14 hours Ago
Sathish GovindMalaysia allocates just 4.7 per cent of its GDP to healthcare — well below the OECD average of eight per cent to 10 per cent. Despite an annual public healthcare budget of RM35 billion–RM40 billion, our hospitals remain overwhelmed, underfunded and desperately short of skilled manpower.
Over 250,000 health workers are stretched to the limit, while delays in surgical and specialist care are quietly growing into a full-blown crisis.Among the most urgent concerns is the alarming shortage of trained professionals — surgeons, anaesthetists, experienced nurses — many of whom have left for the private sector or migrated overseas. Public healthcare is still accessible in principle, but the reality is grim.
Waiting times for many procedures stretch not over days or weeks — but months, sometimes years.The core issues driving surgical delays in public hospitals are well known: a shortage of specialists, inadequate operating theatres and beds, outdated or insufficient equipment, overcrowding, and exhausted staff working long hours.While the current Madani government.
is not responsible for the crisis that has been years in the making, it must recognize that its continuous involvement in the healthcare cannot come at the expense of public healthcare. Healthcare is a public good, and as the government has chosen to remain in the sector, it has a responsibility to ensure that reforms and actions prioritise public welfare, not private interests. Public expectations are high, and the responsibility to act and act decisively -rests firmly with those in power today.
A Modest Proposal for Urgent ReliefGiven the government's commitment to keeping the fiscal deficit below 3.5 per cent of GDP, Malaysia has little room to dramatically expand its public healthcare spending in the short term. Yet the status quo is untenable.
I propose a modest and targeted solution: a RM10 monthly deduction from each of Malaysia's 16.8 million-strong workforce, pooled into a dedicated National Surgical and Emergency Care Fund.At RM10 per month, this would generate RM168 million every month (RM10 x 16.
8 million workers). Over the course of a year, that amounts to RM2.016 billion annually (RM168 million x 12 months).
This substantial sum would be entirely funded by the public, not the government — a citizen-led initiative aimed at relieving the pressure on our overstretched public hospitals. By ring-fencing these contributions solely for critical services such as surgeries, trauma care, and life-saving interventions, this fund would provide immediate and high-impact relief where delays can mean the difference between life and death.By directly strengthening public hospitals and expanding access to urgent care, it will reduce dependency on private hospitals for critical procedures.
Over time, this will help bring down medical insurance premiums. When the public system works, people need less top-up cover. It's a way to cut premiums, improve care, and do it without costing the government a single additional sen.
For low-income earners who cannot afford the RM10, a solidarity-based model can ensure those in higher income brackets contribute slightly more. The estimated RM2 billion raised annually would enable Malaysia to mount focused, high-impact interventions.Where Would the Money Go?These are indicative estimates based on costing models drawn from Ministry of Health data, publicly available figures, and consultations with healthcare practitioners.
They are not final or exhaustive, but they provide a working picture of how RM2 billion annually could be allocated for maximum impact. It is hoped that the Ministry will undertake a detailed study along the lines outlined in this article, so that a comprehensive and actionable framework can be developed.1) Hire More Specialists & Surgical Teams – RM150 millionRecruiting 1,000 new professionals — including surgeons, anaesthetists, and nurses — at an average annual cost of RM150,000 per person would require an estimated RM150 million.
This targeted investment directly tackles the core bottleneck in public hospitals: manpower. By expanding surgical capacity through increased staffing, we can significantly reduce delays in critical procedures.2.
Extend Operating Hours in 100 Hospitals – RM500 millionBy extending operating theatre (OT) hours by four hours a day, five days a week in 100 major public hospitals, we can double daily surgical throughput. Based on Ministry of Health cost metrics, this would require an estimated RM500 million annually to cover overtime pay for medical staff, increased utility costs, and additional surgical supplies. This investment would make far better use of existing infrastructure while reducing the current backlog of patients waiting for critical surgeries.
3. Upgrade Ageing Operation Theatres & Equipment – RM500 millionModernising surgical suites with advanced lighting systems, imaging equipment, anaesthesia machines, and digital integration tools is crucial to improving efficiency and reducing surgical wait times. Many public hospitals are operating with outdated infrastructure that slows down procedures and limits capacity.
An estimated RM500 million investment would enable comprehensive upgrades in targeted facilities. Over time, many of these enhancements pay for themselves through increased surgical throughput and improved patient outcomes.4.
Use Mobile Surgical Units & Partner with Private Hospitals – RM300 millionDeploying mobile surgical trucks has proven highly effective in Sabah and Sarawak, bringing essential procedures to remote communities. At the same time, outsourcing selected non-emergency surgeries — such as cataracts and joint replacements — to vetted private hospitals can rapidly reduce waiting lists. An estimated RM300 million would fund the deployment and maintenance of mobile units, and cover contracted procedures in private facilities under strict quality and pricing controls.
This dual-track approach would bring faster relief to underserved populations without overburdening the public hospital system.5 5. Improve Post-Op Care: Consumables, Medications & Support Staff – RM500 millionA successful surgery is only half the battle — recovery is just as critical.
An estimated RM500 million would cover the full spectrum of post-operative needs: hospital beds, diagnostic tests, medications, rehabilitation support, and the essential non-medical staff who ensure smooth patient care, including porters, radiographers, and ward assistants. Investing in this area will reduce complications, shorten hospital stays, and improve overall patient outcomes.The Case for Urgent, Targeted ActionEven so-called "elective" surgeries like hernia repair, cataract removal, knee replacements, or gallbladder removal can be life-altering.
Delays worsen conditions, extend suffering, and increase long-term costs — not just for patients, but for the system as a whole.This RM2 billion intervention won't solve every systemic issue. But it would significantly shorten emergency room wait times, reduce patient suffering, and restore public confidence.
Strengthening our public hospitals also reduces dependence on private healthcare and, over time, may ease pressure on medical insurance premiums — a win-win for all."In most sectors, quality tends to decline as quantity increases — but in healthcare, the opposite is true. The more cases doctors and specialists handle, the more refined their clinical judgment becomes.
High patient volume sharpens diagnostic skills, accelerates decision-making, and often leads to the development of sub-specialisations.In contrast, private healthcare frequently competes with non-medical amenities — deluxe rooms, designer lobbies, and concierge services — which may offer comfort but do little to improve clinical outcomes. This is why a strong, well-resourced public healthcare system must remain the backbone of our national health infrastructure.
Health is not a luxury. It is a basic right. And unless we guarantee accessibility, we cannot credibly talk about quality of life.
We must stop treating public healthcare as a mere safety net and start seeing it as a national strategic asset — one that requires protection, investment, and collective ownership.Private healthcare still has a role to play. Doctors who enter the field with a commitment to healing will find their work meaningful and sustainable.
But those who view medicine as a path to build fortune from the misfortune of others should consider another profession. This is the healing business — not a marketplace that adds more pain to the sick.© New Straits Times Press (M) Bhd.
