KUCHING: Malaysian Medical Association (MMA) has urged the government to adopt an “all of healthcare” approach rather than an “all of government healthcare” approach in the fight against Covid-19.
Its president Prof Dato Dr Subramaniam Muniandy said the government healthcare facilities should not be taking on this battle all on its own.
“Private healthcare, an important component in our country’s overall healthcare system, can be an added strength in managing Covid-19 but is still underutilised,” he said in a statement yesterday.
According to Subramaniam, it is time Malaysia eases the strain put on its public healthcare and look into the combined strength of public and private healthcare to enhance efforts in its management of Covid-19 as well as other healthcare needs.
He said MMA believed that the people would ultimately benefit from such collaborations while patients would also be better served when both sectors maximised their healthcare services rather than working in isolation.
“There are 7,000 plus MoH (Ministry of Health) trained GPs (general practitioners) and over 3,000 private specialists serving in more than 200 private hospitals nationwide. 2018 figures showed the private sector was served by 14,649 doctors, 5,174 pharmacists and 34,874 nurses.”
He pointed out that private healthcare spending was around 50 per cent of the total national healthcare expenditure with millions of Malaysians and non-Malaysians seeking treatment at private facilities daily.
The private healthcare sector also contributed to millions of jobs nationwide and formed an integral part of the Malaysian economy, he said.
Since the Movement Control Order (MCO) in March this year, he said the Malaysian healthcare response had been largely led by the government healthcare facilities.
There were peak pandemic times when government facilities were stretched to the maximum in certain hospitals or areas and assistance or donations were extended by public, non-governmental organisations (NGOs) and concerned citizens, he said.
“The private healthcare sector since March had been generally on the downward trend with numbers of patients attending contracting significantly. Among the various reasons were the lockdown rules had made patients delay their health checkups while others were trying to avoid attending clinics or hospitals out of fear of contracting Covid-19.
“Affordability among many patients had also decreased significantly due to the economic impact of the pandemic,” he opined.
Subramaniam said many clinics and hospitals nationwide were reporting reduced patient attendance, some by as much as 70 per cent to 80 per cent with significant income reduction and sustainability of their practice severely threatened.
He added that many senior doctors with their wealth of experience were also contemplating closing or retirement.
“It is estimated that around 200 clinics nationwide will close by year end,” he feared.
He said MMA Sabah branch had recently conducted a survey on private sector healthcare in Sabah, indicating that Sabah was the worst affected state, to date.
Out of 209 private doctors who participated in the survey, he said 68 per cent were GPs and 32 per cent specialists, adding that 79 per cent of the doctors surveyed were practising in urban areas.
According to the survey, since MCO in March and now the third wave with Conditional Movement Control Order (CMCO) implemented in October, 70 per cent of private GPs and specialists had a reduced patient load of over 50 per cent or more.
“32 per cent reported the need to close clinic temporarily for various reasons, with one of the main reasons being the need to quarantine due to Covid-19 exposure.
“Other reasons include doctors themselves are in the high risk group and the need to stop services at the height of the pandemic,” he added.
He said if the current situation continued in Sabah, 17 per cent of practices estimated they would not be sustainable in the next three months and another 33 per cent for the next six months.
He said only 25 per cent in the survey estimated they could be sustainable for up to 12 months or more.
Subramaniam said a mere 14 per cent of doctors surveyed reported that they were providing Covid-19 testing.
“Overall, the contraction and loss of private sector doctors and clinics in the country will inevitably lead to more congestion at the government facilities adding even more strain to its funding and finances, not to mention its facilities and human resources.”
He said the proposed 2021 government healthcare budget was RM31.9 billion, a mere 4.3 per cent rise compared to the this year’s allocation, may hardly be adequate if the private healthcare sector was to contract significantly resulting in more shuttling of patients to governmental facilities.
As a result, he said patient care and medical access might be compromised if overcrowding of public facilities increased.
Because of this, he said MMA proposed private-public collaboration to strengthen healthcare in both sectors catering to the spectrum of health needs and affordability.
He said the government should support private healthcare sector in the recovery phase of the Covid-19 pandemic through tax exemptions and grants to the sector targeted at sustaining and strengthening primary care, in particular.
He also proposed decongestion of public hospital and clinic patients to the private sector through outsourcing of services such as follow up of patients with Non-communicable Diseases (NCD) or antenatal care by GP or elective operations by private specialists at an agreed sustainable rate.
“MMA believes the cost effectiveness of outsourcing services and stimulus investments into private healthcare will yield many folds benefits in expanding healthcare access for all.
“Public and private healthcare sector needs to be in a symbiotic relationship if the nation is to be offered the most effective healthcare for all to contain the pandemic and beyond,” he added.