KUALA LUMPUR, June 16 — Some 92 per cent of 9,320 Ministry of Health (MOH) staff disagree with a new shift system at public health clinics, according to a survey by the Malaysian Medical Association (MMA).
Government health care workers reportedly said MOH should first resolve the issues with staff shortage and infrastructure insufficiency before enforcing a shift system — which MMA said had been scheduled for implementation at Klinik Kesihatan from yesterday in phases — as these clinics are understaffed and the current staff are overworked.
As many as 84 per cent of the surveyed health care workers (HCW) said the shift system will increase the current workload, while 89 per cent of them said that such a change will increase work stress and will subsequently cause a burnout.
In another poll conducted by Public Health Malaysia, 63 per cent of the surveyed HCW voted against the implementation of the shift system at government clinics, said MMA.
“There is an acute shortage of doctors, nurses and other support staff at health care facilities in the country including our government clinics,” MMA president Dr N. Ganabaskaran said in a press statement today.
“The shift system will only work provided the government addresses the staffing issues and necessary infrastructural support, Under the new two shift system, there will be less health care workers working per shift due to the shortages.
“Our government clinics are overcrowded. There are peak times at the clinics where the shortage in staff will stress the system. This can greatly affect the quality of care,” he added.
Health director-general Dr Noor Hisham Abdullah told a press conference yesterday that a shift system would cut congestion at Klinik Kesihatan, but stressed that MOH positions must be added first before it can be implemented.
“Maybe we’ll do a trial run at a few Klinik Kesihatan first. And if we can increase positions, equipment, and other needs at the clinic, then perhaps we can implement a dual-shift system,” he said.
“If we use the current human resources available, many of them might disagree because they will have to work two shifts from morning to night,” he added. “It’s a good suggestion, but implementation issues must be prioritised and we’ll discuss it with the relevant agencies.”
MMA further explained today that in addition to basic diagnostic and therapeutic services, HCW in the government clinics are also involved in Covid-19 screening and contact tracing for Covid-19 cases.
“They are also involved in domiciliary care and community outreach programmes.
“The staff are well trained in these aspects to ensure proper care is being given to the ‘rakyat‘. By implementing the shift system, it will be impossible to continue the current care being provided,” Dr Ganabaskaran said.
He further emphasised that a “proper study” should be conducted with the appropriate stakeholders before the implementation of the new shift system.
“Besides doctors and nurses, adequate pharmacists, lab technologists and even ambulance drivers need to be looked into as some cases will need to be referred to hospitals,” he said.
“The Family Doctor Concept is something even the Ministry of Health has supported,” Dr Ganabaskaran added, pointing out that the shortage of doctors in government clinics will affect the Family Doctor Concept as doctors who regularly see a particular patient may not be assigned their usual shift under the new shift system.
“(The MOH) understands (the Family Doctor Concept’s) effectiveness in the prevention, early detection and treatment of chronic illnesses as family doctors will be very familiar with their patient’s medical history from the regular follow-ups and good relationship they have developed with their patients.
“We welcome any enhancement to our health care system but all these dynamics need to be taken into consideration,” the MMA president said.
“On the other hand, we should educate and empower the public to adhere to staggered appointments to reduce congestion in clinics, which we have failed to do from not resorting to a shift system.”
MMA urged MOH to conduct a more detailed study before implementing the shift system.
All MOH clinics in the country are currently open from 8am to 5pm (Mondays to Fridays). The shift system, to address the problem of overcrowding, will extend these clinics’ hours to 9:30pm. The two shifts for staff are from 8am to 5pm and 12:30pm to 9:30pm. MOH staff were notified of the shift system only recently.
These Klinik Kesihatan operate as a one-stop-centre providing outpatient care, treatment for chronic diseases, maternal and child health care, rehabilitation services, dietitian consultation services, nutritional counseling, physiotherapy services, occupational therapy services, emergency cases, pre-pregnancy services, health screening services, methadone services, TB screening and treatment, community psychiatric services, promotion and prevention campaigns, and even quit-smoking programmes, among many others.