Zaliha Cites Pensions As Among Obstacles To Permanent Posts For Doctors

Health Minister Dr Zaliha Mustafa cites the cost burden of pensions on increasing permanent positions in the public health service for doctors. She says she’s in constant communication with JPA and SPA. “It’s not something that we can do instantly”.

KUALA LUMPUR, March 22 – Dr Zaliha Mustafa highlighted the cost burden of pensions as one of the hindrances to increasing permanent positions for doctors in the public health service.

The health minister was responding in Parliament yesterday to Ayer Hitam MP Wee Ka Siong, who had asked her about the status of the previous government’s Cabinet decision early last year to absorb thousands of doctors into public service in a five-year period that he described as a “very critical” need.

Dr Zaliha’s predecessor, Khairy Jamaluddin, announced in February 2022 that the Cabinet had decided to create 4,186 additional permanent positions in the Ministry of Health (MOH) in 2022, comprising posts for 3,586 medical officers, 300 dental officers, and 300 pharmacy officers.

The Cabinet then had also agreed to create at least 1,500 permanent positions for doctors, dentists, and pharmacists in MOH every year from 2023 till 2025. In addition, the Cabinet then had agreed to create 800 permanent posts for specialist doctors and 70 permanent posts for specialist dentists in MOH annually from 2023.

In total, this would mean the creation of at least 8,686 additional permanent positions for medical, dental, and pharmacy officers in the public health service from 2022 to 2025.

“On this matter, I am always in communication with JPA (Public Service Department) and also SPA (Public Service Commission). God willing, we want to absorb as many contract officers as possible into permanent postings.

“But, it’s just that – meaning – it’s not something that we can do, as people say, in a very near time or instantly; this requires a series of continuous discussions,” Dr Zaliha told Wee, who is also MCA president, while wrapping up the debate at the committee stage on MOH’s 2023 budget in the Dewan Rakyat yesterday.

“This is because we need to remember that when it comes to permanent appointments, one more thing that the government needs to look at is the burden for later – when they get their pensions. So this is one thing that we also need to look at.

“Whatever the case, I am confident that the health service is an essential service for which we cannot simply implement previous policies in a blanket approach. So, God willing, give me time to continue discussions with certain parties and certain agencies.”

Malaysia’s pension scheme in the public sector only kicks in when civil servants retire after serving for at least 25 years.

However, the needs of the public health service are today, not a quarter of a century later, based on remarks by nearly 30 MPs who – participating in yesterday’s debate on MOH’s budget – raised dire staff shortages across various levels of the health workforce in public hospitals and clinics in their constituency or state.

“There are multiple issues that depict a crisis in the MOH health service,” said Tanjong Karang MP Dr Zulkafperi Hanapi from Perikatan Nasional (PN).

Former Health Minister Dzulkefly Ahmad, who is Kuala Selangor MP, similarly raised “multiple crises” in the health service, citing CodeBlue’s January 2023 survey among more than 1,600 government health care workers that found 95 per cent believe the public health care system is currently in crisis.

“Is the government aware that the [contract] system has caused The Great Resignation, worsened by overwork or excessive workloads, leading to all-time record [high] resignations among doctors in the territory of Sabah?” said Tuaran MP Wilfred Madius Tangau during his debate.

For Every Permanent Position, Less Than Two Doctor and Dentist Applicants and Less Than Five Pharmacist Applicants

During the debate, Dr Zaliha said there are a total of 9,321 candidates applying for 4,914 permanent positions for medical, dental, and pharmacy officers this year, comprising 7,061 candidates for medical officer positions, 610 candidates for dental officer positions, and 1,461 candidates for pharmacy officers.

Totalling up the three figures, however, leads to a figure of 9,132, not 9,321 as stated by the health minister in Parliament.

Dr Zaliha previously said last January that the 4,914 vacancies in permanent positions this year comprise 4,263 for medical officers, 335 for dental officers, and 316 for pharmacy officers.

This means that there are 1.7 doctors, 1.8 dentists, and 4.6 pharmacists applying for every permanent position in the health service.

The 4,914 permanent posts for doctors, dentists, and pharmacists open this year, however, are not new positions created for the public health service.

Dr Zaliha told a closed-door town hall meeting with doctors last month that the 4,914 vacancies had actually opened up because of resignations of doctors, among other health care professionals.

The health minister told Parliament yesterday that the RM2.6 billion allocated for emoluments of contract workers in MOH involved 39,091 officers across multiple service schemes, including doctors, dentists, pharmacists, specialist doctors, specialist dentists, research officers, science officers, optometrists, environmental health officers, nurses, assistant medical officers, and physiotherapists.

The sum also covers the cost of ganjaran kontrak for officers who completed their contract.

Additional emoluments of about RM1.7 billion under “Dasar Baru” in MOH’s 2023 budget covers emoluments for permanent positions of medical, dental, and pharmacy officers, as well as the creation of new positions across service schemes for new facilities.

A total of 2,971 nurses will be absorbed into permanent service from this year, as well as 792 U29 assistant medical officers, said Dr Zaliha, adding that 1,147 contract medical lab technologists (JTMP) are in service until December 31.

Dr Zaliha also reiterated in Parliament yesterday that the selection criteria for the permanent appointments of doctors are “objective, fair, and transparent”, without disclosing what exactly these were despite long-standing calls from doctors’ groups for the government to publish the selection criteria.

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