Mass media in Myanmar are not free. But can you imagine a statement like this in a newspaper in Vietnam?

"most complaints received by the department reflected patient dissatisfaction with the way doctors and nurses treated them"

The tensions involved in developing a capital/operating health budget are well presented here.

Jamie

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Ministry of Health signals shift in spending priorities
Htoo Thant and Shwe Yee Saw Myint
Myanmar Times
Thursday 7 May 2015

In what some might see as an attempt to present a more patient-friendly face, the Ministry of Health will be shifting its focus in the coming year toward hiring extra staff and dispensing more medicine. A still sizeable, but proportionally smaller, chunk of this year’s budget will go to improving buildings – which critics say the ministry has over-prioritised in recent years.

At a May 4 press conference called to announce the changes, Dr Myint Han, temporary director general of the Department of Medical Care, said K65 billion had been earmarked to provide medicines in public hospitals for the 2015-16 financial year, which began on April 1. According to ministry figures released on May 1, the total expenditure of the department this year will amount to K503.753 billion, of which K296.8 billion will be for capital spending.

Last year the decision was taken to divide the Department of Health into two sections, the departments of public health and medical care. The split formally occurred on April 1.

Total health spending last year was K624.390 billion, rising this year to K691 billion, an increase of some K67 billion, or 10.6 percent.

The increased budget reflects the growth in the number of patients in public hospitals, said Dr Myint Han.

“In Yangon General Hospital, the number of patients has risen almost threefold, from 25,740 in 2008 to 62,478 in 2014,” he said, adding that because of overcrowding some patients had to be accommodated in classrooms.

He said Yangon General would be upgraded from a 1500-bed to a 2500-bed hospital, and that new equipment had been installed.

Throughout the country, the number of hospitals has risen from 897 in 2010-11 to 1029, though the increasing number of patients still outstrips the facilities available.

But facilities and medical supplies are not the only areas where the ministry sees room for improvement. Medical staff could also work on their bedside manner, Dr Myint Han admitted, adding that most complaints received by the department reflected patient dissatisfaction with the way doctors and nurses treated them. “I accept that health workers have to do better to take into account patients’ expectations, and remember that they are ill,” he said, adding that the increase in free medicines and medical procedures had attracted more patients.

The newly appointed permanent secretary to the ministry, Dr Thet Khine Win, agreed that service standards needed to improve.

“Partly because the number of patients exceeds staff capacity, we must admit we have weaknesses in social interactions [between doctors and nurses and patients]. We will give special training to hospital staff to improve this. But patients will have to be patient too,” he said.

U Sein Win, a spokesperson for the health minister’s office, told The Myanmar Times that the ministry was going to use the budget increase to hire more than 100,000 extra staff this year and to raise salaries, as well as buy the extra medical supplies.

Dr Nwe Ni Ohn, a former director of the ministry’s Health Planning Department who retired earlier this year, said that while the government had devoted funds to providing free medicines and updating old equipment early in its term, last year most government funding had been used to renovate hospitals and rural health centres. She acknowledged that this shift had attracted some criticism.

One of these critics is U Myat Nyarna Soe, a trained medical doctor who represents Yangon Region in the Amyotha Hluttaw, or upper house.

He told The Myanmar Times last year that much of the additional funding allocated to the ministry under the new government was being “wasted” because of the ministry’s mismanagement. While the ministry has eight departments, including health planning, medical science, medical research, traditional medicine, and the Food and Drug Administration, 88.1pc of the 2014-15 budget went to the Department of Health, according to government figures.

“This department spends a lot of money on new buildings and renovating old ones,” he said. “But we need to invest in more than just buildings. For example, we need to improve provision of medicine, health services and research. I cannot understand why the government focuses so much on buildings.”

The successors to the Department of Health, the medical care and public health departments, will continue to receive an out-sized piece of the funding pie this year: Medical care will get 66.9pc of the total, while public health will receive 25pc.

Dr Tin Aye, president of the General Practitioners’ Society, said the government should spend more funding on prevention – through the Department of Public Health – in order to reduce treatment costs down the track.

“If the government invests a lot of money in medical treatment, it will never be able to improve the healthcare system. Other countries focus more public funding on prevention,” he said. “But I think the government wants to spend most of its money on medical treatment, including new buildings, because they are tangible things for the public to see.”

Dr Win Oo, a spokesperson for the new medical care department, said that while more would be spent on other areas, the department would still devote much of its budget to capital expenditure to improve public hospitals.

Translation by Thiri Min Htun

http://www.mmtimes.com/index.php/national-news/14326-ministry-of-health-signals-shift-in-spending-priorities.html