VARIOUS issues affecting the public healthcare system and its workforce were voiced out and solutions were provided at the town-hall session held with the Health Ministry (MoH) in Putrajaya yesterday. The town hall, of which the Malaysian Medical Association (MMA) was part of the secretariat, was attended by almost 400 doctors working in the public healthcare system.
In the no-holds-barred session, house officers, medical officers (both contract and permanent), specialists, and consultants spoke freely about their issues. We wish to thank Health Minister Dr Zaliha Mustafa and Deputy Health Minister Lukanisman Awang Sauni for agreeing to the town-hall session that was proposed by the MMA when we met with the minister in December last year soon after she took office.
Many of the issues can’t be resolved overnight, however the town hall was a good start. The minister has a willingness to engage with healthcare workers, to listen to and understand their issues, and she has promised that no action will be taken against any doctor bringing up issues. This is important if we are to move forward and towards more meaningful improvements in our healthcare system.
We also appeal once again to both the Finance Ministry (MoF) and Public Service Department (PSD) to give the Health Ministry the support needed as many of the issues are not for the MoH alone to address. Additional funding and creation of posts will be needed to resolve the human resources issues we are faced with. We understand from our meetings with the MoH that the health minister has been in close engagement with both the MoF and PSD.
The issues brought up by the MMA at the town hall were broadly divided into two categories: human resources and facility/infrastructure.
Under human resources, financial matters (long-overdue on-call claims and salary revision), exploitation (bullying, working hours, wage theft, etc) as well as issues affecting contract doctors/junior doctors, subject matter experts, and specialists were brought up. The MMA also highlighted the need for transparency in MoH data.
Under facility and infrastructure, the MMA highlighted the need for proper development and maintenance of both physical and digital infrastructure. Standardisation and proper maintenance must be insisted upon to prevent a collapse of electronic records systems. There is also a need for transparency in facilities assessments. Reports on the fire at Sultanah Aminah Hospital in Johor Baru should be released to the public.
The MMA presented solutions to each of these issues and will be following up with the MoH on its progress.
Human resources
- Financial matters – long-overdue on-call claims and salary revision
- Exploitation (bullying, working hours, wage theft, etc)
- Issues surrounding
- Contract doctors/junior doctors
- Subject matter experts
- Specialists
- Transparency in Health Ministry data
Facility and infrastructure
- Physical infrastructure
- The need to expedite building of new facilities and adequate maintenance for existing ones
- Digital infrastructure
- Standardisation of digital infrastructure
- Proper maintenance to prevent collapse of electronic records systems
- Transparency in facility assessments
- Reports like the fire at Johor Baru’s Sultanah Aminah Hospital should be released to the public
To address these issues, the MMA had proposed the following:
Acute: (no financial implication)
- Release the criteria for contract to permanent doctors (or to adopt the criteria proposed by the MMA) as well as the criteria for JUSA promotions
- Set up an official myHelp and HelpDoc collaboration where complaints from doctors are filtered by the MMA and sent in to the MoH with a compulsory response within 14 working days; this is to combat all forms of exploitation
- Put up detailed data of the number of doctors needed per hospital by position and department AND the current workforce
Intermediate: (some financial implication)
- Automatic promotion of medical officers from UD41 to UD43 after completion of housemanship
- Years of service from first appointment (“lantikan pertama”) be taken into account when it comes to considerations for promotion
- Revision of on-call claims rate to RM25/hour
Long term:
- Formation of a Health Reform Commission headed by the prime minister and consisting of organisations like the MMA to give input into issues surrounding Malaysian healthcare.
The MMA is aware that many issues are not solely under the purview of the MoH. We therefore call on the prime minister to urge the MoF and PSD to give the Health Ministry full support in achieving the above for the sake of Malaysian healthcare. – The Vibes, February 23, 2023
Dr Muruga Raj Rajathurai is president of the Malaysian Medical Association
