oleh Gandipan Nantha Gopalan
Parti Sosialis Malaysia (PSM) mengambil maklum penjelasan EXCO Kesihatan Awam dan Alam Selangor bahawa Selgate Specialist Hospital Rawang (SSHR) sememangnya dikategorikan sebagai hospital swasta, walaupun Selgate Corporation merupakan syarikat milik penuh Perbadanan Kemajuan Negeri Selangor (PKNS).
PSM juga mengambil maklum bahawa Kerajaan Negeri Selangor menganggap Selgate sebagai rakan strategik yang boleh membantu melalui program seperti Saringan Selangor, promosi kesihatan, harga berpatutan dan program tanggungjawab sosial korporat (CSR).
Namun bagi PSM, persoalan pokok bukan sama ada Selgate boleh menjalankan CSR atau menawarkan diskaun kepada rakyat. Persoalannya adalah mengapa sebuah kerajaan negeri memilih untuk terus mengembangkan sektor hospital swasta ketika sistem kesihatan awam sendiri sedang berdepan dengan tekanan yang serius.
Sumber dan pengaruh yang ada pada Kerajaan Negeri sepatutnya digunakan untuk memperkukuhkan keseluruhan sistem kesihatan awam, melalui penjagaan primer, pencegahan penyakit, kesihatan komuniti, sokongan kepada tenaga kerja kesihatan dan kerjasama dengan Kementerian Kesihatan (KKM) untuk meningkatkan kapasiti perkhidmatan awam.
Malaysia sudah berdepan kekurangan doktor pakar dan petugas kesihatan berpengalaman. Hospital baharu tidak semestinya menambah kapasiti sebenar sekiranya ia bergantung kepada tenaga kerja yang sama yang sedang diperlukan oleh hospital awam. Pengembangan sektor swasta boleh meningkatkan persaingan dalam mendapatkan tenaga kesihatan yang terhad dan seterusnya menambahkan tekanan ke atas sektor awam.
Justeru, dalam keadaan sistem kesihatan awam sedang bergelut mendapatkan tenaga kerja dan sumber yang mencukupi, PSM berpandangan bahawa pembukaan atau pengembangan hospital swasta baharu adalah bercanggah dengan kepentingan kesihatan rakyat.
PSM telah mengambil pendirian yang jelas melalui Kempen “Selamatkan Sistem Kesihatan Awam” pada 2025: moratorium lima tahun terhadap hospital swasta baharu, peningkatan peruntukan kesihatan awam dan langkah untuk mengawal pengkomersialan kesihatan. Pendirian ini turut ditegaskan semula dalam Kongres Nasional PSM ke-28 pada 2026.
Maka, PSM tidak boleh menerima hujah bahawa beberapa program CSR atau saringan percuma boleh menjadikan pengembangan hospital swasta selari dengan kepentingan rakyat. Program CSR boleh membantu sebahagian rakyat untuk sementara waktu, tetapi ia tidak mengubah sifat asas hospital tersebut sebagai hospital swasta.
Lebih penting, CSR tidak boleh dijadikan penampan untuk menutup persoalan dasar yang lebih besar: mengapa kerajaan membantu mengembangkan sektor swasta ketika sektor awam sedang memerlukan lebih banyak tenaga, sumber dan sokongan?
PSM menuntut kerajaan negeri Selangor:
- Hentikan sebarang pengembangan atau pembukaan baharu hospital swasta melalui syarikat milik atau dikawal kerajaan negeri.
- Hentikan penggunaan modal dan sumber kerajaan negeri untuk memperbesar kapasiti hospital swasta dan alihkan keutamaan kepada pengukuhan kesihatan awam.
- Kerajaan Negeri perlu mendedahkan jumlah modal dan sumber awam yang digunakan untuk pengembangan perniagaan kesihatan Selgate serta justifikasi mengapa pelaburan tersebut lebih diutamakan berbanding keperluan kesihatan awam.
- Kerajaan Negeri perlu mengadakan perbahasan awam mengenai dasar penglibatan syarikat milik kerajaan dalam sektor kesihatan dan menghentikan pengembangan model kesihatan yang berasaskan keuntungan.
PSM ingin menegaskan: kami tidak menentang pembinaan kapasiti kesihatan. Kami menentang penambahan kapasiti melalui pengembangan sektor swasta ketika sistem kesihatan awam sedang bergelut.
Kerajaan Negeri Selangor mungkin tidak mempunyai kuasa untuk membina hospital KKM. Tetapi kerajaan negeri mempunyai pilihan tentang ke mana modal dan pengaruh negeri disalurkan. Dalam pilihan tersebut, PSM memilih untuk tidak menambah hospital swasta. Perkukuh sistem kesihatan awam kita!
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Gandipan Nantha Gopalan ialah Timbalan Setiausaha Agung Parti Sosialis Malaysia (PSM).
Tandatangani petisyen dalam talian untuk kempen “Selamatkan Sistem Kesihatan Awam” di sini.
It’s a harsh reality that’s difficult to accept, especially with the rising costs of insurance premiums. Unfortunately, the government has not established an independent body to monitor these inflated charges imposed by private hospitals. Bank Negara has also fallen short in this regard. Instead, the government should prioritize strengthening public hospitals and constructing new ones. Instead, they are issuing licenses for the establishment of more private hospitals, which contributes to the brain drain as specialized doctors leave the public sector.
The soaring medical insurance premiums may result in an increased lapse rate among policyholders. Many individuals are likely to revert to the already overcrowded public healthcare system. It is crucial to construct new public hospitals and halt the licensing of private hospitals to reduce the migration of medical officers, specialists, and other healthcare personnel due to the strain on public facilities. Additionally, we need medical officers and specialist doctors to train those undergoing the “housemanship” program.
t’s the moral obligation of the government to provide quality health services as part of the social wage. Healthcare is a right, not a privilege.
1. What percentage of the Malaysian population relies on public healthcare, and what percentage of specialist doctors are employed in public healthcare? Approximately 70% to 75% of the Malaysian population depends on the public healthcare system for their medical services, with the public sector providing around 75% of all hospital inpatient care. While 75% of Malaysians utilize public healthcare, only 25% of specialist doctors are employed within this sector. Nonetheless, the public healthcare system is currently facing a significant shortage of specialists and medical officers, resulting in a critical “brain drain” toward the private sector and foreign countries.
2. What factors contribute to brain drain in public healthcare in Malaysia? The phenomenon of brain drain within Malaysia’s public healthcare system is primarily influenced by factors such as inadequate compensation, demanding working conditions, and restricted opportunities for career advancement in the public sector. These issues have led to a substantial number of resignations among medical officers and specialists. Professionals in the Malaysian healthcare system are frequently attracted to positions in countries such as Singapore and the United Kingdom, where they can receive substantially improved salaries, enhanced work-life balance, and increased professional recognition.
3. Does medical tourism lead to an increase in the number of private hospitals and the migration of specialist doctors and medical staff from the public sector? Medical tourism frequently results in a rise in the number of private hospitals and contributes to a “brain drain” of specialized physicians and medical personnel from the public sector to the private sector in host countries, such as Malaysia. This occurrence is a prevalent outcome of the development of medical tourism, as affluent international patients increase the demand for advanced, technology-driven medical care that is more financially beneficial for private organizations.
4. Does the issuance of new licences by the government for the establishment of private hospitals contribute to brain drain in the public healthcare sector? The issuance of new licences by the government for the establishment of private hospitals may contribute to the brain drain within the public healthcare sector. The increase in licences for private institutions has been identified as a primary factor leading to a reduction in the availability of specialist doctors and other medical personnel in government facilities. It is crucial for the ‘Madani’ government to focus on enhancing public healthcare, given that two-thirds of the Malaysian population depends on it. Additionally, a considerable number of specialist doctors have already departed from the public sector. Addressing this issue is essential for the welfare of the public.
5. The “Magnificent Seven” proposed initiatives aimed at enhancing public healthcare in Malaysia are frequently examined in relation to the issues of overcrowding, workforce burnout, and funding inadequacies. These proposals centre around structural reform and the integration of public and private sectors, with the goal of improving the sustainability of the healthcare system for both the government and the populace.
The Magnificent Seven Proposed Actions include the following:
a. Strengthening the Public Health System (Infrastructure & Personnel): This involves the establishment of additional hospitals in urban areas to mitigate overcrowding and an increase in the workforce, including doctors, nurses, and specialists.
b. Integrating General Practitioners (GPs): This initiative seeks to engage the 7,000 private GPs in the long-term management of chronic conditions such as diabetes, hypertension, and asthma, thereby alleviating the burden on public hospitals.
c. Funding for Migrant Worker Healthcare: It is proposed that a portion of the migrant worker levy be allocated to the Ministry of Health to address treatment costs, to enhance the management of communicable diseases.
d. Reducing Out-of-Pocket Expenses: The government is encouraged to finance up to 90% of costs associated with essential medical supplies (including plates, screws, stents, and eyeglasses) to lessen the financial strain on patients.
e. Addressing Brain Drain and Supporting Staff: The implementation of a “Special Services Commission” is proposed to enhance payroll systems, offer sabbaticals for specialists every four years, and impose a moratorium on the establishment of new private hospitals to maintain talent within the public sector.
f. Increasing the Healthcare Budget: It is suggested that the Ministry of Health’s budget be increased annually to attain a sustainable and elevated percentage of GDP, thereby securing long-term funding for healthcare improvements.
g. Transitioning from Sick Care to Preventive Care: This initiative emphasizes a shift from a focus on treating illnesses to prioritizing preventive and promotional healthcare services through community nursing and enhanced health education.
B. In contrast to most taxes, the ramifications of wage suppression do not finance public services or redistributive programs that support vulnerable populations. Rather, it enhances corporate profitability and diminishes the share of income that workers receive. The prevailing low salary levels in Malaysia are symptomatic of an economic growth model that restricts wage growth. For four decades, the country has adhered to a strategy that fosters wage suppression to attract foreign direct investment (FDI). This model is characterized by initiatives aimed at de-unionizing the labour force, lowering collective bargaining coverage, and employing migrant labour to diminish payroll expenses.
A living wage is characterized as the minimum income required for a worker to adequately fulfil the basic needs of their family. The objective of a living wage is to afford workers a foundational yet respectable standard of living through employment, alleviating the need for government assistance. The current minimum wage of RM1700 does not meet the criteria for a living wage, particularly given the prevailing cost of living.
The term ‘social wage’ frequently appears in journalistic discourse, referring to a range of public services that typically encompass education and healthcare. In a context where fair monetary compensation for workers is unattainable, the government has a responsibility to provide subsidized healthcare. The administration should model public healthcare systems akin to those in England (NHS) and the Nordic countries, recognizing that delivering quality healthcare services is a moral obligation. Healthcare should be regarded as a right rather than a privilege.
Regrettably, influential figures from Bretton Woods institutions—the World Bank, International Monetary Fund, and World Trade Organization—have influenced Malaysian policymakers to regard healthcare as a market commodity geared towards profit generation. Health expenditures are often mistakenly regarded as a form of subsidy and perceived as a burdensome drain on national finances. The PSM opposes this perspective, advocating for a human rights-based approach where the government is tasked with providing healthcare services for all citizens. The health system ought to be government-led, government-funded, and rights-oriented.
Quality healthcare services should be conceptualized as part of the “social wage” that has already been ‘pre-paid’ by workers and farmers through their acceptance of inadequate wages. Funding for public health service budgets should derive from taxes imposed on the wealthiest individuals and largest corporations, rather than introducing new taxes on the B40 and M40 demographic groups or mandating health insurance premiums—options currently under consideration by policymakers.
It is imperative for policymakers to initiate measures that ensure a greater portion of the substantial wealth generated by the labour force is allocated towards enhancing the quality of life for the populace. Establishing an efficient public healthcare system that is free at the point of access must be a fundamental objective