The recent announcement by Prime Minister Anwar Ibrahim – declaring a 15 per cent salary increment for civil servants across the board in the implementing, as well as management and professional groups – has undoubtedly been well-received by many within the government sector.
However, this blanket approach raises a serious question: Why has the government failed to address the specific and pressing needs of health care workers, particularly doctors?
The failure to offer special incentives or targeted compensation for the health care sector demonstrates a lack of understanding and appreciation of the unique challenges faced by medical professionals.
While the increase in salary for all civil servants might seem like a step in the right direction, it is nowhere near sufficient to address the distinct pressures and responsibilities of doctors and other health care professionals.
Malaysia’s health care system is under severe strain. Without more comprehensive measures, the country risks exacerbating the existing brain drain and undermining the long-term sustainability of its health care infrastructure.
The real question here is if such a small measure is enough reduce the brain drain of doctors moving out of our health care system or will it just barely help them with the constantly increasing cost of living?
No Special Incentives For Doctors: An Unjust Generalisation
The decision to offer a standard 15 per cent raise to most civil servants, including doctors, fails to recognise the unique nature of the medical profession.
Unlike many other civil service roles, being a doctor comes with a unique set of responsibilities, including life-or-death decision-making, gruelling work hours, and a high degree of emotional, mental, and physical exhaustion.
The work environment for doctors is incomparable to that of a desk job in a typical government office. The lack of targeted incentives for doctors and health care professionals who face these challenges every day is disappointing and counterproductive.
In many countries, doctors receive higher salaries and special allowances to reflect the demands and importance of their work. Malaysia, however, continues to place doctors under the same umbrella as other civil servants, neglecting the fact that these individuals carry the nation’s health care system on their backs.
Such oversight could have dire consequences for the country’s health system in the long run especially since Malaysia is transitioning into an ageing nation.
Doctors Are Not Just Civil Servants
Equating doctors with the rest of the civil service workforce is a gross misunderstanding of the value and contribution of medical professionals. Doctors are not just civil servants; they are the frontline warriors who keep the population healthy and ensure the well-being of the nation.
An LHDN tax officer, a police inspector, an administrative officer, and a doctor cannot be placed on the same pedestal when it comes to job demands and responsibilities.
Yet, the general civil service pay raise treats them as equals, ignoring the clear differences in workload, required expertise, and level of accountability involved.
A 15 per cent salary increase might be fair for administrative staff, but for doctors who routinely work beyond the standard 9-to-5 hours, it is a glaring understatement of the value they bring to the country.
Doctors’ work hours are gruelling, often extending to 36-hour shifts during on-call duty or beyond that for specialists dealing with emergencies. The daily stakes are incredibly high, with the mental, emotional, and physical demands of saving lives weighing heavily on them.
When health care professionals endure such long hours, putting their well-being at risk, it is disheartening to see them grouped into the same compensation package as those whose work is limited to more traditional office hours.
This type of salary structure fails to recognise the intricate skills doctors possess, the years of training and study they have undertaken, and the monumental responsibility they shoulder in providing critical care to patients.
This mismatch between compensation and the job’s demands is an injustice that the government must address. Without meaningful pay adjustments, Malaysia will continue to see its health care workers resignation rate increase as doctors are driven to exhaustion, and ultimately, to the doorsteps of other countries that offer better compensation and working conditions.
Neglect Of Other Health Care Workers
It is not just doctors who are feeling the sting of this inadequate raise. Other health care professionals, such as nurses, pharmacists, radiographers, and lab technicians, are equally vital to the functioning of the health care system.
Like doctors, these professionals faced unprecedented levels of stress and work during the Covid-19 pandemic. Many are still dealing with the after-effects — be it burnout, increased patient loads, or more complex paperwork as health care regulations evolve in response to new diseases and public health challenges.
The blanket salary increase fails to account for the increased workload and administrative burdens placed on these professionals. The pandemic permanently altered the landscape of health care, with many workers now handling more patients and performing more tasks than ever before.
This increased demand has not been matched with adequate financial compensation, which is vital to both recognising their contributions and ensuring the sustainability of the workforce.
The government should also consider implementing retention packages, including better benefits, professional development opportunities, and even housing subsidies to encourage doctors and health care workers to remain in the public sector. These measures should not just be aimed at doctors but at all health care professionals who play an essential role in ensuring the nation’s health.
Disappointing Lack Of Progress From The Health Ministry
What is perhaps most disheartening is that it has been over eight months since Dzulkefly Ahmad was appointed as Health Minister, yet there has been no significant progress in addressing the pressing concerns of doctors and health care workers.
While his appointment was met with optimism, the lack of any word on increasing on-call allowances or other critical reforms is a clear indication of the government’s indifference toward the health care sector.
Doctors are currently receiving a meagre RM9.16 per hour for on-call duty, which often stretches to 24 hours. For a profession where decisions can mean life or death, such compensation is nothing short of an insult.
The failure to raise on-call allowances is not only disappointing, but reveals a concerning lack of urgency in addressing the needs of the medical community. This silence from the Health Ministry is deeply demoralising for doctors, nurses, and other health care workers who continue to endure long hours and stressful conditions without adequate compensation or recognition.
Dzulkefly’s continued inaction reflects a larger issue within the government: a failure to prioritise the health care sector despite the obvious strain it is under. If the current trajectory continues, it is unlikely that the government will be able to retain health care talent or improve conditions for doctors and nurses.
Without immediate intervention, Malaysia risks pushing its already overworked health care professionals to the brink, leading to an exodus of talent that the country can ill afford. The worst part is, the government didn’t even explain how they are funding the salary increase for the civil service.
The Problem Of Brain Drain
One of the most significant challenges facing Malaysia’s health care system is brain drain, which sees many of the country’s best and brightest doctors leaving to pursue better opportunities abroad. A 15 per cent salary increase is unlikely to make any meaningful difference in retaining these talents.
Health care workers, especially those with specialised skills, are in high demand globally. Countries such as Singapore, Australia, and the United Kingdom offer far more competitive salaries and benefits.
With decreasing number of doctors due to brain drain, workload will definitely increase. In near future, with an increased number of patients to care for, is this 15 per cent raise even sufficient? After calculations, the raise of salary is very minimal for all categories (UD41-52). Do not forget that, with a higher salary, it may also come with a step up in tax brackets (one will have to fork out more money in the next income taxation).
In order to address brain drain, the government needs to go beyond incremental salary increases and introduce more substantial incentives. A 40 per cent salary increase, at the very least, would be a more appropriate reflection of the demands placed on doctors and would help make staying in Malaysia a more attractive option.
In addition, on-call allowances need to be significantly increased. Raising the on-call allowance to at least RM700 per on-call shift (up 218 per cent from the current RM220) would be a fairer and more realistic compensation for the level of work required.
It would be also appropriate to reduce the income tax of all health care workers by 5 to 6 per cent (apart from an increase in salary, on-call allowance, and other sorts of competitive benefits).
A salary increment of 40 per cent is appropriate after taking into account the inflation, and the fact that doctor wages have stagnated for 12 years since 2012. Under a 40 per cent raise, a medical officer’s salary increases from RM6,000 to RM8,400 per month. At an average of 70 working hours per month, his salary will be about RM120 per hour (overall wages will be higher if there is an on-call allowance increase).
This salary of RM120 per hour will be nearly as high as a private hospital medical officer’s salary. It can be seen as a competitive salary scheme, hence attracting more doctors to stay in the public health service.
The Ministry of Health once claimed that doctors are an asset to the country. Is this just all talk and no action? Have they thought of a more serious consequence, such as a strike by doctors or health care workers like what has been happening in the UK?
Definitely, we do not want to see that happen in our country. But there is always a possibility in the near future when doctors get fed up with this poorly managed system.
Malaysia remains at the lower end of the spectrum across different countries regarding on-call allowances, which is one of the key factors contributing to dissatisfaction among health care workers and the ongoing brain drain.
Most developed nations prioritise competitive on-call compensation to retain their health care workforce, particularly in demanding specialties and locations.
To avoid further brain drain and ensure the sustainability of Malaysia’s health care system, the government must introduce more substantial salary increases and allowances specifically targeted at the medical profession. A 40 per cent salary increment and higher on-call allowances are necessary to retain talent and maintain the health of the nation.
CodeBlue is providing the author anonymity because civil servants are prohibited from writing to the press.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
