Strengthen primary care by implementing Family Doctor system

By:

Lim Chee Han

Affiliations:

Agora Society Malaysia

Policy Code:

3i Health

Problem Statement:

Rakyat’s health is not doing well. National Health and Morbidity Survey 2019 shows that the general trends of non-communicable diseases (NCD) in the country are going worse: higher obesity, diabetes, hypertension, high cholesterol. In fact, the number of hospital admission due to NCD also demonstrates that these
unhealthy communities occupied significant resources for secondary/tertiary healthcare. Should the trends continue, it will be increasingly more costly for the government to deal with in future. Currently about half of the MOH Budget are used for ‘medical care’ (hospital/tertiary care), the largest MOH budgetary category item which was worth more than RM10bil each year.
Late presentation of diseases makes some medical treatment more likely to be ineffective and government has to spend more on such treatment. The issue is that our primary care does not work for adults who will only seek for treatment when they fall sick.

Value(s) and Belief(s):

Healthcare is not only for the sick. Primary care is the cornerstone of community healthcare which can provide continuity of care, health screening and necessary health advice to the people. It is best to have a dedicated person to know the personal and family history and establish trust and bond taking care of people.

Proposal of Solution:

MOH should set up and implement family doctor policy and system to provide continuity of care, help do health screening and regular check up (ie. annually) and so to offer timely health advice to their patients, intervene before the case goes worse. Currently 70% GPs are in the private sector, and significant portion of them signed up the ProtectHealth PeKaB40 programme. For the family doctor programme to work, MOH has to integrate public and private sector and pay the enrolling GPs per capita they put under their care annually.
Therefore, the government should increase budget allocation for Public Health programme, where primary care is concerned. Health promotion and preventive care can work best if primary care is proactive and provide continuity.

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