Doctors’ Strike A Trade Dispute, Not Under MMC: Ex-MMA Head

Senior physician Dr Milton Lum says proving that a strike causes harm to patients will not be easy, as the onus is on the employer to look for a replacement doctor to care for the patient.

KUALA LUMPUR, July 13 — Disagreements over the contract scheme for government doctors should be brought to the Labour Department instead of the Malaysian Medical Council (MMC), said former Malaysian Medical Association (MMA) president Dr Milton Lum.

Senior physician Dr Lum told CodeBlue that it is “simplistic” to assume that the MMC could readily take disciplinary action against individual contract doctors and strike them off the register on allegations that a doctors’ strike resulted in harm to the patients.

“The person or organisation that complains (against an individual doctor) has to prove that a patient suffered because the doctor didn’t come to work. But if the doctor has given a reason for not coming to work that day, then he is not guilty of anything. How are you to blame the person?

“Proving that a particular doctor didn’t come to work for whatever reason and a patient was harmed, as a result, is not going to be easy. The onus is ultimately on the employer to look for another doctor to care for the patient,” Dr Lum argued.

An independent group of disgruntled government doctors organising the #HartalDoktorKontrak movement previously said it expects thousands of contract medical officers to join a day-long walkout on July 26 outside their respective health care facilities in each state.

The anonymous group, however, said that medical officers assigned to Covid-19 hospitals will not be mobilised on the day of the strike, unless precise arrangements can be made amid a surging epidemic that is particularly brutal in the Klang Valley.

“We understand that the pandemic is a national emergency. The goal of the strike is to get what we have demanded but at the same time, we do not want to jeopardise our patients’ health — that is the last thing we want to do,” the group’s spokesperson Dr Mustapha Kamal A Aziz said.

Dr Lum highlighted that complaints made against doctors must be filed individually, not against a group. He said rather than resorting to the MMC, the matter should be brought to the Labour Department instead, as Dr Lum viewed the affair personally as an employer-employee conflict between the Ministry of Health (MOH) as employer and their contract doctors.

“Looking at this hartal, based on what has been reported, (I find that) this is a matter between employer and employee. It has nothing to do with professional conduct, and the MMC’s job is to look at professional conduct. It has no reason to look at an employer-employee relationship,” he told CodeBlue.

“Some employers have tried to complain about their doctors to the MMC, but they have not succeeded. This issue is between the government and junior doctors over contracts. What has this got to do with professional conduct? It should be settled with the Labour Department, not MMC.”

The MMA, which is an association of doctors but not a workers’ union, has echoed Health Minister Dr Adham Baba’s recent warning that medical doctors would risk deregistration by going on strike.

“MMA and Schomos maintain our stand that we do not condone a strike but we empathise with them and remain committed to protecting the welfare of doctors and the medical profession.

“We will continue to push our demands through constant engagement through the official channels. From our last meeting with the MOH, we were told that the matter will be resolved at the next Cabinet meeting,” Schomos chairperson Dr Vijay Ganasan said yesterday.

Dr Adham previously said he would submit his plan on addressing contract doctors’ welfare and career progression to the Cabinet on Wednesday.

The MMC was established under the Medical Act 1971 as the regulatory body of the medical profession to oversee the registration of medical practitioners across the public and private sectors in the country. Health director-general Dr Noor Hisham Abdullah, who also heads MOH that acts as a health care provider, is currently president of the MMC.

Section 29(2) of the Medical Act stipulates that the MMC may take disciplinary action over registered individuals who have been “convicted in Malaysia or elsewhere of any offence punishable with imprisonment” or “guilty of infamous conduct in any professional respect”. Disciplinary punishments include striking offenders off the register, suspension from the register, and reprimands.

Meanwhile, the MMC’s Code of Professional Conduct 2019 states that the council may institute disciplinary proceedings when a practitioner appears seriously to have disregarded or neglected his professional duties to his or her patients.

This includes:

  • conscientious assessment of the history, symptoms and signs of a patient’s condition;
  • sufficiently thorough professional attention, examination and where necessary, diagnostic investigation;
  • competent and considerate professional management;
  • appropriate and prompt action upon evidence suggesting the existence of a condition requiring urgent medical intervention; and
  • readiness, where the circumstances so warrant, to consult, or refer the patient to appropriate professional colleagues

Neither the Medical Act nor the Code of Conduct, however, makes mention of disciplinary action against doctors who do not come in for work, or more specifically, for participating in a strike.

Organisers of the Hartal movement said it would push ahead with plans for a strike if requests are unmet despite the government’s latest warning about potential deregistration by the MMC.

Dr Mustapha Kamal maintained that a strike is “inevitable” until its demand for permanent positions for the remaining 22,288 contract doctors is fulfilled.

“I believe whatever the circumstance is, we will always have to refer to Article 10 of the Federal Constitution. Other than that, it is for the courtroom to decide (if the warning is an abuse of MMC as the regulator of medical practice).

“We have given ample time, as well as room for discussion and negotiation. As long as the demands are not met, the strike will always be on the table,” Dr Mustapha Kamal told CodeBlue.

Yesterday, Hartal claimed in a Facebook post that 300 contract medical officers, specifically the May 2017 cohort, were offered permanent roles effective from July 15. The positions entail placements in Sabah and Sarawak, with an allocation of Grade UD43.

The latest move is seen as at odds with the government’s previous proposition for contract doctors in the December 2016 cohort, which offered a one-year contract extension to work at Covid-19 vaccination centres (PPV) and Covid-19 facilities.

The anonymous group also asked why the latest offer amounted to postings in Sabah and Sarawak when urgent manpower is needed in the Klang Valley. The #HartalDoktorKontrak movement also claimed that the positions were offered to those who had left service.

“Is the system not updated? Or is there even a system to this?” they asked.

Dr Mustapha Kamal said the group remains open to discussion. However, only the Public Services Commission (SPA) has responded to their memorandum sent via email on June 30. Other recipients included Dr Adham and Dr Noor Hisham.

“We are happy to talk and negotiate,” he said.

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