The Academy of Medicine of Malaysia (AMM) welcomes the decision by the Ministry of Health (MOH) to confer permanent posts to 150 contract medical officers (MO) in Sarawak on 5 October 2020. There now remains 4,541 permanent positions approved by the Public Service Department (JPA) for MOH throughout 2020 that have yet to be created.
We urge that these permanent positions are filled instead of creating more contract posts. Contract MOs are currently helping to keep our health system afloat during the pandemic. It is imperative that the government acknowledge their contributions and sacrifices by providing them with job security and the opportunity for career progression, through permanent posts.
We also refer to our statement on 17 July 2020 urging the government to create meaningful training pathways and permanent posts for MOs. We reiterate this call, in anticipation of Budget 2021 that is scheduled to be tabled in Parliament on 6 November 2020.
As a professional society representing specialists in Malaysia, we are concerned about the downstream effects of today’s MO policies on tomorrow’s specialist services. Malaysia is currently facing a shortage of specialists with only 3.9 specialists to 10,000 population (as of 30 June 2020) compared to the OECD (Organisation for Economic Cooperation and Development) average of 14.3 specialists to 10,000 population in 2018.
This deficit is higher in rural areas and eastern states of Malaysia and is expected to increase even further if MOs are unable to continue their postgraduate studies and pursue specialisation due to their contract status.
There must be a systemic shift in the way we conduct specialist training alongside creating permanent MO posts ensure that applicants to postgraduate programmes are suitably accepted and graduate within the stipulated time.
The AMM is prepared to aid in streamlining the postgraduate training process for both trainees and trainers, as we have done with the basic surgical e-training management platform (EMP) launched on 23 August 2020. The EMP improves access to advanced specialist training by recognising and capturing basic training-in-place and workplace-based assessments, i.e. trainees are not required to go designated major training hospitals.
We acknowledge that the issue of contracts versus permanent posts is a broad and complex question within a rapidly changing health care environment. Nonetheless, the simple fact remains that current contract posts do not allow for adequate access to specialist training (either via the parallel pathway or university-based programmes); therefore, Malaysia will face a critical shortage of specialists in years to come.
We are also mindful that the government must act fairly toward all civil servants across all ministries. It is therefore worth noting that permanent posts with EPF (Employees’ Provident Fund) is more cost-effective in the long run compared to contracts which require monthly social security (SOCSO) payments from the government. This must be considered when drafting Budget 2021.
Moving away from the contract system toward permanent posts will open doors for our frontline MOs to further specialise and provide them with job security. The government must act now to ensure there are enough specialists for future Malaysians.
The Academy of Medicine of Malaysia (AMM), embracing 11 Colleges and 15 Chapters, is a registered body representing medical specialists in Malaysia.
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