Permanent Posts May Motivate Rural Medical Service: Sarawak MP

By CodeBlue | Posted on

Almost half of Sarawak’s rural clinics don’t have a doctor, says Dr Kelvin Yii.

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KUALA LUMPUR, July 24 — Willingness to serve the interiors starved of basic medical care should be a criterion for government health professionals to get permanent posts, Bandar Kuching MP Dr Kelvin Yii said.

He cited statistics from the Sarawak state government that show 45.6 per cent, or 98 out of 215 rural clinics, do not have a doctor, and are only run by medical assistants and nurses.

Many of these clinics also only provide basic medication such as paracetamol, and rely heavily on irregular mobile medical services provided through air and water to the interiors.

As stated by the DAP lawmaker, mobile clinics in Sarawak are set up to cater to people living in rural parts, while the Flying Doctor Service (FDS) is provided by helicopters to indigenous people who live deep in the jungles and cannot be reached by any other means.

However, Dr Yii noted that the FDS only goes to villages once a month at the most and once in three months at the least. The service is dependent on weather conditions. The FDS also only spends three hours a day at a particular place even if it visits every month.

“So, imagine that among these 30 days, for 29 days, they have nothing there,” he said.

A Sarawak state health department official told a conference organised by the Galen Centre for Health and Social Policy in Kuching last December that the FDS is limited to treating only simple and light conditions, and people would still need to get to a hospital somehow or other. FDS also can’t carry out medical evacuations.

“This is the dire need faced by many rural health care facilities, not just in Sarawak, but many places all around the country. People living in the rural areas also have a right to quality care and proper access to health care services and this must be properly addressed,” Dr Yii said in a statement yesterday.

As such, he said willingness to work in district or rural hospitals or clinics should be made part of the government’s consideration for permanent postings for doctors, pharmacists, or dentists.

“This will address both the need in the rural areas, and also the severe lack of specialists especially in Sabah and Sarawak.”

Dr Yii complained about the lack of clear assurance from the government to resolve the problem of contract health workers, based on Health Minister Dr Adham Baba’s written reply to his question in Parliament. Neither did the government clarify the selection criteria for permanent appointments.

Dr Adham told Dr Yii in a written Parliament reply on July 22 that the Ministry of Health (MOH) does not list work in the interiors as a criterion for government doctors, dentists, and pharmacists to be considered for permanent posts in the public sector.

As of March 31 this year, MOH has appointed 35,506 contract officers, comprising 18,838 medical officers, 5,103 pharmacy officers, and 4,130 dental officers.

Dr Adham also added that MOH would prioritise medical officers who passed their membership examination or entrance examination for specialist study in the parallel pathway (training outside local programmes) for permanent positions in the civil service.

“While I welcome the Ministry’s announcement that those that passed the Entrance Exam or ‘Membership Part 1/A’ or parallel specialisation pathways has advantage in application for permanent posting, but what is concerning in that currently, those that are willing to work in district health care clinics/hospitals, especially in the rural areas are not given special consideration for permanent posting,” Dr Yii stated.

He said the scenario will also discourage young medical officers and health care workers from wanting to serve in the rural areas as they were not offered an incentive to do so, despite the dire need of medical practitioners there.

CodeBlue reported Wednesday that west coast peninsular Malaysia had two to 18 times more specialists compared to Sarawak, and between three and 33 times more than Sabah, across the anaesthesiology, surgery, orthopaedic surgery, medicine, paediatrics, and obstetrics and gynaecology departments, based on 2010 data from the Clinical Research Centre.

Dr Yii also reiterated his earlier stand for MOH to be transparent in the selection criteria of medical officers for permanent posts by eliminating favouritism and bias to prevent any sort of discrimination in the selection process.

“Clear criteria should be laid out and explained to these young health care workers so they know what they can do to prepare for what is needed.”

Earlier, Dr Adham pointed out that the Public Service Size Control Policy states that new positions can only be created through trade-offs.

It is to be noted that the Public Service Department has approved the “trade-off” of 10,675 new permanent positions in phases to fill vacancies at new and upgraded health facilities, comprising 997 medical officers, 282 pharmacy officers, and 154 dental officers.

Recently, Dr Adham also said contract medical officers can finance their own specialist study and go abroad as they’re currently not eligible for the Hadiah Latihan Persekutuan scholarship for local training.

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