KUCHING: Healthcare, is normally defined as the treatment or management of any health problem through the services that may be offered by nursing, medical, dental or any other related service.
Healthcare may be curative, preventative or even palliative solutions.
A system of health care is one that is organised to give health services to a population or a group of people.
Over the years, Malaysia has been very attentive about its healthcare system.
The existence of many medical schools is enough to demonstrate that the country is serious on providing quality healthcare, not only to its local populace, but also to the expatriates and visitors, as well as tourists.
The nation is very fortunate to have a very comprehensive range of healthcare services, be it private healthcare or public healthcare.
The government is very committed to its principles of universal access to high-quality healthcare, which the local Ministry of Health offers through a network of nationwide clinics and hospitals.
Healthcare is an important part of a long-term economic development – an issue that involves multiple stakeholders such as the local govnerment, non-governmental organisations (NGOs), academic experts and private organisations.
These multiple stakeholders are trying to contribute to ensure the availability and the quality of the healthcare services in Malaysia.
As chronic and non-communicable disease rates continue to climb, these stakeholders engage in deep thought on how to provide, disseminate and pay for adequate prevention and treatment.
In recognising that the private healthcare sector participation is crucial towards the development of the country, the Malaysian government has taken steps to promote greater participation of the private sector in the provision all levels of healthcare services.
This is being done through public-private partnership (PPP) where private healthcare is being outsourced.
As such, certain medical services are provided as part of the public system-based reimbursement.
Overview of the Malaysian healthcare sector
Healthcare in Malaysia is mainly under the jurisdiction of the Ministry of Health Malaysia.
Currently, the nation practices a dual healthcare system and has good access to a blend of government and private healthcare services through a network of hospitals and clinics.
According to the Performance Management and Delivery Unit (Pemandu), Malaysia currently spent about 4.7 per cent of its gross domestic product on healthcare with the government paying a signifi cant portion of the country’s total health expenditure.
In addition, Malaysia’s health expenditure was well above that of many neighbouring countries, but significantly lower than the developed countries, it pointed out.
Furthermore, a report from the Malaysia Medical Tourism Outlook 2012 shared the same sentiment, adding that Malaysia had one of the most developed healthcare infrastructures in the region and was considered as a paradise for hospitals and healthcare facilities.
Malaysia presents a formidable competitor to its regional rivals in terms of cost and is much superior in terms of healthcare services, English speaking staff, healthcare infrastructure, strict government regulations on maintaining high standards of healthcare delivery systems and has foreign-trained specialist doctors.
Public healthcare in Malaysia is heavily subsidised, as the government is determined to maintain medical services at an affordable and accessible level.
In contrast, the private healthcare sector, while not subsidised, is thriving predominantly in the urban areas.
Though the public sector provided a full spectrum of medical services, the focus was increasingly shifting towards prevention, disease control and rehabilitative services rather than curative services that some private healthcare provided, its stated.
Pemandu, however also stressed that the initiative for the healthcare sector rested on fi ve common enablers, namely skilled human capital; effi cient use of infrastructure; regulatory reform; strategic cross-border alliance and targeted marketing strategy.
Data provided by Pemandu also showed that the healthcare industries in Malaysia would double its human capital count to 340,000 by the year 2020.
Furthermore, the healthcare industry aspired to generate RM35 billion incremental gross national income contributions and RM50 billion in the year 2020.
Going private
According to Rhenu Bhuller, vice president of Healthcare Frost & Sullivan Asia Pacifi c, Malaysia had a signifi cant number of private hospitals, with an estimated 220 private hospitals were established in 2011.
These private healthcares were mainly operated by major groups.
“The market size of the private healthcare sector in Malaysia is estimated at almost RM8 billion this year, an increase of RM2 billion in 2010,” she revealed to BizHive Weekly in an online interview.
“This growth is driven by the Malaysian population seeking higher and better quality private healthcare, which has, for example shorter waiting times.”
In addition, Bhuller said the growth contribution was also driven by the ability of Singaporeans to use their health insurance funds at registered hospitals in Malaysia and the comparatively high cost of treatment at private hospitals in Indonesia.
Within the nation itself, she said there was disparity between the private healthcare infrastructure and growth rates.
“West Malaysia represents 90 per cent of the private hospital market, which is heavily concentrated in Penang at 25 per cent and Klang Valley with an estimated 50 per cent of the private hospital market.
Less than 10 per cent of private hospital beds are in East Malaysia,” she said.
Thus, there exists the need for more private healthcare players in Sabah and Sarawak.
Private healthcare providers are continuously looking to expand beyond major cities, eyeing to increase their penetration rate and reach patients over a wider geographical area.
“Outpatient attendances are seeing faster growth than inpatient attendance and as such patients are more willing to pay for faster service, especially in getting a diagnosis and quick consultation.
“These will continue to see growth rates of above 15 per cent over the short to mid term,” she said.
When asked on how the current economic outlook was affecting the growth of private healthcare in Malaysia, she said that it was on a positive note.
She explained that when overall household expenditure was squeezed, there was a tendency to move towards the public health system.
“Historically, public healthcare systems have been higher in terms of patient growth in times of economic uncertainty as patients delay non-essential or elective procedures, and medical tourism for elective procedures also tended to slow down.” she said.
“However, continued urbanisation within the country, easy access to high quality private healthcare services and the growth of private health insurance in Malaysia will somewhat stem the decline, and therefore the private healthcare sector will continue to grow although at a slightly slower rate compared to 2010.”
Bhuller said the increasing availability of tailored medical insurance packages in Malaysia, and the increasing awareness of the urban population on the value of private health insurance had enabled increasing use of private healthcare services.
Currently, there are 27 registered medical insurance providers in Malaysia as at March 2012, nine out of which also provide life insurance policies.
In 2010, the written premium for general medical insurance was estimated at RM643.5 million or US$200.4 million, and was forecasted to grow to RM1.5 billion or US$490.7 million by 2016.
Outpatient and diagnostic services, as a result of consumers’ increasing awareness on preventive healthcare and the value of staying out of the hospital, would continue to drive growth for the private hospital sector, she said.
Regarding the Economic Transformation Programme (ETP), she said that the government had included the healthcare sector as a focus area for development to transform the country into a higher income economy.
She further explained that, “Expansion of the private healthcare market and the ability to market Malaysian private healthcare services beyond Indonesia and Singapore are going to be crucial factors in achieving these goals.”
She further added that, other ways in which the private healthcare market would support ETP goals were through healthcare services such as imaging and medical diagnostics, where they could provide support to the stretched services available in the public healthcare sector.
When asked how the private healthcare sector in Malaysia would fare in the near future, she said that the private healthcare in urban areas was already well served.
“Providers here need to focus specialty or differentiation through wholistic healthcare on specialty services.
“There are still opportunities in underserved towns for smaller day private outpatient clinics, as well as opportunities to promote Malaysian private healthcare services to patients such as from Australia or North Asia for example,” she said.
The opportunities for growth of specialty centres focussing on cardiovascular and metabolic diseases, orthopaedics and oncology, as well as day surgery and diagnostic centres are abundant.
“Not just for treatment, but holistically from a patient education and diagnostic perspective to follow on care,” she added.
Training of ancillary workers and specialists to support these areas can not only bring up the standard of specialist care in the country, but also enable faster growth of the private hospital market.
Other areas that the private healthcare sector could contribute to the country’s growth as well as supporting the ETP would be through clinical trials, as most clinical trial centres today were in the public settings.
She continued that, “This is to make sure that the combination mentioned and PPP for healthcare services would be new models.” “This is also a way in which private healthcare services access can be expanded throughout the population and subsequently ease the strain on public healthcare services, as the strongest and most sustainable healthcare systems are those where there is a good balance between public and private usage,” she concluded.
STRENGTH
• Healthcare in Malaysia is more afordable than its counterparts in the region, appealing to costconscious consumers.
• MOH’s plans for improving doctor to paitent ratio means improved access to foreigners.
• Overall packaging in terms of services, hospitality and resorts provide strong value-added propositions.
OPPORTUNITIES
• Cost of healthcare services in the developed nations lead patients to look for services outside their countries.
• Importation of foreign clinicians may ease the concern of some medical tourists in the nation.
THREATS
• In comparison with Singapore, Malaysia is seen as less safe which may put a barrier towards some patients.
• Malaysia has yet to carve out a niche in any specific areas of excellence.
• Emerging markets such as Korea and Taiwan are growing rapidly on par with Malaysia and have signifi -cant measures to appeal towards foreigners/locals.
WEAKNESSES
The current manpower shortages may inhibit a private hospital’s ability to deliver desired luxury services to patients.
As this is a concern, the Ministry of Health Malaysia (MOH) and the Malaysian Medical Association has yet to review the current medical regulations that limit the entry of foreign medical practitioners and the adoption of advance medical procedures.
If the relaxation of regulatory rulings is commenced, it will liberalise healthcare manpower supply and bring in more expertise to support the healthcare service industry.