Healthcare in Malaysia is catered both by public and private providers. The government is still the main provider as healthcare in the country is still heavily subsidised. Private healthcare cost is fully borne by patients or through their insurers.
The 9th Malaysian Plan (9MP), expected to be out in April, will outline the government strategies and focus for the healthcare industry for the next five years (2006-2010).
Information gleaned from the Health Minister’s recent speeches, the thrust for the 9MP will be towards achieving greater health through consolidation of services. This is expected to be achieved through various efforts, including the wellness paradigm and a change of mindset to the acceptance of health as the responsibility of all.
Does this mean that within this period the Malaysian National Healthcare Financing Scheme (similar to Australia’s Medicare system) will finally be implemented?
Per the industry feedback, government will really have to do so very soon as the escalating healthcare costs is creating a burden too great for them to bear.
Basic healthcare information for Malaysia
|
Population (2005) |
26.13 million |
| Life expectancy |
71.8 (male), 76.2 (female) |
| Infant mortality / thousand |
5.1 |
| No. of doctors |
18,246 |
| No. of hospitals (public & private) |
351 |
| No. of hospital beds |
Approximately 48,000 |
The public health sector is the main provider of medical services in Malaysia.
There are a total of 123 public hospitals in Malaysia with an additional six specialist medical institutions including psychiatric hospitals and the National Heart Institute.
There are five teaching hospitals (under the jurisdiction of Ministry of Education) and another three hospitals governed by the Ministry of Defence (for use of army and retired army personnel and their families only). Together they make up almost 38,000 beds in the country.
There has been rapid growth in private hospitals in the last two decades. In 1980, there were only about 50 private hospitals with 2000 beds. Currently there are more than 210 private hospitals with more than 10,000 beds.
Although private hospitals are concentrated in the urban areas, such as Klang Valley and the cities in Malaysia, there have been increasingly more set-ups in the bigger towns all around the country.
The growth of private hospitals also contributed to the shortage faced by the public sector. More than 45 per cent of the total numbers of doctors (approximately 16,000) are working in the private sector.
The current ratio of doctors per population is 1:1200, which is still far from the national target of 1:600 by 2020 and similarly ambitious targets for nurses (current ratio 1:518) and other medical personnel. To achieve this, a number of expansion strategies are being pursued. This includes:
- The construction of new medical training centres
- The recruitment of foreign doctors and specialists
- Acknowledging foreign medical degrees formerly not recognised (with conditions attached)
- An increase in the number of scholarships for the foreign training of Malaysian doctors
- The establishment of new medical colleges and twinning programmes
Health tourism is increasingly becoming an important source of income to the private healthcare providers in Malaysia. This is fully supported by the Malaysian Government, through the Ministry of Tourism. The Ministry provides an international platform for the private healthcare providers to showcase the Malaysian healthcare capabilities.
It may come as a surprise to some but Malaysia is almost a net exporter of medical equipment. While Malaysia imports high technology medical devices costing RM929 million in 2002, the exports are almost equivalent at RM904.63 million. Malaysia is currently the world’s largest supplier of medical gloves and catheters.
Construction activities in the public sector for the next five years are expected to slow down compared to the previous 10 years. Required infrastructures are mostly in place, thus construction of new hospitals are only limited to those which were ‘postponed’ from the 7MP and 8MP. These include the Women & Children’s Hospital, rehabilitation hospital and psychiatric hospitals and some state hospitals.
The private sector seems to be doing well – health contacts speak of new hospitals being planned and current ones expanding.
The National Health Financing Scheme is possibly the foremost priority of the government in the 9MP. The project continues with assistance and references sought from domestic parties and various countries around the world with a similar scheme, including Australia. It has been suggested that this reform be introduced in stages to allow time for the scheme to evolve and educate the general public.
In a few years, we have seen the trend of Australian health/medical offerings changing to lean towards services. The tie-up of Australian universities offering health-related courses in Malaysia is one of the best examples. There are also various Australian consultants working on current ongoing hospital projects, both public and private.
Although Australia is not the main supplier of medical equipment, companies have been successful in penetrating this market with their offerings of innovative/niche medical products.
Opportunities exist in the following areas:
- Training and specialised medical education for healthcare personnel (nursing, paramedical and management programs)
- Innovative/specialised/niche medical equipment
- Health IT systems and services
- Health consulting services
Malaysian tariffs vary for medical equipment and disposables. Most imported medical equipment are not subjected to tax. Import tax for complementary products (eg. hospital beds and spare parts) ranges from zero to 30 per cent of the products value. Some products have additional sales tax ranging from zero to 10 per cent.
It should be noted that X-ray/laser equipment requires an import license, which must be applied for by the importer, ie. Malaysian company.
The various channels of entry into the Malaysian health industry are:
- Direct marketing by principal companies (eg. Johnson & Johnson, 3M, Braun, etc.)
- Sales through local agents or distributors
- Sales through trading houses
- Direct sales to re-sellers (eg. pharmacies, rehabilitation centres)
- Direct sales to end users (eg. hospitals, clinics, medical practitioners)
Direct export is the most common entry strategy in the provision of services. This includes management, consultancy and training programs. These export transactions are concluded through direct negotiations with end customers.
For indirect exports, establishing a local presence is important and there are various ways to do this:
- Appoint an agent or distributor
- Form a joint venture partnership
- Form short-term partnership (ie. one or two year contract with opportunity to review the partnership at the end of each term)
- Form ‘ad-hoc’ partnership (ie. different partners for different projects)
- Set up a local office
Malaysian companies are very open and receptive to new products and services. The following suggestions are for Australian companies who are interested in marketing their products and services:
- Be prepared to visit the Malaysian healthcare sector regularly (at least two to three times a year)
- Follow up on previous visits (through telephone, email or faxes)
- Learn about the cultural issues in Malaysia
- Prepare information packs about your company, products and services offered
- It is preferable to have a local agent or distributor
Government:
Ministry of Health Malaysia – www.moh.gov.my
Royal Customs and Excise Department, Malaysia - www.customs.gov.my
Department of Public Health, Malaysia - http://dph.gov.my
Kuala Lumpur General Hospital - www.hkl.gov.my
Associations:
Malaysian Medical Association - www.mma.org.my
Association of Private Hospitals of Malaysia - www.hospitals-malaysia.org
General information:
Kumpulan Perubatan (Johor) Sdn Bhd - www.kpj.com.my
Pantai Holdings Bhd - www.pantai.com.my
University Malaya Medical Centre - www.ummc.med.um.edu.my