Further to the Malaysian Medical Association’s (MMA) proposal to the Ministry of Health (MOH) on switching to a shift system to prevent public health care burnout and any further brain drain, we would like to emphasise the need to first carry out a pilot project over six months (at a few MOH facilities) to more effectively address its long-term implications on our health system.
If the government plans to go ahead with implementing a shift system for public health care doctors, it must ensure that the following will not be compromised:
Manpower
Implementing the shift system would need sufficient manpower. Some centres may need 200 to 300 per cent more doctors for this to happen.
The shift system, therefore, should be implemented at centres with adequate numbers of not only doctors, but other health care workers as well.
We reiterate that a detailed analysis of data on the distribution of the public health care workforce be carried out as a first step, as the issue of health care worker maldistribution is still prevalent at public health care facilities nationwide.
Training
Training needs must be met when implementing the shift system.
While we understand that service provision is vital, every effort should be made to ensure that our future specialists are well equipped and competent as they shoulder the heavy burden of patient care and safety.
Remuneration
Income from allowances must not be affected. Removing the on-call allowance for medical officers will potentially result in a 20 per cent pay cut or more, which will be very unfair for junior doctors who are already struggling to cope with the rising cost of living.
A quantum of flexi allowance (such as that given to house officers) must be given to make up for any loss of income. The MMA would like to suggest a flexi allowance of at least RM1,500 for medical officers to mitigate the financial implications and resignation trends amongst doctors in public health care.
Finally, the MMA believes it is crucial to initiate early discussions with stakeholders to collaboratively determine the most effective path forward.
Dr Azizan Abdul Aziz is the president of the Malaysian Medical Association.
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