut drastically and now they will to go through the whole process of applying it from  “Program Khusus.”

This will impact the work of the clinician which in turn affects the patients and the quality of care.

Because in the end, without planning, I foresee patients getting the short end of the stick. Imagine being told by your clinician — I’m not sure if we can treat you because it depends if our funding application is approved.

So if at the start of the year, clinicians know they have a certain amount of budget to help a certain amount of patients, they can plan accordingly.

At end of the day, core issue is that the 4.3% growth in health budget is highly insufficient especially when facing the urgent need to deal with Covid-19 and also other prevalent diseases, and to address the systemic gaps in healthcare due to decades of under investment.

Such increase is expected due to expenditure for Covid-19, but it also shows there is no growth for other disciplines and little investment to address systemic shortcomings. We need to do more.

To build a resilient healthcare system, we need to invest to make sure it has sufficient infrastructure and human resource to handle not just a pandemic, but also not neglect the quality of care for other patients.

Dr. Kelvin Yii

MP for Bandar Kuching