No more bullying! MoH must make sure policy in effect: doctors

KUALA LUMPUR – The Health Ministry (MoH) needs to imperatively put in place the policies being drawn up to tackle bullying at public health facilities, and make sure they are not just seen on paper, say medical fraternity practitioners.

Malaysian Medical Association (MMA) president Dr Koh Kar Chai said the ministry must ensure that the policies are observed on the ground at every level in order to see meaningful changes in the work environment and culture.

He said that while the recent Healthcare Work Culture Improvement Task Force’s (HWCITF) findings into bullying found that 60% of respondents perceived work culture in the ministry to be positive, 20% surveyed confirmed that bullying exists in government health facilities.

“Now that we know the issue of bullying in the ministry is indeed prevalent and not hearsay, the ministry needs to act by ensuring a comprehensive policy based on the recommendations of the task force to successfully eradicate the problem – once and for all,” Dr Koh said.

Last week, the HWCITF said there was no concrete evidence of workplace bullying being linked to the death of a houseman in Penang, but noted instances of coercion and overwork existed within the ministry’s workforce.

However, the task force pointed out there were other factors that had pressured the deceased throughout his course of work. These included high self and workplace expectations, a challenging environment, and a heavy workload – apart from long shifts.

“Incidences of bullying, burnout, and unhealthy workplace culture do indeed occur in the ministry, but they happen on different levels and are not prevalent in all Health Ministry facilities,” said task force chairman Datuk Siti Hamisah Tapsir.

The task force also made ten recommendations for the ministry to help curb the instances of bullying and raise the workplace standards for staff, especially the junior doctors.

On May 13, Health Minister Khairy Jamaluddin announced the formation of the HWCITF, which was tasked to look into bettering the working culture among Health Ministry staff following the alleged bullying incident in Penang.

The death of the Penang Hospital houseman in April this year reported by The Vibes is believed to be the second involving a junior doctor in the state. Since its formation, the task force has held dozens of group discussion meetings to make recommendations to the Health Ministry.

In December 2020, The Vibes reported that another doctor who had resigned from the same hospital had died suddenly.

The HWCITF also conducted a survey involving a total of 110,411 ministry officials and staff to establish its findings.

Dr Koh said a new code of conduct for ministry employees and a system that includes consistent enforcement and continuous measurement for improvement and progress in this area needs to be developed to transform the work culture. 

He added that the code of conduct must emphasise respect among colleagues as its main pillar.

“In healthcare, respect for people should be an innate quality among all those serving,” he said in a statement.

“It is noted that the study was rather comprehensive, with an attempt to involve personnel in the various services within the ministry. We appreciate that the task force went to great lengths to reach out to the various respondents in different parts of the country.”

Dr Koh also said the data compiled in the survey would have been more robust if there was an even higher number of respondents, and if more healthcare facilities were included. He said the outcome of the study has shown that there are indeed shortcomings that needs urgent attention.

“The ministry has to accept the recommendations brought forth by the task force and work on implementing them.

“A time frame should be given for a review to be done to see the effects of the implementation of such recommendations and for MoH to come up with further recommendations if needed.”

He also said that the HelpDoc platform set up by the MMA in 2017 to report issues of bullying will have an important role in addressing the issue.

Doctors holding back due to fear of superiors

Meanwhile, a senior doctor who declined to be named, said the task force should not be disbanded after completing the report.

Instead, the doctor said that the effort should be continued for years to come to ensure the ministry adopts all the recommended measures.

“The study may have included a sizable sample but it’s important to note that the surveys were mostly carried out on those who are still in service.”

“They (task force) should be looking at those who have left the public service due to bullying to get their input because some respondents (still in service) may deny the existence of bullying due to fear of their superiors.”

The doctor added that housemen, being the most junior officers, were among the most ill-treated in public health facilities, and were prone to be assigned to menial tasks.

“When they (housemen) are berated by seniors in front of patients, the patients will not respect them. There are instances where the housemen are threatened with having their months-long attachments extended simply because the medical officers or surgeons did not like them.” – The Vibes, August 22, 2022