Only 5% Of Public Hospitals, Clinics Have Adequate Manpower: MMA Schomos Poll

An ad hoc poll conducted by MMA Schomos last month among >100 respondents nationwide found that only 5% of public health care facilities had adequate manpower. Half of respondents attributed the manpower shortages to doctors’ resignations or transfers.

KUALA LUMPUR, May 27 — The Malaysian Medical Association (MMA) today expressed deep concern over the distribution of manpower across public health care facilities, including hospitals and public health clinics (Klinik Kesihatan). 

In a recent ad hoc poll conducted by the MMA’s Section Concerning House Officers Medical Officers and Specialists (SCHOMOS), it was found that only 5 per cent of public health care facilities have adequate manpower, while nearly half of the respondents say that shortages are due to doctors quitting or being transferred.

The MMA is urging the Ministry of Health (MOH) to conduct a comprehensive study with transparent publication of results on public health care manpower and workload in order to tackle the issue of manpower shortages. They hope that the findings from their survey will further shed light on the situation at public health care facilities.

The MMA’s SCHOMOS manpower ad hoc poll was conducted online via Google Forms in early April to obtain a quick overview of the current status of manpower distribution in government facilities.

The survey received a total of 117 responses from various public health care facilities across the country. Participants in the survey were from Johor (14), Kedah (13), Kuala Lumpur (7), Negeri Sembilan (9), Pahang (4), Penang (9), Perak (10), Perlis (1), Sabah (20), Sarawak (19), Selangor (9), and Terengganu (2).

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According to the poll results, only six responses (5 per cent) indicated that they had adequate manpower, whilst 36 responses (32 per cent) needed an increase of up to 50 per cent of manpower, and 51 (46 per cent) needed an increase of up to 100 per cent. 18 responses (16 per cent) needed more than twice the current number of doctors to provide adequate services.

There were six responses who were “unsure” as to how many doctors they actually needed.

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On the reasons for lack of manpower, nearly half (48.3 per cent) of the 117 respondents in the ad hoc poll stated that doctors were quitting or transferring, 34 (28.8 per cent) was because of doctors quitting, and only 16 (13.6 per cent) was due to transferring only.

Quitting means resignation from the service, whereas transferring means doctors were transferred to another facility, due to specialisation training or other factors. 

The MMA believes one of the main reasons for this lack of manpower is brain drain. There is a sudden increase of doctors resigning and not accepting permanent posts.

The quitting of doctors does not come as a surprise, and the issue has been brought up repeatedly, most recently by Senator Dr RA Lingeswaran, who said a total of 3,046 contract doctors resigned in the last three years (according to the MOH). 

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In the MMA SCHOMOS ad hoc poll, 51 (43.6 per cent) of responses also stated that there was some form of facility or equipment failure, thus contributing to challenges in providing optimal patient care at their facility.

A combination of reduced number of doctors with infrastructure failure indicates that there are difficulties in providing good quality health care to the rakyat.

To effectively tackle these issues, the MMA proposes the following:

  • Real time data: We need a transparent dashboard that displays the number of health care workers in the system. We again reiterate the importance of having transparent data readily available for public reference. The human resource unit of the MOH needs to take this seriously as only with proper data can we establish the true extent of the shortages. We did this for Covid-19 data, so we don’t see why the same can’t be done for public health care human resources.
  • Remuneration: This includes drafting out new salary terms for all health care workers in alignment with the increase in civil servants’ salaries, in order to be competitive with private practitioners. The MMA welcomes the announcement that civil servants’ salaries will be increased by more than 13 per cent starting December this year, and await news on the new on-call rates.
  • Retention: There are groups of doctors whose contracts are ending this month and in July, but there has been no concrete answer as to what happens to them after that. Shouldn’t the MOH be retaining them to help curb the present drastic lack of manpower?
  • Repair broken facilities and replace spoilt equipment: More effort is needed in this area, and the MOH must ensure that resources are not all spent within the urban areas, as rural Malaysians deserve equal quality care.

The MMA urges the government to take these issues seriously before the health care system collapses. The Public Service Department (JPA), the Ministry of Finance (MOF), and the MOH need to work closely with all stakeholders to stop the situation from further deteriorating.

In the long term, we need a Public Service Commission that can manage the health care system, which should be independent of the current JPA-MOF-MOH trinity, to allow for more flexible decision-making when it comes to staffing and service expansion needs.

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