KUALA LUMPUR, Dec 15 — The upcoming transfers of over 1,000 medical officers for permanent positions next Monday are expected to trigger staff shortages and resignations, doctors say, a repeat of last July’s relocations.
A surgeon working in Melaka Hospital said the state’s general hospital is set to lose 13 medical officers (MOs) to the December 18 relocations, plus an additional three MOs resigning from the public service, bringing the total loss to 16 MOs.
“A repeat of the same fiasco. The disruptions did take place in July, but for a limited period only, as quite a number of medical officers were sent over by MOH,” the surgeon told CodeBlue.
“The situation is status quo — not very much changes. Unfortunately, I am not too sure at a hospital level, but in my department, the surgery department, three MOs have quit. This is due to poor financial compensation and tough working conditions with an unclear future pathway.
“The workload will inevitably increase as the number of cancer diagnoses increases and with private health care beyond the reach of many.”
Last July, an inexplicable omission of the entire state of Melaka from the permanent placements of more than 4,200 medical officers nationwide led to staffing shortages in Melaka Hospital that suspended its iFOBT colorectal cancer screening service and a reduction in elective surgeries.
The massive July relocation exercise also affected other major public hospitals in the Klang Valley – notably at Kuala Lumpur Hospital’s emergency department and Selayang Hospital’s obstetrics and gynaecology (O&G) department — where doctors warned that staff shortages could lead to potential resignations, longer wait times, suboptimal care, and possibly endangering patients’ lives.
Last December 4, when Dr Zaliha Mustafa was still health minister, the Ministry of Health’s (MOH) Human Resource Division (BSM) ordered more than 1,000 contract MOs and over 400 contract pharmacists to quit public service before reporting for duty in their new location as permanent officers on December 18.
This decision has come under the scrutiny of the medical fraternity that questioned the forced resignations that will take effect on December 18, saying that this would prevent health care professionals from claiming for interstate transfer allowances, besides affecting their salary scales and promotions as years of service under contract are not taken into account.
Dr Zaliha also revealed that a whopping 10 per cent – which she considered to be insignificant – of more than 4,200 medical officers who were offered permanent appointments last July 31 had rejected their offers.
Melaka Hospital Surgeon: ‘The System Is On The Verge Of Collapse’
The surgeon at Melaka Hospital – who spoke to CodeBlue before Dzulkefly Ahmad replaced Dr Zaliha as health minister in a Cabinet reshuffle last Tuesday – said the resignations of health care workers from the public service were worsened by the “rudderless” state and “lacking leadership” in the MOH.
The surgeon claimed that Dr Zaliha was not on the ground and was “in no hurry to improve the system”.
“To be honest, the system is on the verge of collapse, and even so, the government has no incentive to correct it,” said the surgeon, describing the handling of human resources within the MOH as “abysmal”.
He hoped to exit the system before its “eventual demise”, adding that a good first step would be for the government to recognise that clinicians are burning out and that the public health service is crumbling.
The Melaka Hospital surgeon urged the government to introduce social health insurance with mandatory contributions from everyone, so that there is “adequate funds for developing health care capacities”.
“Patients have to buy into the system and only then would they be responsible for their own health,” he added.
HKL MO: Doctors Quit After Transfer To New Hospital, Department
Many medical officers in Kuala Lumpur Hospital’s (HKL) emergency department are quitting because they are unfamiliar with the hospital, having been transferred from a different area and after previously serving a different department.
“It’s not them to be blamed, as some of them have already been in a certain department for so long, and suddenly, they have to relocate to somewhere they are not familiar with,” an HKL medical officer from the emergency department told CodeBlue.
“For instance, how do we expect a Klinik Kesihatan MO who is trained in primary care to settle down in the neurosurgical department? In my department alone, six out of the eight new permanent MOs quit. I wonder what the number is at the national level.”
The emergency doctor said workload is always increasing in line, with rising patient loads and staff resignations exceeding those absorbed into the service.
“A big number of floating MOs (those who just completed housemanship) are leaving in January as well, so may Allah help us all.”
The HKL medical officer – who spoke to CodeBlue before Dzulkefly returned as health minister last Tuesday – gave a Grade F in the area of health care workers’ welfare for the Madani government’s first year, claiming that nothing was done after government doctors’ town hall meeting with Dr Zaliha last February.
“What’s the point of meeting all of us when all of our concerns are being ignored? From GEG (generational end game) to delisting liquid nicotine, do they even care about the health of Malaysians?” said the emergency doctor.
“We need a new minister who is actually able to listen, have empathy towards health care workers, and act according to evidence because that’s what medicine is all about.”
Terengganu MO: More Permanent Doctors Quit
Like the HKL emergency doctor, a medical officer serving in Terengganu said more doctors have resigned from the public health service, believing that nothing has changed for them on the ground.
“So far, two doctors with permanent titles have resigned. There are multiple factors, including workload, on-calls, and family issues.
“Plus being permanent MOs, the grade and net salary is still the same as contract officers. Only the title is different. Need three years to wait for a grade increase,” the Terengganu government doctor told CodeBlue.
The medical officer rated Prime Minister Anwar Ibrahim’s government a Grade D for the lack of improvement in the public health care system in the administration’s first year.
“D — very little improvement. The decision of not increasing the on-call allowance is very disappointing,” said the medical officer, who spoke to CodeBlue before Dzulkefly’s appointment as health minister.
Last month, the Malaysian Medical Association (MMA) lambasted Putrajaya’s rejection of its proposal to increase medical officers’ weekend on-call allowance from RM9 to RM25 per hour.
MMA described the MOH’s written response to MMA – issued last October, 10 months after Dr Zaliha’s town hall with doctors organised by the association last February – as “inaccurate, insensitive, and inefficient”.
The MOH, which provided a written response to MMA’s proposals, maintained its status quo for key demands like a raise in doctors’ on-call allowance, clear selection criteria for permanent and JUSA positions, and promotions for contract medical officers.
Last Wednesday – a day after Dzulkefly’s appointment as health minister – his deputy Lukanisman Awang Sauni, who spoke mostly off the cuff in the Dewan Negara, acknowledged that government doctors are overworked without sleep, like “zombies”.
Crucially, Lukanisman admitted that medical officers’ weekend on-call allowance is just RM9 per hour – something which was never acknowledged, and even disputed, by the MOH during Dr Zaliha’s tenure.
The deputy health minister said while the Public Service Department (JPA) has yet to make a final decision on the MOH’s proposal to raise doctors’ on-call rates, he expressed confidence that the central agency would accept it with the Review of the Public Service Retirement System (SSPA).