In response to the recent formation of the Malaysian Cabinet, Malaysian Medics International (MMI) wishes to express our support and heartfelt gratitude to the newly appointed health minister, Dr Zaliha Mustafa, for pledging to address pressing health care issues involving the placement of graduate doctors and matters pertaining to medical infrastructure and services.
While we fervently anticipate the Ministry of Health’s (MOH) upcoming plans, we wish to highlight several pertinent issues that require further consideration as we strive for a more equitable and responsive health care system.
MMI acknowledges and supports the health-positive initiatives implemented by the previous minister, including an increase in budgetary allocation to the MOH, the formation of a Healthcare Work Culture Improvement Task Force (HWCITF), and the increase in permanent positions to contract doctors.
In the interim, we humbly call on the MOH, other relevant stakeholders, and distinguished policymakers to consider the following:
Improve The Availability Of Scholarships For Master’s And Parallel Pathway Programme To Contract Doctors
MMI welcomes the awarding of Program Latihan Kepakaran (PLK) with MOH scholarships for 216 contract officers (medical and dental) to undergo medical specialisation, dental specialisation, and parallel pathway programmes for the 2023/24 academic session.
While we recognise that contract officers make up about 16 per cent of the 1,347 scholarship award recipients in 2022, we call upon the MOH to further break down the number of contract officers receiving scholarship awards under each of the three categories mentioned above, such as the number of contract medical officers receiving PLK for medical specialisation and parallel pathway respectively and vice versa for contract dental officers.
This will ensure better transparency and understanding of the awarding of such scholarship awards for health care workers and the general public.
MMI also acknowledges that the number of contract officers receiving PLK with an MOH scholarship (216) is a far cry from the “up to 3,000” positions as allocated under Budget 2022.
First, we would like to seek the MOH’s clarification regarding this matter and its plan to mitigate this matter. Second, while we sincerely appreciate the MOH’s effort in awarding scholarship awards for contract health care officers for the first time since the contract is implemented, we urge the MoH to apply for higher allocation under the new Budget 2023 (post-GE 15) to continue awarding more scholarship awards to contract medical officers.
We hope that this will address the issue of insufficient medical specialists in Malaysia, i.e., 3.9 specialists per 10,000 population (as of June 20, 2020) as compared to 14.3 specialists per 10,000 population as per the OECD (Organisation for Economic Cooperation and Development) average in 2018.
Evaluate And Address Shortages Of Medical Specialists In The Public Health Sector
MMI recommends the MOH and policymakers to re-evaluate the retention strategies of trained physicians and specialists. This includes, but is not limited to, assessing the motivations behind Malaysian medical students’ decision to study and subsequently work abroad and the preferences of trained medical specialists to work in the private health care sector.
As quoted by former health minister Khairy Jamaluddin, 28,000 medical specialists are needed by 2030 as Malaysia heads towards becoming an ageing nation. In addition, we urge that the health sector will be provided with a comprehensive allocation in Budget 2023 to support the notion of increasing permanent employees.
Improve The Quality Of The National Postgraduate Training Programme Curriculum
MMI welcomes the notion of improving the curriculum of the National Postgraduate Training Programme to enhance the quality of medical professionals as outlined in the 12th Malaysian Plan. The incorporation of emerging technology in the health sector will simultaneously provide a robust training environment for postgraduates and catapult the accessibility of health care services to the rakyat.6
We encourage the MOH to explore the possibilities of leasing medical equipment to facilitate procurement and the biomedical engineering sector to conduct research and development on new medical technologies for our local hospitals.
In addition, MMI also supports the former health minister’s plan to strengthen the National Expertise Studies Programme. This includes establishing a professional qualification examination to address issues of graduate quality and competence, as well as establishing technical committees for the Bachelor of Medicine and Bachelor of Surgery, as well as Bachelor of Dental Surgery, to maximise offering capacity, control the quality of graduates from these programmes, evaluation and updating of the Second Schedule of the Medical Act 1971.
Review Existing Guidelines And Policies On Managing Junior Doctors With Mental Health Conditions
To address the plight of junior doctors, MMI urges that the government reappraise existing training and scoring evaluations. Stringent time frames for junior doctors to complete their training, particularly housemen, is one of the many reasons that deter housemen from actively seeking professional help catering to their mental health needs, thereby, potentially jeopardising quality patient care.
In the best interest of all parties, we recommend that the MOH implement policies that adequately address and support junior doctors with mental health conditions which include, but are not limited to, the permission of short-term mental health leaves, eligibility to hold non-clinical roles during the housemanship training period, and the establishment of mental health support services to provide a seamless transition into one’s clinical duties.
MMI also acknowledges the allocation of budget for the MOH in Budget 2022, which provided for additional personal income tax exemptions on medical expenses incurred when consulting or receiving treatment from psychiatrists, clinical psychologists, and registered counsellors.
Improve The Welfare Of Contract Doctors Undergoing Housemanship Training Or Compulsory Service Period
Unlike their peers who have permanent positions in the MOH, contract doctors are not entitled to apply for unrecorded leave and special children’s sick leave. Currently, the categories of unrecorded leave for government employees include three days for the deaths of family members, including parents-in-law, 90 days of maternity leave, and seven days of paternity leave.
We applaud former Prime Minister Muhyiddin Yassin for announcing that the cabinet had agreed to upgrading the benefits of contract doctors, which included special medical duty leave, TB leave, and allowance to visit their place of origin.
However, we urge the MOH to consider additional leave benefits, namely hazard leave, cancer leave, and special children’s sick leave to be granted to contract doctors.
Furthermore, MMI implores the MOH to enforce the mandatory weekly working-hour regulation for junior doctors to safeguard their wellbeing. While a MoH circular in 2019 detailed that the weekly working hours of junior doctors were to be reduced to 60 to 62 hours, this has not been implemented by the majority of the hospitals, with junior doctors reporting working more than the stipulated hours with consistently long overtime stretches.
Working under such strenuous circumstances with high expectations to perform effectively will inevitably result in dire consequences for both medical professionals and the rakyat. Therefore, we humbly plead that equitable treatment is provided to every doctor as they are unanimously carrying out the same duty of providing care for the rakyat.
In conclusion, MMI appreciates the effort that the government has demonstrated in mitigating various health care issues. As we step into a new era, we urge the government to consider our requests alongside future plans to safeguard the sustainability of the future of our health care system.
Malaysian Medics International (MMI) is an international medical student-led organisation that aims to connect, educate, and cultivate, advocating for inclusivity and diversity, reform in medical education, and the welfare of junior doctors and medical students.
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