Excellencies, Ladies, Gentlemen,
National and International Distinguished Guests,
Today, it is my great pleasure to attend the closing of the “37th Health Conference”, which is auspiciously held here at the moment. This annual conference is important for us all, especially the management and every official of the Ministry of Health, relevant organizations including development partners to gather together to review the progress, assess the achievement made in 2015 and identify challenges facing in health sectors, so that we further make joint efforts to tackle those issues for the benefit of Cambodian people and our society.
According to the report of His Excellency Mam Bunheng, Minister of the Ministry of Health, I have noted that in 2015 significant progresses have been made in this sector by extending broader coverage of health services, strengthening public health intervention to deal with cross-cutting issues, improving the quality of health service delivery, expanding the nation-wide coverage of Health Equity Fund (HEF) for the poor, building capacity of human resource and strengthening management, expanding physical infrastructure, and strengthening law enforcement on the Management of Private Health Service, etc.
In this regards, I highly appreciate the great efforts made by every level of health officials at all levels to fulfill their duties and responsibilities in order to overcome the difficulties in 2015, so that achieve Cambodia’s Millennium Development Goals (CMDGs) relating to health, eventually contributing to the better enhancement of general conditions and welfare of Cambodian people.
In fact, these efforts have contributed to achieving the four CMDGs target in reducing child mortality, improving maternal health, combating HIV/AIDS, malaria and other diseases, and forging global partnership for development before the deadline.
Overall, Cambodia has made remarkable progress in socio-economic development by ensuring macro-economic stability and sustaining long-term high economic growth, together with political stability, full peace nationwide, and favorable environment of regional and global integration.
At the same time, health status of Cambodian people has been improved significantly thanks to rapid and sound economic and social development underpinned by the expansion of health infrastructures, more development of human resource and expansion of social health protection program, especially Health Equity Funds for the poor, expansion of physical infrastructures, public transportation, housing, water supply, hygiene, education and so on. It’s also important to note that strong economic growth and fruitful redistribution of equitable growth to every citizen enable us to lift millions of people out of poverty.
However, we are fully aware that there are more difficult tasks that we need to undertake to further develop Cambodia’s health sector in order to increase the coverage, improve the operational quality and, particularly, transform it into even more acute political tools in poverty reduction and in ensuring the welfare of the people.
Moreover, our demography vividly shows the need to re-orient our focus on strategies of health sector, education sector and economic sector, as more and more people live in cities and towns with higher standards of living. Now, non-communicable diseases have become the number one health concern, especially the rise of chronic non-communicable diseases such as heart diseases, neurological diseases, cancers and diabetes.
Therefore, the health system has to be strengthened in order to make its more responsive and accountable through reviewing and increasing institutional capacity by any means in order to be ready to cope with the change in pattern of all these illnesses.
In the context of fast development, health sector still plays a very important role in ensuring the wellbeing and the sustainability of the economic growth. In this sense, we have to set clear targets to develop health sector, enabling us to grasp opportunities for sustaining strong growth of Cambodia’s economy, especially through expanding broader health coverage, strengthening the quality and ensuring the affordable price of health services. These are all concerns that need to be tackled. In this regard, I wish to share my few views that are the main focus for the implementation as follows:
First, good health status of Cambodia people will provide them ability and opportunities to better improve the standards of living, so that they are able to contribute to sustainable socio-economic development. In this regard, the leadership and officials of the Ministry of Health as well as managerial officers and operational staffs in all health units in both national and sub-national levels must pay higher attention to better improving the quality of public health with reliability, safety, efficiency, and equity.
Second, must sharpen the key roles of health system by ensuring that there is sufficient health services in order to respond to demand for health care of our people, and those health services have to be ready when people have health problems. As for health service quality provided in both public and private sector, it has to reach the acceptable and preferable standard. In this sense, strengthening of health service system has to be a core function of health system and core duties of all health officials and staffs.
Third, as geographical condition is no longer concerns for people to access to local health facilities for basic health care, there is a need to reduce financial barrier or reduce the burden of out-of-pocket expenditure in health service. Rather, the whole health system will not contribute to enhancing equitable access to health care among the people, especially poor people, vulnerable groups and low-income families. Based on this principle, all hospitals have to ensure that all Cambodian people, who come to hospital to obtain health service, are able to get health care wherever they live, despite they can or cannot afford to pay for health service.
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Most Medical Staff Are Ethical and Professional
This is a very important point for our medical officials everywhere to continue to implement. People’s complain about behavior of medical officials should be of particular interest that we should not overlook. I also raised this issue at the inauguration of the Japanese-assisted referral hospital in the province of Sihanouk. Although a large number of medical officials are highly devoted and I compared them to the armed forces that never spend their holiday time with families. They took turn to be on duty at hospitals. It is a sacrifice. However, we must admit shortcomings of some medical staff with regard to their behavior toward patients, on the one hand, and mentality of money first, on the other. This is a relevant point that we must take actions together to guarantee that our medical officials serve our people with similarly good health, irrespective of wealth status. I hope we will avert this situation of one dead fish spoil the rest in the same basket. I am calling on medical staff/officials, who misbehaved to change their working attitude to serve common objective of serving people.
Medical Specialists to Become RGC civil servants
Not long ago, Minister of Health, HE Mam Bun Heng, raised this issue of medical specialists, on whose situation we had not been flexible. Normally, medical specialists spent more time studying than medical general practitioners. However, when they finished their studies at an older age, they are no longer eligible to become RGC civil servants. The law has set an age variation between 30 and 35 for medical specialists. I already approved some already. Please find out how many medical specialists are there that are not yet in the RGC civil servants. I am asking the Ministries of Health and Public Functions to review this matter and incorporate them into the RGC civil servants. We need them and because we do not have enough medical specialists that we are sending patients for treatments abroad. It is bizarre to have medical specialists but they are not in the state lists. Now I am declaring them automatically.
Retired Medical Specialists to Hold Political Functions
We also have to look into an issue that medical specialists will retire at the age of 60 years old. I have assigned some of them to political functions so that they have chance to continue their practices. The current statute for Royal Government officials allows them to work until 60 years old. We can assign them to political functions after retirements and send them to work in certain hospitals. For new medical specialists we have allowed them to get on to RGC civil servants, not at 30 years like before but at 35 years old. We also declare accepting all medical specialists. Please check them all out and we may put them all on the April payroll right away.
However, the biggest issue here is behavior of medical staff/officials. I may correct what I said earlier. It was not 99%. I checked again. They said 90% of medical staffs are not good. If 90% of them are not good, how could Cambodia survive? In a family of ten children, if nine of them are bad, how could the family survive? I disagree. However, I agree that there have been shortcomings and misbehaviors of medical staffs as persons and not health sector as a whole. We need to change our attitudes. The worst thing is we do not have medicines or medical equipments. That we have them now, what we need to do is to change our attitudes. We must try to reduce bad words in our dialogue with patients. It should not be difficult to do it.
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Fourth, Health Equity Fund (HEF) is the only financial risk-pooling mechanism that shows about the efficiency of public investment in promoting the poor’s health, providing financial support and reducing the out-of-pocket expenditure health care. In this context, it is needed to explore possibility to expand HEF for the poor and vulnerable groups, and initiate the development of social health insurance system with sustainability for people based on economic condition, legal basis, and National Policy on Social Protection.
Fifth, Ministry of Health must thoroughly review, monitor and reassess all key policies relating health, laying out in Rectangular Strategy- Phase III, aimed to further enhance the quality of health service deliveries, increase trust of Cambodian people in public health care through enhancing good governance, strengthening institutional capability in health sector at all levels, increase conceptual knowledge and personal morality of doctors, civil servants, health officials and users of health services and enhance partnership with private sector to provide better health care.
As mentioned above, I believe Excellencies, Ladies and Gentlemen, every level of the officials of the ministry of health, relevant ministries-institutions, sub-national administration will continue implementing my recommendations with high responsibility and effectiveness. New direction set in the conference, together with proposed recommendation will further contribute to sustainable and inclusive national socio-economic development.
Finally, along with the closing of the 37th Health Conference, I wish Excellencies, Ladies and Gentlemen, and all participants the four gems of Buddhist blessing, Longevity, Nobility, Health, and Strength.