Government should give serious consideration to the Citizensí Health Manifesto For Malaysia adopted by concerned NGOs and individuals in September

- Budget '98 Committee Stage (Health Ministry)
by Lim Kit Siang

(Dewan Rakyat, Monday): The entire medical profession is opposed to the privatisation of medical examination and management of foreign workers, which has been awarded to Fomema.

Although the implementation date for the privatisation of medical examination and management has been deferred because of a review by the Economic Planning Unit as a result of the widespread objection to the creation of the Fomema monopoly, it was recently reported that the Immigration Department would only accept medical examination of foreign workers certified by Fomema as from December 1.

Why should the Immigration Department interfere in a matter which should be within the jurisdiction of the Health Ministry by unilaterally deciding on the implementation date of the Fomema monopoly?

Up to now, the government has not been able to give good and convincing reasons why the medical examination of foreign workers could not be continued under the present system by medical practitioners without the creation of a monopoly which would only add to costs and help spiral inflation at a time when the country is going through an economic crisis.

At present, the average fee for medical examination of a foreign worker is in the region of RM120-130, but under the Fomema monopoly, the fee for medical examination of foreign workers would be hiked to the region of RM205-220. This could easily mean a RM200 million annual profit for Fomema as the 1.7 million foreign workers in the country would have to undergo annual medical examination.

The creation of a monopoly for medical examination of foreign workers is most unacceptable and unjustifiable, as being clearly against the public interest, and I call on the government to heed the objections of the medical profession, whether expressed by the Malaysian Medical Association (MMA) or by individual medical practitioners and scrap the whole Fomema privatisation scheme altogether.

Over the years, the allocation for health care in the budget has been on the decline as compared to the Gross National Product, especially with the extension of the policy of corporatisation and privatisation to public sector health care. This is a cause for anxiety for Malaysians who want to ensure that health care must remain affordable and accessible to all, particularly the low-income groups.

In the last few years, there have been no less than five consultant reports commissioned by the government since the mid-1980s on the governmentís role in health care, but none of these reports had been made public and there have been very limited discussion on this important subject.

In the Seventh Malaysia Plan, the government announced its intention to set up a National Health Security Fund (NHSF), which would be a form of national health insurance. Very little, however, is known about the NHS Fund as the government has not released any details about the NHSF and I call on the Government to have the closest discussion and consultation with the MMA and health service providers with regard to the proposed NHSF so that Malaysians would have a health system all citizens can feel proud.

In September, NGOs like MMA, Aliran, Malaysian Academic Movement and concerned individuals released a Citizensí Health Manifesto For Malaysia calling on the government to carry out healthcare reforms which would adhere to the fundamental principles of equitable, accessible, effective and sustainable healthcare.

The Manifesto urged the government to discard the notion that corporatisation and privatisation would eliminate or markedly reduce the role of government in healthcare, particularly in healthcare financing.

Has the Government set up a task force to study the Citizensí Health Manifesto for Malaysia and what is its standon it? The Government should give serious consideration to this Citizensí Manifesto for Health.

The Government is building an IT Hospital in Selayang, which has been described as one of the most advanced and IT-enabled hospitals in the world with the introduction of the Total Hospital Information System (THIS) to provide a total integrated solution centred around an electronic medical record (EMR), which captures and stores all relevant clinical data for each patient in electronic form. The Selayang Hospital is believed to be the first in Southeast Asia to have an EMR implemented making it the first filmness and paperless hospital in the region.

I understand that each bed would have a computer terminal and all medical records and data would be digitised.

The question is whether Malaysia needs such an IT hospital at a time when the basic health and medical needs of Malaysians could not be met on an affordable and accessible basis and whether we have a proper order of national priorities.


*Lim Kit Siang - Malaysian Parliamentary Opposition Leader, Democratic Action Party Secretary-General & Member of Parliament for Tanjong