KUALA LUMPUR: The highly-centralised structure in the Health Ministry needs to be reviewed as it could lead to over-bureaucratisation.
Health Minister Khairy Jamaluddin said, even though such a structure housed several advantages, a better way of doing things would be to allow Malaysia's healthcare system to be self-governing.
As it is, he said, the Health Ministry had over a quarter of a million employees aside from the many hospitals nationwide.
This, he said, had led to the ministry being the biggest payor and health provider in the country, aside from being the only health regulator.
"One thing is of course to spend money in the right place and the other is to deploy people in the right places.
"But it becomes difficult to deliver services because you are conflicted in many ways. You pay, you provide, you regulate yourself and there is a risk of over-bureaucratisation and an increase in administrative cost.
"In the long run, we should focus on policy, research and regulation. We should start looking at an autonomous structure for our hospitals.
"Some of the bigger hospitals can be more autonomous with its own governance structure, own board, own CEO (chief executive officer) and with the ability to retain savings because if there are any savings, it will be poured back into a consolidated fund," he said during the Health Policy Summit 2022 held at the World Trade Centre here today.
However, he stressed that there must be proper regulations in place to prevent the hospitals from being "too business-minded".
"Of course, you have to put in safeguards to ensure that autonomous hospitals continue to serve the public good, otherwise they can be too business-minded as well.
"So, you have to start looking at autonomy and regulations, whether or not you carve out regulatory functions from the ministry itself.
"Funding is the first and main concern because we need to figure out how to finance the system, where is the source of funding, and if we managed to get the funding, which aspects do we want to spend on. Do we want to hire more healthcare workers? If yes, in which sectors and what is the ratio.
"Second, in terms of the quality of services. What are the qualities needed to ensure 10 million of our citizens remain healthy in 10 years to come to avoid them being admitted for diabetes, hypertension, heart attacks and other diseases. A million Malaysians fall sick annually for diseases that can actually be prevented."