Thread by @Khairykj

Persidangan Kemuncak Dasar Kesihatan 2022 atau Health Policy Summit 2022: The Future of Our Healthcare - Health White Paper Development bermula hari ini. Persidangan ini melibatkan nama-nama terkenal dan berpengalaman dalam sistem kesihatan di dalam dan luar Malaysia. #HWP

In discussing on the way forward for our healthcare system, we will be taking a step closer towards securing much needed systemic and structural reforms to future-proof our health system, reforms that are long overdue. #HWP

The Health White Paper will be tabled to secure Parliamentary agreement and commitment towards future-proofing Malaysia’s healthcare system. #HWP

The health-seeking model we have has changed very little over the past 65 years. The health model today is still premised on a predominantly curative lens, responding after the fact to illness, disease and infirmity. We do not sufficiently anticipate the future. #HWP

We do not sufficiently anticipate the future. Patients will usually wait until they are very unwell before actively seeking care from the doctor, often at fairly advanced and chronic stages in the case of non-communicable diseases or NCDs. #HWP

Based on the National Health and Morbidity Survey, there has been an increase in chronic diseases since 2011. The 2019 numbers show that 1 in 5 adults have diabetes, 3 in 10 adults have hypertension, and 4 in 10 adults have elevated cholesterol levels. #HWP

1 in 2 Malaysian adults are overweight or obese and 1 in 4 Malaysian adults are not physically active. 4.8 million Malaysians above 15 years old are smokers and 600,000 Malaysian children aged between 13 and 19 have taken up e-cigarettes. #HWP

As of 2017, the direct health cost and loss of productivity due to chronic diseases have been estimated to cost Malaysia RM22.53 billion, which is nearly 40% of our total expenditure on health. #HWP

We are an ageing nation. It is projected that by 2040, people aged 65 years old and above will rise to 14.5% of the total population of Malaysia. With the considerable improvements in our health system, Malaysians are now living longer but not necessarily in better health. #HWP

These trends - increasing NCDs, unhealthy ageing and negative mental health - will continue to be with us, putting increasing pressure on our health system unless we review the system’s fitness for purpose. #HWP

We need to move away from “sick care” to health care and wellness. Our ultimate goal should be to ensure that all Malaysians, no matter who they are or how old they are, can live long and healthy lives. #HWP

We need to achieve this by protecting public healthcare as a fundamental public good in Malaysia, available virtually free to anyone who chooses to access it with quality of care similar to, if not better, than for those who choose to pay for healthcare privately. #HWP

The challenge for us as a nation is, in ten years, how can we see 10 million Malaysians become healthier than they are today? That will be the big outcome of the White Paper. #HWP

We need to create a system with the resources to keep 10 million Malaysians healthy and out of hospitals over the next 10 years. The way we think about the role of the healthcare system needs to change, which brings me to the first systemic challenge that the #HWP must address.

In order to move from “sick care” to health care and wellness, the Health White Paper will need to address the imbalance in resource allocation, organisation and policy focus between primary health care and hospital care. #HWP

Primary healthcare needs to be prioritised. It needs to be viewed as the cornerstone of the health system, bringing care closer to the people as well as the primary line of defence in addressing demographic challenges, changing disease patterns & increased environmental hazards.

Key systematic reforms need to be geared towards making primary health care services in Malaysia capable of providing whole- person care throughout their lifespan, not just for specific diseases. Now, more than ever, is the time to have a renaissance in primary health care. #HWP

The second systemic challenge that the #HWP must address is the maldistribution of equipment, capacity and skill mix between the public and private sectors in the healthcare system, which contributes to gaps in coverage across state and urban-rural lines.

Resources across the public sector and private sector, needs to be more effectively and efficiently utilised. Less dichotomy and more partnership or integration will reduce pressures on public sector facilities to cope. #HWP

We cannot consider reform without understanding the funding aspect of the health system. How the system is financed plays a vital role in transforming the health system, affecting everything from the sufficiency of infrastructure to the number of healthcare workers. #HWP

The various healthcare funding mechanisms in the country needs to undergo transformation, and these include private health insurance, employment-based health benefits, and government funding for health and social care. #HWP

We need to consider a long-term solution for healthcare funding where all parties share responsibilities for the health needs of the population. #HWP

The #HWP is focused on securing long-term change. We are considering gradually increasing the healthcare budget up to targeted
levels over a number of years while working out funding structures to make the system more sustainable and progressive.

To be very clear, I want to increase the annual budgetary allocation for public healthcare to 5% of GDP over next few years. Beyond that, we should discuss other long-term solutions. It is not either one or the other.

The #HWP will need to challenge every aspect of government to think of health outcomes if we are to succeed in keeping Malaysians healthy. We need to tackle poverty as a negative determinant to good health.

We need to provide quality education, equitable access to services, protect the environment, fight and reverse climate change, ensure food and nutritional security, plan for more green, safe, open and livable spaces in our cities and towns. #HWP

At the same time, we also have to look at health determinants at the personal level such as lifestyle and behaviour. These include risk factors such as smoking, substance use, diet and exercise, to name a few. #HWP

In Malaysia, cigarette smoking is the leading cause of preventable morbidity and mortality. It leads to an increased risk for cardiovascular disease, the leading cause of death in the country. Non-smokers exposed to second-hand smoking are at equal risk. #HWP

The e-cigarette and vaping industry is often underestimated but e-cigarettes in fact comprise 42% of the tobacco market share. We are seeing increasing cases of EVALI (e-cigarette or vaping use associated lung injury) with the prevalence of these devices. #HWP

Changing traditional norms of acting and behaving is hard. But we can humanise healthcare to be more person-centred and acceptable to younger generations through technology. With such innovations, it is also possible to make healthcare accessible and affordable for everyone. #HWP

New technologies, seminal advances in medicine, and a radical shift in the population's behaviour and norms are coming together. There are new opportunities that can impact many parts of our old healthcare models. We can fundamentally rethink every challenge. #HWP

Currently, hospital services constitute a significant part of the patient's experience, which may not necessarily be true in the future. With a fundamental shift from ‘sick care’ to health care and wellness, the health system as we know it today would naturally change. #HWP

By using science, data, and technology, we will be able to identify sickness & disease earlier, intervene proactively, to help people sustain their health and wellbeing and free up resources for critical cases requiring curative care with cutting edge treatment protocols. #HWP

This fundamental shift in service delivery and focus will require an organisational change in the healthcare system by integrating public and private delivery of healthcare. It would require flexibility on the part of both the public and private sectors. #HWP

We should not let the lessons and opportunities of the COVID-19 pandemic pass us by. The #HWP should be our collective statement of intent on how we can make our health system more sustainable and resilient through a "whole of government" and "whole of society" mindset.

We have been engaging with a wide range of stakeholders to seek proposals on systemic healthcare reform since early this year.

A Health White Paper Advisory Council, comprising 13 diverse subject matter experts will be appointed, to lend their assistance in challenging and refining our policy priorities. #HWP

The Health White Paper will be focused on the most fundamental reforms to address major systemic and structural challenges faced by the healthcare system rather than a specific disease or an individual demographic group. #HWP

While we have been consulting a diverse range of stakeholders in developing the #HWP, we need to make sure the plans for reforms are themselves future-proof and critically will outlast any incumbent minister.

Bi-partisan support for the proposed reforms within the Health White Paper is critical and I hope that we will all play a part in supporting its tabling to Parliament at the end of this year. #HWP

To further secure the reforms, the Health White Paper will also propose a Health Reform Commission to independently monitor, advise and report on the status of implementation to the government, the Parliament, and the people. #HWP

In having a transparent and well- appointed Health Reform Commission, we hope that it will create institutional check-and-balance and ensure follow-through on the reforms, regardless of changes in the political sphere. #HWP