SPEECH BY YB DATO DR. CHUA SOI LEK, MINISTER OF HEALTH MALAYSIA,
AT THE ANNUAL SCIENTIFIC MEETING 2005 OF THE NATIONAL HEART
ASSOCIATION, HOTEL HILTON, KUALA LUMPUR, 15 APRIL 2005, 9.00 AM
Ladies and Gentlemen.
Good morning to all of you.
1.
Thank you for inviting me to your Annual Scientific Meeting today. I am
pleased to note the good response and interest shown by participants from the
various parts of the country in this meeting, and I bid all of you a very warm
welcome.
2.
All of us are well aware of the massive impact of cardiovascular diseases on
the health and well-being of our people. Since 1970, cardiovascular diseases have
been the number one killer in Malaysia. In 2002, they accounted for 118,262
admissions into the Ministry of Health hospitals, or 7.2% of total admissions; but
killed 8,384 of them, accounting for 24.5% of all deaths in our hospitals. Coronary
heart disease in particular had increased from 27% of total cardiovascular deaths in
1985 to 30.5% in 2002. Thus, heart disease is an important cause of premature
deaths in Malaysia, resulting in significant social and economic implications for the
country.
3.
Consequently, cardiovascular diseases and their treatment continue to
consume a large portion of our healthcare budget, and more funds will be channeled
under the 9th Malaysia Plan to address the various risk factors in the development of
cardiovascular diseases, such as diabetes, smoking, hypertension and high blood
cholesterol, through health education and other health promotional activities. We
need to teach our people to take better care of their hearts and their health.
4.
Modern
day
treatment
of
cardiovascular
diseases
has
advanced
tremendously with both drug therapies as well as device therapies. In fact quite a
number of the new drugs such as anti-platelet and anti-heart failure medications not
only provide symptomatic relief but also prolong if not save lives. Almost all the new
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drugs are available in our Ministry of Health (MOH) hospitals, even though they may
be categorised as class A drugs for prescription by specialists only under specified
conditions. Indeed, many of the latest device therapies such as bi-ventricular pacing,
automatic implant defibrillators and drug eluting stents were even available in
Malaysia ahead of USA, and they are readily adapted for use by our cardiologists for
the benefit of fellow Malaysians.
5.
As cardiovascular diseases affect not only grown ups but also infants as well,
I would like to say “SYABAS” to our Malaysian paediatric cadiologists, especially
those at the National Heart Institute (IJN), who are among the most experienced and
advanced interventionists in the region, as reflected by their volume and types of
interventions, their publications, and invitations from various bodies in the region in
acknowledgement of their expertise. As some of the problems of congenital heart
diseases start at the fetal stage in the womb, I would encourage them to pursue the
final frontier of paediatric cardiology by acquiring the necessary skills and expertise
to be leaders in the field of fetal intervention for congenital heart diseases, where the
babies are treated even before they are born.
Ladies and Gentlemen,
6.
The Ministry of Health has over the past 10 years developed and provided a
comprehensive cardiac program which is not only readily accessible but affordable to
our people. Basic non-invasive cardiac tests such as ECG (electrocardiogram),
stress ECG, Holter and echocardiogram are available in all the state hospitals and
bigger district hospitals of the Ministry of Health. We have also set up four cardiac
centres for invasive cardiac tests and treatment at the Penang Hospital, Sultanah
Aminah Johore Baru Hospital, Sarawak General Hospital and the soon to be
operational Serdang Hospital. Some of these cardiac centres are equipped with
state-of-the-art facilities such as 64-slice CT scanner, cardiac MRI and integrated
cardiac information management system at the Sarawak General Hospital and the
“paperless, total hospital information system” for Serdang Hospital.
7.
Apart from the equipment, the Ministry is also spending a substantial amount
of its allocations on cardiovascular drugs. The Ministry’s total expenditure on drugs
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has increased from RM228 million in 1996 to RM751 million in 2003, and
cardiovascular drugs account for a major portion of this expenditure. For instance, in
2003, cardiovascular drugs top the list of drugs that we acquired from Pharmaniaga,
our major supplier, accounting for RM70.2 million or 18.5% of the total amount
expended with Pharmaniaga.
8.
I understand that just the use of statins in the primary prevention of
atherosclerosis alone costs the Ministry up to RM 10 million annually. At our National
Heart Institute (IJN), subsidy payments made by the government for government
patients and the private poor rose from RM 31.3 million in the first fiscal year ( Sept
1992-Aug 1993 ) to RM 144.5 million in the last fiscal year, Sept 2003-Aug 2004.
These figures give just a fractional glimpse of the financial burden imposed on the
Government by heart disease and other cardiovascular diseases.
9.
We are also pleased to see the rapid development of cardiac facilities in the
private health care sector. Today, I understand that besides the 8 government
centers (4 in the Ministry, 3 in the universities and IJN), there are 40 plus hospitals
and clinics in the private sector that offer cardiology and cardiothoracic services.
With good facilities and excellent standards of service, we should be able to compete
for a share of the health tourism dollar that has been dominated by the private
sectors in Singapore and more recently Thailand. In fact, a study commissioned by
our Government on health tourism in 2002 indicated that cardiology topped the list of
tertiary health services most in demand among our health tourists, accounting for
27% of total foreign patient revenue, followed by general surgery (13%) and
cardiothoracic surgery (13%).
Ladies and gentlemen,
10.
Every year there are new breakthroughs in drugs and devices for the
treatment of cardiovascular diseases, reflecting the amount of resources being
channelled into the number 1 killer worldwide. These drugs and devices will get
better and better but not necessary cheaper. Therefore, while the Ministry will
continue to acquire the newest technologies and treatment options for our rakyat, it
will be done only after appropriate health economic considerations.
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11.
There are many clinical trials going on worldwide on the management of
cardiovascular diseases, in line with the practice of evidence-based medicine; and I
am very pleased to note that Malaysian cardiac centres are being increasingly
invited to participate in these multi-centre international cardiovascular trials. There
can be no better recognition of the standards of practice and the caliber of our
specialists than being invited to collaborate in such studies.
12.
Given the rapid technological advancements going on in the field of
cardiology, there is a pressing need for the medical profession in the related
disciplines to participate in continuous professional development to acquire newer
skills. The lines separating the traditional domains of the cardiologist, cardio-thoracic
surgeon, vascular surgeon, radiologist and other medical specialists continue to blur
and each should not feel threatened or resist advancement because of vested
interests. The ultimate consideration should the patient’s safety and well-being.
13.
There are so many issues that we need to address in order for us to get
cardiovascular diseases under optimal control. In this respect we at the Ministry of
Health will continue to look forward to professional bodies like the National Heart
Association to play their respective roles in helping us achieve our hope of a “healthy
nation with a healthy heart “.
14.
On that note, ladies and gentlemen, I have pleasure in declaring open your
Annual Scientific Meeting today. Thank you.
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