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Call on govt not to cut budget for cancer care
Published on: Monday, January 25, 2016

Kota Kinabalu: Together Against Cancer Association Malaysia (TAC) is calling on Prime Minister Datuk Seri Najib Razak to maintain the budget for oncology as proposed in the Federal Budget 2016 which was unveiled in October 2015.Chairman of TAC, Ranjit Kaur made the call when met at the TAC-organised Malaysian Experience Exchange for Patient Organisations (MEEPO) Capacity Building Workshop held at Zara's Boutique Hotel, here, Sunday.

Speaking to the Daily Express, she said : " Our Cancer group is concerned about the negative impact cuts may have on people with cancer and their families.

"While we are aware that our economy is not doing well, it must be remembered that the general public are also affected by an increased cost of living and the ringgit's depreciation. Hence, cutting the budget for cancer care may have a huge impact on cancer patients and their families."

She noted that the budget allocation in the Supply Bill proposed for Radiotherapy and Oncology was increased to RM172.8 million in 2016, up from MYR129.7 million in 2015.

"Costs of healthcare in Malaysia are constantly increasing due to innovations in screening, diagnosis and treatment.

We would like to see cancer patients gain improved access to high quality healthcare in Malaysia," she said.

Ranjit was responding to the Health Minister's recent announcement to slash expenditure by 10pc at the Federal Cabinet meeting to be held on Jan 28 to re-evaluate Budget 2016.

"This is the first time in as long as people can remember that the healthcare expenditures will decline by 10pc," she lamented.

As such, she said, TAC would like to seek the Government's assurance that the cut in the healthcare budget will not affect cancer treatments or hamper doctors' ability to choose the best therapies for patients.

According to Ranjit, leading oncologists (cancer specialists) too are concerned that the increased pressure on resources risks stalling recent advances in driving up early diagnosis and improving survival rates in Malaysia.

"While we understand that cuts are inevitable, we have to avoid a situation where some cancer patients will be deprived of potentially life-saving and life-extending medications. Treatments for existing patients need to continue while a comprehensive review for a long-term reform of the cancer care system that is pragmatic and sustainable is undertaken," she said.

Quoting the results of a local study, Ranjit said it showed that 50pc of all deaths due to breast cancer in Malaysia could have been prevented with earlier diagnosis and better treatment. A more recent study called the Asean Costs in Oncology (Action) Study showed the devastating impact of out-of-pocket cancer expenditure on families.

Against this backdrop, TAC reiterates its call for real and substantial progress towards tackling cancer over the next few years. "TAC wants to see concrete steps focusing on early diagnosis and the best treatment.

We want to deliver the best survival rates in the region and bridge the gap with the developed world," she added.

At the end of the one-day workshop, Ranjit mobilised the participants (including patients) to sign up for "Speaking in One Voice : Together Against Cancer".

Meanwhile, Deputy Chairman of Tac, Dr Lim Teck Onn said it would be disastrous for the country if the Government decides to cut the healthcare budget as it would adversely affect the quality of healthcare services.

"As it is, people are already moving from private hospitals to government hospitals because of the economic crunch.

They want to conserve their income. The Ministry of Health should consider increasing its budget to allow for this perceived trend, instead of decreasing it," he contended.

In his presentation on Cancer Health Facts : What Patient Organisations can do to Advocate for Better Cancer Care Financing, Dr Lim emphasised the pressing need for Malaysians to stand up for better cancer care and lobby for proper financing in place.

He argued that Malaysia is not poor, yet it underspends on healthcare and medical treatment "while ordinary citizens (private) are baring much of the financial burden.

"Generally, people are not aware that cancer care is so bad in Malaysia. They must know that really we are not treating patients with cancer well and for that people suffer or die unnecessarily. For some reason, the powers that be don't like to spend money on cancer patients. Hence, cancer care has been neglected in the country.

"Why? Traditionally, cancer has a bad image as a disease. People have the perception that when you have cancer, you are going to die. We should not discriminate against cancer patients vis-à-vis patients with kidney failure for which dialysis is provided for years," Dr Lim said.

Expressing concern, Consultant Breast Surgeon, Dato' Prof Dr Yip Cheng Har of Ramsay Sime Darby Healthcare said more doctors may leave the government service if there is cutback on scholarships and training for doctors.

Earlier, in her paper on Action Study Results, she said cancer is costly in terms of time, emotions, relationships, health and most importantly finance.

Dr Yip said the phenomenon is reflected in the findings of the 2011 Asean Costs in Oncology (Action) Study involving 9513 cancer patients (64pc were women) in eight low and middle-income countries in Southeast Asia (Cambodia, Laos, Myanmar, Malaysia, Thailand, Indonesia, Philippines and Vietnam). Breast cancer was the commonest of all.

Some 1662 cancer patients in Malaysia participated in the study.

"The Action study showed that in Malaysia, 45pc of households experienced financial catastrophe (defined as spending more than 30pc of household income on cancer treatment). These are out-of-pockets (OOP) defined as payments that are not covered by insurance or government.

"They (45pc) experienced economic hardship (defined as inability to pay for medicine, medical consultation or tests, rent, mortgage, school fees, medical expenses) at one-year after diagnosis," she shared in shedding light on the economic impact of cancer diagnosis on daily lives of Malaysians.

On the coping mechanisms, Dr Yip, who is also Clinical Professor of University Tunku Abdul Rahman (UTAR), said these include using savings set aside for other use (53pc), asking for financial assistance from family and friends (47pc), seeking financial assistance from government/community (31pc), selling assets (4pc) and personal loan (2pc).

Citing two key findings, she pointed out that late cancer stage at diagnosis is associated with higher risk of economic hardship and having some form of health insurance provided protection from economic hardship.

This led the consultant breast surgeon to propose three policies – Since it is cheaper to treat early cancer, public education and early detection programmes should be carried out; Access to prompt treatment for cancer patients will improve the cure rate; and Governments need to improve financial risk protection for cancer patients by channeling public funds to those in need.



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