KUALA LUMPUR, Feb 17 – Ipoh Timor MP Howard Lee Chuan How has advised government health care workers inclined towards industrial action to use the threat of a strike to get reforms.
The government backbencher from the DAP said he was told by some government doctors, who previously participated in a walkout, that their protest then had no impact because it was not disruptive.
Hence, why some doctors from the public health service are now planning to go on strike without advance warning to force a “true crisis”, Lee said.
“A strike to me, as a frequent participant of demonstrations, is a tool for leverage to pressure the authorities to bring about change,” Lee told Malaysia Gazette in an interview here yesterday.
“It’s like – ‘I give you two weeks and in two weeks, if you don’t do a, b, c, d, e, f, I will go on strike’. So this is a strike planned well in advance to avoid harming patients, so that patients don’t die and patients don’t get sicker. It’s only disruptive to the authorities.
Lee stressed that a strike from the public health service should not victimise anyone else but the authorities. A “surprise” strike without a list of demands and time for negotiations isn’t real industrial action, he said, but mere “screaming”.
“To me, if people want to go on strike, make sure that others know when you are going on strike. Otherwise, people will die.”
Reformasi Kesihatan Malaysia, an informal group of government doctors, has listed a dozen demands for the government to fulfil to avert a strike in the public health service, including transparent selection criteria for permanent positions, an increase in on-call allowances, and salary hikes for all health care workers.
Hartal Doktor Kontrak, which organised a brief walkout among contract doctors in mid-2021, said their demands remained the same as before: permanent posts for all contract doctors and clear criteria for permanent positions.
Health Minister Dr Zaliha Mustafa has yet to comment on the demands by both doctor groups, but announced that she will hold a town hall meeting with doctors next Wednesday at the Ministry of Health’s (MOH) headquarters in Putrajaya.
‘Zaliha First Minister to Admit There’s A Problem’
Lee spent much of his Malaysia Gazette interview defending Dr Zaliha, who has come under heavy fire from many government health care professionals for not openly acknowledging the core issues of staff shortages and bad working conditions in the public health service that are causing many, including doctors and nurses, to quit their jobs.
In the Dewan Rakyat yesterday, Dr Zaliha, a freshman MP from PKR, again repeated the seven steps to reduce overcrowding in emergency departments that she previously mentioned last month, even though her statement then had been widely panned by many government doctors as most of the seven measures have already been implemented for years in various public hospitals – to little avail.
“Why aren’t you stressing the issue of increasing staff? That is the root issue. The other suggestions are good, but the issue of staff shortages is the most pressing one,” Dr Khairul Hafidz Alkhair Khairul Amin, founder and chairman of influential doctors’ group MedTweetMY, tweeted in response to the health minister.
Lee, who is a member of the DAP’s central executive committee, claimed that Dr Zaliha was the first minister to acknowledge problems.
“I think this is the first minister who truly – without just nodding her head and accepting it – but from her own mouth, she has said that she knows, she understands, and she accepts that there is a problem. So that’s a start,” Lee told Malaysia Gazette.
Contrary to Lee’s claim, Dr Zaliha has never – in her public statements – acknowledged the ongoing crisis in the public health service, the shortage of health care workers, or complaints of toxic work conditions in the MOH.
In a recent TikTok video urging health workers not to go on strike, all the health minister said was – “I actually understand; I really understand that problem”, without specifying what the “problem” was – before going on to say, “This requires a little bit more time for me to understand it better and to understand this issue as best as I can before we can implement the best solutions”.
In a series of tweets last February 1, posted after CodeBlue’s survey among more than 1,600 government health care workers revealed deep anger and dissatisfaction in the public health service, Dr Zaliha simply expressed appreciation for health workers’ “views and feedback” on the “current situation” of the public health care system.
Lee, a Perakian legislator, told Malaysia Gazette that just three to four days after Dr Zaliha was sworn in as health minister last December, he met her in her office. There, the minister told him that she was aware of mounting problems of insufficient wards and staff in Raja Permaisuri Bainun Hospital (HRPB) in Ipoh that Lee had cited and asked for his assistance.
“That very day, she instructed an audit – a needs analysis audit – to review the sufficiency of staffing, equipment, wards, and beds. Since then, this has been in progress.”
Dr Zaliha’s statement last December 26, issued two weeks after CodeBlue reported that critically ill patients were waiting up to six days in HRPB’s emergency department (ED) for ward admission, made no reference to the Ipoh general hospital, only overcrowded EDs of MOH hospitals in general.
She also made no reference to instructing a new audit, simply saying that MOH was currently reviewing the “latest data, audits, and research” related to workloads and ED congestion nationwide, particularly in specialist hospitals.
Nearly two months later, as of today, Dr Zaliha has not published the results of the needs analysis audit cited by Lee, besides talking about MOH’s seven measures to decongest EDs that have already been implemented in the past.
‘Certain Groups in MOH Are In Denial, Blocking Change’
Lee, without naming names, claimed that “certain groups” in the MOH refuse to admit that there are problems in the public health service and are blocking attempts for reform.
“I have heard powerful voices saying, ‘What’s all this fuss? Everything’s fine. The policies are all fine, no problem’. This denial is a big problem,” Lee told Malaysia Gazette.
He said that when government health care workers complain about understaffing and emotional pressures, such as when patients under their care die amid staff shortages, their employers instead accuse them of tarnishing MOH’s reputation or send complainants into “cold storage” in the service.
“This means that people who already feel victimised are further oppressed by the oppressor. Imagine how we would feel.”
When asked if the “oppressors” he was referring to was the management, Lee replied: “Certain individuals who are given the responsibility to manage”.
He questioned if the “authorities” had the political will to confront “uncomfortable” things.
“There are certain groups in the MOH who are blocking the process of change towards something better,” Lee said.
“However, do we want to stop just because of these obstructing groups? No. From what I see, the minister is tough, determined, and on the pulse despite her gentle demeanour.”
The DAP lawmaker said he has also suggested to Dr Zaliha to table the human resources section of the Health White Paper earlier before tabling the entire document in Parliament in June, as human resources in the public health service are the main problem.
“We really need to delve deep into what the problems are. I think the solution is there, but we must know the actual state. The health minister has already announced that the Health White Paper will be tabled in June,” Lee said.
When Malaysia Gazette pointed out that issues of medical brain drain, understaffing in the public health service, and health workers complaining of being overworked and underpaid were not new problems, Lee responded: “But we’re a new government.”
Malaysia Gazette noted that policies in the public health care system remained the same, despite a new minister being in charge now.
“But there might be changes,” Lee said. “It’s not just a matter of waiting for the White Paper, but working on the White Paper so that we have a basis to bring about change because we can’t just announce it without providing the basis for it.”
Correction note: The headline was amended to better reflect Lee’s remarks, while the stand-first was corrected to clarify that it’s Lee’s claim, not Dr Zaliha’s, that certain groups in the MOH are blocking change.