Inside the health ministry’s shift towards structural reform

The health ministry in Malaysia is shifting its focus towards structural reforms to tackle the strain on the public healthcare system. This includes long waiting times and a shortage of specialists in high-demand fields. The initiative is part of the RESET strategic agenda, which encompasses MediAsas, diagnosis-related group financing, alternative service delivery models, and inter-ministry collaboration.

Dr Azman Yacob, senior health officer, emphasized that healthcare transformation is a long-term process that requires cooperation beyond the health ministry. The Hospital Services Outsourcing Programme, introduced in 2024, has proven effective, reducing waiting times for arteriovenous fistula surgeries by 75% and MRI/ultrasound services by 20%. CT scan waits have also decreased by 14%.

Dr Noor Ashani Yusoff, president of the Malaysian Urological Association, welcomed the health ministry's efforts, stating that MediAsas will make private medical insurance more accessible, indirectly easing the pressure on public hospitals. Addressing manpower shortages, the ministry has made significant strides, appointing 18,755 permanent medical, pharmacy, and dental officers and 4,328 nurses since 2023.

The legacy contract doctor system is set to end by 2028 as medical officers transition to permanent roles. Furthermore, the ministry is expanding sponsorships for the parallel pathway programme, increasing it to 600 annually across 14 medical fields, up from just 52 in 2022. This move, along with provisions in the Medical Act 1971, aims to recognize specialists from both the local master's and parallel pathway programmes.

Specialists undergoing supervised working experience (SWE) receive a monthly allowance of RM1,900 to RM3,100. These reforms are geared towards creating a more efficient, integrated, and sustainable health system, ensuring patient access, quality, and safety remain at the forefront.