KUALA LUMPUR, Nov 22 – Dr Zaliha Mustafa has dismissed issues highlighted during the nationwide relocation exercise last July of over 4,000 trained medical officers for permanent positions as an occasional “exaggeration”.
The health minister opined that the rate of rejection of permanent offers in that placement exercise at one in 10 doctors was “not that high”.
Dr Zaliha explained that the deployment of medical officers to East Malaysia was based on vacancies. Although there were also openings in the peninsula, the majority of doctors were assigned to Sabah and Sarawak to balance out the public health care system.
“According to the Ministry of Health’s (MOH) records until September 2023, 3,837 out of 4,263 eligible medical officers accepted the permanent offer and selected their preferred placement destinations. Among them, 3,836 reported for duty.
“In reality, the issues are sometimes exaggerated (dibesar-besarkan). But if we look at the data, the situation is not that serious,” Dr Zaliha said during her winding-up speech for the Supply Bill 2024 in the Dewan Rakyat Monday.
Official data until last September also showed that 426 medical officers (9.9 per cent out of 4,263 contract doctors offered permanent positions) declined their permanent offer, described as “not a lot” by Dr Zaliha. Among the 426 medical officers who declined to take up permanent appointments, 35 opted to resign.
“By percentage, it is not that high, but MOH is looking at how…we hope those appointed will stay because we need doctors, especially in the public health service,” the health minister added.
In July, CodeBlue ran a series of stories detailing the impact of the massive relocation exercise on major public hospitals in Melaka and the Klang Valley — notably at Kuala Lumpur Hospital’s emergency department and Selayang Hospital’s obstetrics and gynaecology (O&G) department — where staff shortages could lead to potential resignations, longer wait times, suboptimal care, and possibly endangering patients’ lives.
CodeBlue also reported that some young doctors in their early 30s resorted to pawning gold and withdrawing from their Amanah Saham Bumiputera (ASB) accounts to fund their relocation from the Klang Valley to Sabah.
More recently, CodeBlue reported complaints from Selayang Hospital medical officers about increasingly frequent verbal abuse from patients’ accompanying relatives at the understaffed emergency department, including one case that led to a staff member filing a police report against a patient’s accompanying family member in October.
MOH data obtained by CodeBlue in July revealed that over 1,000 medical officers received placements in Sabah and Sarawak collectively during the relocation exercise last July 31 at the expense of central states like Negeri Sembilan, Melaka, Selangor, and Kuala Lumpur and Putrajaya that suffered net losses of more than 100 doctors each.
Dr Zaliha explained that the MOH will prioritise the needs of an area when making decisions about placements and relocations of government health care professionals.
“If possible, we want to meet all the needs. However, there are times, or most of the time, when we have to consider the local needs and priorities among those places.
“In certain areas, for example, in Kuching, Sarawak, it’s a big city. The complexity of health issues there is different. So, perhaps we need to place (officers) there first compared to, for example, Sibu. These are among the things we will take into consideration when assigning our officers,” Dr Zaliha said.
Despite the MOH’s complex human resource challenges, Dr Zaliha said she had prioritised and worked to resolve issues related to contract doctors since assuming the role of health minister over the past year.
“When I became health minister, the first, or among the important things I tried to address is the contract doctors issue. To fully understand these issues, we need to look at the entire ecosystem, and to do that takes more than a couple of days.
“It requires a holistic review, with input from various agencies, which is why we now have the High Level Committee, which I co-chair with the Chief Secretary (KSN), to figure out the best solution – and we have many agencies and ministries who are involved in this committee, including the Public Service Department (JPA), Ministry of Finance, Ministry of Higher Education, because this is important.
“This is why we have short-term and midterm solutions where the prime minister, who is also the finance minister, approved 12,800 permanent positions for contract doctors. This is a huge figure that has never been done by any of the previous administrations,” Dr Zaliha said.
“So, we have to give credit to the government today.”
The government allocated an additional RM1.5 billion under the Health Ministry’s whopping RM41.2 billion budget next year, to fund emoluments and additional allowances for the increased number of permanent positions in 2024.
“This (additional RM1.5 billion) is to fund emoluments and various allowances for the additional number of permanent positions in 2024, including 1,500 positions for medical, dental, and pharmacy officers, 800 specialist doctor positions, and 30 dental specialist positions – spanning from 2023 to 2025.
“This is in addition to the creation of 14,416 positions across various service schemes that will be provided in 2024 to facilities that have been upgraded,” Dr Zaliha said.
The government’s plan to absorb 12,800 contract doctors over three years, as announced by Prime Minister Anwar Ibrahim in April, should result in an average of around 4,200 new permanent positions being made available each year until 2025.
However, the allocation of additional emolument funds for 1,500 positions in next year’s budget for the Health Ministry suggests that only a third of the permanent positions are genuinely new, with the rest likely filling existing vacancies due to resignations.
Health director-general Dr Radzi Abu Hassan’s statement last August 4 noted that the large-scale appointment of more than 4,000 medical officers for permanent positions for 2023 was actually kick-started last year – under then-Health Minister Khairy Jamaluddin – before the offers for permanent appointments were made this year.
Khairy said in February 2022 that the Cabinet, under then-Prime Minister Ismail Sabri Yaakob’s administration, had agreed to create 4,186 additional permanent positions in the MOH for 2022, comprising 3,586 medical officers, 300 dental officers, and 300 pharmacy officers.
He also said the Cabinet had agreed to create at least 1,500 new permanent positions for medical, dental, and pharmacy officers in the MOH every year from 2023 to 2025.