KUALA LUMPUR, Feb 22 – The Public Service Department (JPA) has instructed the Ministry of Health (MOH) to stop extended hours at public health clinics on Sundays and public holidays, as staff cannot be paid for such services.
According to a circular dated February 10, 2023, by Health deputy director-general Dr Norhayati Rusli (public health), as sighted by CodeBlue, a review of extended hours at klinik kesihatan nationwide revealed that state health departments were providing this service with varying operating hours, according to need, that violated a 2007 circular by the Health director-general on extended hours at klinik kesihatan.
The No. 8/2007 circular by the Health director general dated December 10, 2007, had stated that public health clinics nearby identified hospitals could provide services after office hours, also known as extended hours, from 5pm to 9pm on weekdays (Monday to Friday), as well as from 8am to 12pm on Saturdays. Services on Sundays and public holidays were excluded.
At a February 5 meeting this year by Dr Norhayati with representatives from MOH’s human resource and finance divisions, as well as state health departments, the human resource division said JPA’s approval was needed to extend hours at klinik kesihatan to Fridays for Kedah, Johor, Kelantan, and Terengganu; to Sundays for Perlis, Penang, Perak, Selangor, Kuala Lumpur and Putrajaya, Negeri Sembilan, Melaka, Pahang, Sabah, Sarawak, and Labuan; as well as to public holidays for all states.
MOH’s finance division representatives also advised the ministry to stop extended hour services at klinik kesihatan outside the days and hours authorised by the Health director-general’s 2007 circular, pending JPA approval of this policy, to “avoid the issue of payment of allowance for extended hours”.
Subsequently, a February 9 meeting between Health Minister Dr Zaliha Mustafa and JPA deputy director-general (development) Zulkapli Mohamed, as well as other MOH and JPA officials, discussed MOH’s application to expand klinik kesihatan extended hours to Fridays (for Kedah, Kelantan, Terengganu, and Johor), Sundays (for other states), and public holidays.
“This was to take into account an urgent need to reduce overcrowding from non-emergency cases at hospital emergency departments, as well as to ensure continuity of service at klinik kesihatan,” Dr Norhayati said in her February 10 circular.
Instead of allowing MOH’s plan to expand extended hours to all public health clinics across the country, JPA told the ministry to stop the extended-hour service that is currently being provided at certain klinik kesihatan that breach the Health director-general’s 2007 circular.
According to Dr Norhayati’s circular, JPA told MOH to provide it a proposal paper on the expansion of extended-hour services at klinik kesihatan for perusal before JPA can forward it to the Ministry of Finance (MOF) for approval and funding for the policy.
“JPA also issued a reminder that all klinik kesihatan that provide extended hours must abide by the Health director-general’s No. 8/2007 circular to avoid the issue of payment of allowances for extended hours,” said Dr Norhayati.
Several klinik kesihatan currently provide extended-hour services beyond what is permitted by the Health director-general’s 2007 circular (weekdays: 5pm-9pm from Monday to Friday and 8am-12pm on Saturdays).
From July 3, 2022, MOH provided extended-hour services at Klinik Kesihatan Kuala Lumpur and Klinik Kesihatan Putrajaya Presint 9 that covered weekends (including Sunday) and public holidays from 8am to 10pm. Extended hour services at these two public health clinics on weekdays are provided from 5pm to 10pm, going an hour beyond the 9pm limit set by the Health DG’s 2007 circular.
From July 6 last year, MOH provided extended-hour services at three public health clinics in Selangor – Klinik Kesihatan Pandamaran, Klinik Kesihatan Kajang (Hulu Langat), and Klinik Kesihatan Taman Ehsan (Gombak) – that covered 8am-12.30pm on weekends (including Sunday).
Selangor state health director Dr Sha’ari Ngadiman issued a circular last February 14 – in reference to the February 5 meeting among MOH officials and state health departments – to halt extended hours on Sundays and public holidays at klinik kesihatan in Selangor that were providing these services.
The affected clinics listed in his circular are Klinik Kesihatan Ampang and Klinik Kesihatan Kajang in the Hulu Langat district; Klinik Kesihatan Puchong Batu 14 in the Petaling district; Klinik Kesihatan Bandar Botanik; Klinik Kesihatan Bandar Botanik in the Klang district; and Klinik Kesihatan Taman Ehsan in Gombak.
These facilities now only provide NNJ clinic (for jaundiced babies) services on Sundays and public holidays from 8am-12pm, besides the usual extended hours on Saturdays from 8am-12pm.
Operations at these public health clinics from 8am to 9.30pm on weekdays are to be in shifts; the shift system at Klinik Kesihatan Kajang was estimated to start last February 15, as well as from March 1 for Klinik Kesihatan Taman Ehsan.
The Selangor state health department had made the announcement on its website on the halt to extended hours at klinik kesihatan in the state on Sundays and public holidays, in line with the Health director-general’s 2007 circular.
Despite JPA’s instruction to MOH at their February 9 meeting to stop public health clinics’ extended-hour services that were not authorised by the Health DG’s 2007 circular, Dr Zaliha told the Dewan Rakyat last February 15 that MOH headquarters would discuss “improving the implementation of extended hours for the operation of MOH klinik kesihatan”, as per a graphic she posted on Twitter, as among seven measures to decongest emergency departments nationwide.
Parliament’s Hansard recorded Dr Zaliha’s “extended hours” remark as “a standard hours”.