malaysia health care

8/8/2019 Malaysia Health Care

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The objective of the health services in Malaysia is to raise and continuously improve the

health status of individuals, families and communities. This includes health promotion,

disease prevention as well as curative and rehabilitative services.

The healthcare system in Malaysia involves many different agencies and organisations that

may be directly, or indirectly, related to health. The Ministry of Health (MOH) acts as the

primary provider, planner and organiser of medical, and health services for the nation and

is thus the governments lead agency for health.

Malaysia generally has an efficient and widespread system of health care, operating a two-

tier health care system consisting of both a government-run universal healthcare system

and a co-existing private healthcare system. Two-tier health is a situation that arises when

there is a basic health care system financed by government providing medically necessary

but perhaps quite basic health care services, and a secondary tier of care for those with

access to more funds who can purchase additional health care not covered by the publicly

financed system or which permits better quality or faster access.

Healthcare in Malaysia is divided into private and public sectors. The main bulk ofPublic

Sector is under the MOH, which provides care at three levels primary, secondary and

tertiary.

Primary health care is the thrust of the Malaysian healthcare system and the country is a

signatory to the Alma Ata Declaration of 1978. There is government acknowledgement that

equity in health is not the purview of the health sector alone. Government policies for the

poor have included targeting healthcare delivery to the economically disadvantaged and torural populations. The concept and philosophy of health in Malaysia is embodied in the

following tenets:y Health is a fundamental right of every Malaysian and every individual has the right to

develop and lead a healthy life. With this right, there must also be a balanced individualresponsibility to maintain his or her own health and the realisation that health is anasset, which must be actively acquired.

y Health is a shared responsibility of the government, the profession and the community.y The government continues to advocate health as a social responsibility.y Health is a public service to be made available to everyone, with equity of access, both in

geographical and cost terms.

y There must be continued creation of equal opportunities for health, and efforts must beconcentrated to bringing health differentials down to the lowest possible level.

Primary care is the term for the health services that play a central role in the local

community. It refers to the work of health care professionals who act as a first point of


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consultation for all patients. Such a professional would usually be a general practitioner or

family physician, depending on locality. They may then refer to secondary care.

Primary care involves the widest scope of health care, including all ages of patients, patients

of all socioeconomic and geographic origins, patients seeking to maintain optimal health,

and patients with all manner of acute and chronic physical, mental and social health issues,

including multiple chronic diseases. Comprehensive healthcare services are provided

covering antenatal, postnatal, child health, adolescent, school health, wellness, elderly,

mental health, nutrition and dietetics, home care nursing, rehabilitation, occupational

health and health surveillance.

Consequently, a primary care practitioner must possess a wide breadth of knowledge in

many areas. Continuity is a key desirable characteristic of primary care, as patients usually

prefer to consult the same primary care doctor for routine check-ups, and every time they

require an initial consultation about a new complaint. Collaboration among providers is a

desirable characteristic of primary care.

Common chronic illnesses, usually treated in primary care, include Hypertension, heart

failure, and angina, Diabetes, Asthma and COPD, Depression and anxiety, Back pain,

Arthritis and Thyroid dysfunction.

Secondary health care is the service provided by medical specialists who generally do

not have first contact with patients, for example, cardiologists, urologists and

dermatologists. A physician might voluntarily limit his or her practice to secondary care byrefusing patients who have not seen a primary care provider first, or a physician may be

required, usually by various payment agreements, to limit the practice this way.

Consequently, secondary care physicians will only see patients referred by a primary care

physician or another specialist.

Allied health professionals, such as occupational therapists, speech therapists, and

dietitians, also generally only work in secondary care. These professionals do not receive

patient self-referrals; they work with physicians to co-manage the aspects of a patients

health related to their area of expertise. Some allied health professions, such as

physiotherapy, may be accessed through patient self-referral or through physician referral.

Examples of Secondary Health Care are Hospital Sg Petani(Kedah), Hospital Temerloh

(Pahang), Hospital Slim River(Perak), Hospital Keningau(Sabah), Hospital Lahad

Datu(Sabah), Hospital Bintulu(Sarawak) and Hospital Putrajaya.

Tertiary health care is specialized consultative care, usually on referral from primary or

secondary medical care personnel, by specialists working in a center that has personnel and


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facilities for special investigation and treatment. For medical and surgical emergencies,

these are adequately provided for, with a government-managed fleet of ambulances,

including airlift capacities for more interior remote sites.

Tertiary Care Hospitals have recently made its presence felt in the Malaysian public

healthcare sector, beginning in the 1980s, with the expansion and privatisation of theUniversity of Malaya Specialist Centre (Petaling Jaya), and the building of the Universiti

Kebangsaan Malaysia Medical Centre (Bandar Tun Razak, Kuala Lumpur), and the

renowned National Heart Institute (Institut Jantung Negara, IJN), along Jalan Tun Razak.

These have provided excellent specialist care for several highly specialized medical

disciplines such as cardiology, cardiothoracic surgery, nephrology, cancer care, neurology

and some infectious diseases. These however cater predominantly to our Malaysian civil

servants, pensioners and their dependents (including many of our VVIPs), but due to facility

constraints, long waiting times are now the norm.

In comparison, secondary medical care is the medical care provided by a physician who acts

as a consultant at the request of the primary physician.

The Private Sector on the other hand, has always attracted both general and family

physicians who had opted out by opening individual clinics or by joining more established

group practices; while specialists join the better-paying more personalised care practices in

urban private medical centres.

Private clinics cater to most of the fee-for-service self-paying public, which include: private

sector employees through panel doctor contract/insurance arrangement; thus relieving the

already overloaded Ministry of Healths public clinics. In general, the choice for such privateclinic consultations and treatment is due to easier access, simpler registration and

appointment, and shorter waiting times. There is also possibly greater continuity of care

with better personal attention from ones own family physician or general practitioner

Redistributing public sector patients who sometimes have to wait several hours, to a panel

of urban or suburban private clinics nearer their home, can be a real option for better

patient care and attention.

Besides that, for more serious illness and injuries, hospital care through well-equipped

emergency departments (EDs) is now the expected practice. These medical emergencies are

previously offered only at larger public sector general or district hospitals. These days

however, most private medical centres boast of state-of-the-art emergency care at more

luxurious settings and costs. Personal and more attentive specialist care are now demanded

and offered at many of these private EDs, where many orthopaedic surgeons and

neurosurgeons now practice privately.


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However, private medical centres are not simply for emergency and/or trauma care. Most

are now developed as competitive consumer-driven full-fledged healthcare facilities to cater

for the more discerning public who would pay more to obtain perhaps better (perceptibly),

more personalised, faster (less or no waiting time) and possibly more comfortable and/or

luxurious medical care.

Health insurance or maintenance organisations have also bought into this system to offer

more premium benefits to their clients, particularly those of the corporate world, where

risk-averse and delay-averse market-driven results are expected. Executives and staff are

offered contracted quicker and direct access to possibly more expert specialised care, with

faster turnaround times and earlier return to work expectations. Healthcare industry

players such as the state-owned KPJ group (Johor State Development Board), Parkway

Holdings (Singapore-based, American-invested), and latterlyKhazanah National

Berhad(a Ministry of Finance Malaysian GLC) have greatly influenced the direction and

expansion of these private services, while at the same time inflating the cost of private

health care services by offering more sophisticated amenities and newer technology-driven

expert care.

malaysia health care

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