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HEALTHCARE
81 organisations say ‘No’ to privatisation of hospital dispensaries Aliran Monthly Vol 24 (2004): Issue 11/12
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A demonstration was held outside the Health Ministry by around 400 people. A ten-member delegation led by Dr. Jeyakumar Devaraj met with Health Minister Dr. Chua Soi Lek. Among the members of the delegation was PSM National Chairperson, Dr. Nasir Hashim, PAS Central Committee Member Dr. Hatta Ramli, Parti Keadilan Rakyat leader, Tian Chua, JIM Deputy President Hj Zairol, Jalil (SPNS), K.Arumugam (Concerned Citizens Group), Paul Sinnappan (People’s Service Organisation) and Lim Ban Teng (DEMA). The final memorandum below was endorsed by 81 civil society groups: Stop the privatisation of government hospital dispensaries We, the undersigned groups, are shocked and disappointed to read Health Minister Dr Chua Soi Lek’s press statement published in the New Straits Times (4 December 2004), which stated that the Malaysian government would privatise government hospital dispensaries from next year. According to the Health Minister’s statement, the government has spent RM800 million annually to supply medicines to government hospitals and clinics but the people do not value medicines supplied free and have abused and wasted them. We categorically reject the line taken in the Health Minister’s statement and the logic of his argument because privatisation will create difficulty for the public, especially the elderly and low-income families. We present below our arguments for the attention of the Health Minister and the Barisan Nasional Cabinet with the hope that the proposal to privatise the dispensaries be scrapped immediately. 1. The majority of Malaysian citizens rely on government hospitals. In 2003, government hospitals recorded admissions of about 1.8 million patients. This total represents 80 per cent of all patients who receive in-patient treatment in Malaysia for 2003. Government hospitals also treated 7 million outpatients in 2003. These figures clearly prove that many Malaysian citizens rely on government hospitals for treatment when they fall ill. Any action to force patients to bear the costs of medicines will burden the majority of ordinary citizens. 2. Most Malaysian citizens come from the low- or medium-income group The government’s own statistics as recorded in the Eight Malaysia Plan reveals that 25 per cent of Malaysian citizens earn a monthly household income of less than RM1,000 and another 32.7 per cent earn a monthly household income in the range of RM1,000-2,000. In view of the people’s low level of income, private dispensaries in government hospital dispensaries will add further economic burden to more than 75 per cent of low- or medium-income Malaysian families (who earn a monthly household income of less than RM3,000). 3. Malaysian government expenditure on health is well below the recommended WHO levels The World Health Organisation (WHO) has recommended that governments in developing nations should invest 5 per cent of GDP in their healthcare systems. The Malaysian government’s expenditure on healthcare is only 2.7 per cent of national GDP compared with 13.7 per cent in the United States, 5.8 per cent in Britain, 3.8 per cent in the Philippines, 5.7 per cent in Thailand and 3.1 per cent in Singapore (Souce: World Health Report 1999 and 2000). Please support our work by buying a copy of our print publication, Aliran Monthly, from your nearest news-stand. Better still take out a subscription now. If you prefer to read our web-based edition, please support our work and make a donation. Not only does the Malaysian government spend well below the recommended levels, but they now want to take steps to further reduce public expenditure. 4. The Malaysian healthcare system is extremely cost-effective Although the Malaysian government’s expenditure is very low compared with other countries, the Malaysian healthcare system’s performance has been excellent if viewed in terms of its reach across the community, infant and maternal mortality rates, and life expectancy - all of which have almost reached excellent developed nation levels. This proves that the government healthcare system is far more cost-effective compared with free market systems that are guided by competition among private hospitals and insurance firms and motivated by profit maximisation. We do not understand why the Barisan Nasional government, which presides over a healthcare system that has received praise from the WHO and other internationl bodies, is so determined to change our healthcare system to a privatised system. The experience of other countries clearly proves that the free market approach only raises medical costs while denying proper treatment to the low-income group. 5. The privatisation of various healthcare areas that has taken place has only added to the cost of healthcare services. The Malaysian government privatised the medicine procurement section (General Medical Store) in 1993 and five support services in 1997. The cost of these privatised sectors has soared two to four times. When the medicine procurement section was privatised to Southern Task Force, a Renong subsidiary, medicine costs skyrocketed by 230 per cent. The privatisation of the five support services to Radicare, Tongkah and Faber Mediserve has resulted in costs surging from RM140 million in 1996 to RM450 million in 1997. Until now, the Malaysian government has not yet revealed to the people the benefits it has achieved from this privatisation and at what cost. We feel that the Malaysian government should hold a detailed referendum on healthcare privatisation before taking any new steps in this direction. It is also our view that this action is only aimed at increasing profits, and the privatisation of dispensaries will only profit a few firms with certain vested interests. 6. The National Healthcare Financing Scheme has still not yet been launched Consumer organisations, the doctors’ association and the Citizens Health Initiative have stressed that an equitable Healthcare Financing System must be set up before any corporatisation or privatisation is undertaken. Unfortunately, although the Malaysian government has spent thousands on study after study on this issue, it has failed to announce the results of these studies or to hold an open dialogue with the Malaysian people to build a consensus on a fair and reasonable financing system. It is our stand that the current healthcare system belongs to the people of Malaysia, and the Barisan Nasional government does not have a mandate to change or privatise it as they like. The BN government must be more responsible and should obtain a mandate from and the permission of the people before it undertakes any privatisation of this public service. 7. Caring society Among our national aspirations is the creation of a caring society in which the disabled, the poor and the elderly will be given protection and supplied with proper basic amenities. As it stands, the public healthcare system is an important component in fulfilling this social responsibility. The privatisation of public hospitals will undermine our efforts to create a caring society. For these reasons, the groups presenting this memorandum demand:
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Privatisation will create difficulty for the public, especially the elderly and low-income families.
