Budget 2027 starts building a care system. Two things could still undo it.

For years, Malaysia’s answer to an ageing population was cash. A bit more aid each Budget, a bit more coverage. Budget 2027, tabled on 9 October, does something different. It starts putting up the frame of an actual care system: a law, a trained workforce, tax relief for families, faster licensing for care facilities.

I think the direction is right. I also run a licensed nursing home, so I can see two places where this frame could buckle. Who trains the carers. And who pays for years of care.

What actually changed

Look at it against earlier Budgets and the shift is clearer than the headline numbers suggest.

The allowance for people caring for a bedridden family member goes from RM500 to RM600 a month. It hasn’t moved since Budget 2021. Service tax on elderly care drops from 8% to 6% from 1 January 2027, and care fees up to RM96,000 a year are exempt altogether. In July, the Finance Ministry and KPWKM were still studying that exemption. Three months later it’s in the Budget. That’s a ministry that listened.

The Senior Citizens Bill (Rang Undang-undang Warga Emas), already through public consultation, is back in the Budget speech with a clear purpose: to deal with neglect and strengthen care around older people. Licensing for private health facilities moves online through e-CKAPS, with processing time targeted to fall by up to 65%. A care system needs somewhere licensed to care for people, and right now there isn’t much. As of the MOH register dated 17 July 2026, still current when I checked on 13 October, 18 licensed nursing homes with 629 beds serve the whole country, down from 19 homes and 637 beds in February.

Then there’s the workforce money. Last year’s Budget gave RM5 million for care worker training. This year, more than RM40 million goes through HRD Corp to train 8,000 people for elderly care alone.

That’s a different scale. It’s also where my worry starts.

Train 8,000 people to what?

Care workers in Malaysia already come through several doors. There’s the national skills certificate route, the SKM. There are training providers recognised by KPWKM. Now there’s HRD Corp. Each door has its own syllabus, its own assessment, its own idea of what a competent carer looks like.

I’ve written before that the SKM standard for elderly care has no dementia unit at all, in a sector where dementia is so often what ends home care. That gap is one example. The bigger problem is that nobody has to agree.

Put 8,000 new trainees through whichever syllabus each provider happens to run, and in two years we’ll have 8,000 more certificates and the same uneven care. Families won’t be able to tell what a certificate means. Operators won’t either, and will end up retraining people they’ve just hired.

KPWKM has said national care standards will become the reference for training, certification and monitoring. Good. The order matters, though. Syllabus before scale. If HRD Corp cohorts start training before that alignment, we’ve spent RM40 million building the old problem bigger.

Better pay starts with a career path

The second worry is quieter. The minimum wage rises to RM2,000 from June 2027, but SMEs with sales under RM50 million are exempt. That covers almost every care operator in the country. The 8,000 people we’re about to train are heading into a sector the new floor may not reach.

I want carers paid better. But forcing it overnight would backfire. Wages are the biggest cost in care, so a sudden jump lands on families’ bills, the same bills the Government has just taken the service tax off.

Pay that lasts comes from a career, not a decree. Today a carer who wants to earn more usually has to stop caring. The SKM ladder climbs from care work into administration and then management, off the floor and into an office. There’s no recognised way to grow as a carer: to become the person a home relies on for dementia, wound care or the last weeks of life, and to be paid for it.

That’s the direction the national care standard needs to take. If it tells employers, families and carers what each level of skill is worth, pay can rise with competence, and operators can plan for it.

Taiwan shows the cost doesn’t have to fall on operators alone. On a study tour there at the end of September, care leaders told our delegation their long-term care workforce grew from about 20,000 to more than 110,000 under their last ten-year plan. Their new plan pays for retention and rewards residential homes that bring in smart care technology. One home we visited in New Taipei lifted staff retention from 73% in 2022 to almost 90% this year. Its technology had one stated purpose: give carers more time with residents.

No sensor turns a bedridden resident at three in the morning. But technology can take the paperwork and manual checks off that shift, and the time saved is what makes better pay affordable. Budget 2027 already extends accelerated capital allowances on ICT to 2030, and MDEC has RM30 million to help 4,000 SMEs adopt AI. Care should be near the front of that queue.

RM40 million across 8,000 trainees is about RM5,000 each. That buys a course. A career path is what keeps them.

Nobody has answered the five-year question

The Government is plainly thinking about lifetime money now. Automatic EPF membership at 18. Monthly i-Emas payouts from 55 or 60. MediAsas, the new basic medical plan, for hospital bills. Wider tax relief so that caring for parents and grandparents now covers all care expenses, not just medical ones.

Useful, all of it. But none of it pays for years of care.

In July, an MP told Parliament about families paying around RM2,500 a month at a registered elderly care centre. Five years at that rate is RM150,000. Last year, only about one in five EPF members aged 51 to 55 had reached EPF’s basic savings level for their age. Licensed nursing care, with its clinical scope, costs more.

MediAsas will help with the hospital stay. What families can’t plan for is everything after the discharge letter, when care runs for five or eight years. That’s the conversation we need next: some form of long-term care financing, whether insurance, a pooled scheme or something built on EPF. It won’t fit in one Budget. It needs to start in the next one.

What the next twelve months decide

Budget 2027 deserves its credit. The frame is up, and that’s further than we’ve been.

What keeps it standing is two decisions, and neither costs much to start. Build the HRD Corp courses to the national standard from day one. And put long-term care financing on the table before Budget 2028, not after the next crisis.

Cash got Malaysia through the last decade of ageing. It won’t get a family through five years of their mother’s care.

Denis Lim is Managing Director of BIGTREE Medicare & Nursing Home in Melaka and Vice President of AgeCope Melaka. Budget figures are from the Budget 2027 speech text tabled on 9 October 2026. National licensed nursing home figures are from the MOH register of licensed private nursing homes, TARIKH KEMASKINI 17 July 2026 (checked current on 13 October 2026) and 20 February 2026. EPF savings data is from a Finance Ministry parliamentary reply, October 2025.