Govt mistaken 1Care Healthcare is the best

Wan Azizah surprise visit at Gaya Street

Posted by Christina Liew

Wan Azizah: The government is mistaken if it thinks that the proposed 1Care healthcare policy will be the best way to overcome the challenges plaguing Malaysia’s healthcare system. Under the proposal, the rakyat as well as both employers and the government are expected to contribute to a health financing scheme in which private and public healthcare providers will be integrated.

The World Health Organisation recommends that government expenditure for health as a percentage for GDP should be between 5 to 6 per cent. Malaysia’s total health expenditure in 2008 was 4.8 per cent but government expenditure was only 2.2 per cent. In 2004, private health expenditure as a percentage for GDP overtook government health expenditure for the first time.

The proposal that approximately 10 per cent of workers’ salaries would be contributed to the health financing scheme will further burden the rakyat. At present, they are stuck in the middle income trap of low wages and rising costs. This situation will be further exacerbated when the government introduces a goods and services tax soon. Combine this with the endemic corruption and leakages that plague government expenditure (including health) it should not surprise the government if the rakyat rise up in anger at the 1Care proposal.

We do not dispute that there are challenges under the present healthcare system in the country. There is a growing gap between government and private hospitals. There is a need to stem the tide of migration from government to private hospitals. Malaysians cannot continue to rely on out-of pocket treatments for their healthcare.

Yet there have been many restructuring attempts in the past where decisions taken without a proper and transparent consultation process ended with bigger problems for the rakyat. Our government hospitals have not been spared from the privatisation of essential services that have increased profits for select-few companies at the expense of the taxpayers and patients.

The 2010 World Health Report on Health Systems Financing by WHO clearly states that 20 to 40 per cent of health expenditure is wasted due to inefficiency. 1Care ultimately means that the rakyat and government will be subsidising private hospitals in a manner similar to that of private colleges today under the PTPTN scheme. It is important to note that we are not against private hospitals.

In fact, we believe they provide a useful service particularly to Malaysians who can afford them and should continue to do so. The integration proposed by 1Care however will deny the choice for a segment of Malaysians and do not hold up to any quality standardisation.
We call upon the government to be transparent regarding the stage at which 1Care is at the moment. There have been conflicting answers that do not increase the confidence of stakeholders in a major shake-up of the nation’s healthcare system.

Pakatan Rakyat, as underlined in our Buku Jingga, is committed to protecting healthcare as a right for all Malaysians. We believe that rather than implementing this new 1Care proposal, the government should increase the percentage of government expenditure for health over a span of a few years to leverage on the good basic health infrastructure available in the country.

We would look into the formation of a Health Service Commission that is committed to improve the quality of service, increase the remuneration of health personnel, guarantee appointments based on merit, ensure transparent procurement and re-examine privatised services in government hospitals.

FELDA.

This is another bad deal for Sabah FELDA should return 306,000 acres of land to the State Federal Land Development Authority (FELDA) should return 306,000 acres of land to the State of Sabah because FELDA had breach its promise and reneged from its obligations to develop the land given to FELDA intended to serve the interest of the people of Sabah.

At the same time, Sabah BN State Government should be held responsible for its failure to protect the interest of the State and its people in the land settlement schemes undertaken by FELDA. As a result, the State Government had sacrificed more than 306,000 acres of its prime agricultural land to the Federal Government including thousands of acres of state land involving native customary land held by the local native communities such as in Tungku of Lahad Datu.

As the government of the day, BN Government should explain to the people and account for its failure and incompetence in allowing FELDA to deviate from the original objective after having allocated some 306,000 acres of State land to FELDA for land settlement schemes intended to serve the benefit of the people of Sabah.

In 1979, the Sabah Berjaya State Government by the Sabah Chief Minister invited FELDA to develop about 200,000 acres of land in the District of Kinabatangan for the purpose of settlement scheme subject to the conditions of a written agreement signed on behalf of the Sabah State Government and FELDA.

The total acreage was later increased to 250,000 acres covering Kinabatangan and Lahad Datu in 1983 and further increased to more than 306,000 acres. In the written agreement, FELDA had agreed to establish the Selection Committee to manage the selection and engagement of settlers for the settlement scheme. FELDA should appoint at least two (2) members representing the Sabah State Government as members of the Selection Committee consisting of a total of four (4) members with a FELDA member as its chairman. FELDA had also agreed that a settler selected by the Selection Committee shall be entitled to, amongst other things, be engaged in the development and maintenance of the allocated land subject to payment of wages and dividends.

FELDA was required to provide a housing plot of land to each settler and his family together with a dwelling house built on it within the residential land of the scheme. In fact, FELDA only used less than 10% of the land allocated to it by the State Government for the intended settlement scheme involving only about 1,500 settlers each allocated with 14 acres of land.

All good things came to an end for Sabah after FELDA had taken over the land from the State, the Federal Government, in breach of its obligations under the agreement, decided not to take any new settler in January 1990. The reason given was that the Federal Government wanted to reduce its financial burden in providing infrastructure and basic facilities within the schemes.

But the Federal Government or FELDA did not relinquish or return the land back to the State despite having abandoned its original objective for land allocated by the State Government. The present BN State Government should explain why it had allowed FELDA to deviate from its original objective and why the BN State Government had failed to enforce the written agreement signed during the Berjaya Government?

Instead, FELDA continued to occupy and develop the massive acreage of land into oil palm plantation as landowner utilizing public funds and generating billions of revenues and profits for the benefit of the Federal Government. I am not surprised the revenues from Sabah had contributed substantially to the RM400 million FELDA office complex built recently in Kuala Lumpur.

Judging from the development within FELDA scheme in Tungku at Lahad Datu which is akin to a township, the State Government has indirectly allowed the creation of a new federal territory within the State of Sabah after Labuan. In Tungku, FELDA manages its own security force and control and restrict the usage of public road at certain hours of the day. FELDA has its own infrastructure including power plant and water supply whereas ironically, the local communities adjacent to FELDA township are still without any basic facilities such as piped water and electricity supply.

Like the petroleum saga, the FELDA settlement scheme involving the loss of more than 306,000 acres of State land was another bad deal from the Federal Government at the expense of the State of Sabah and its people. It is grossly unfair and reflects the arrogance of the Federal BN Government towards the State of Sabah.

This is another case of the BN Federal Government having reneged from its obligations to the people of Sabah. I urge the BN State Government to take immediate step to enforce the agreement including to recover ownership of the land from FELDA for the benefit of the State and its people who are landless since it was FELDA that had abandoned the settlement scheme and did not honour its part of the bargain under the agreement.

It is not difficult to understand why Sabah has become one of the poorest State in Malaysia after 48 years of nation building under the BN government. It is time for the Sabah BN component parties and their elected members to stop playing lip service to the people when they have been parts of present BN government for years. It is their duty to demand the Federal Government led by UMNO to channel and invest all the revenues and profits taken from FELDA schemes in Sabah to the State Government for development purposes or to demand for the return of the 306,000 acres of land back to the State.

Dr Wan Azizah Wan Ismail is President of Parti Keadilan Rakyat