In recent years, the Malaysian health care system has faced mounting challenges, particularly when it comes to preventing brain drain and retaining talent while simultaneously maintaining the morale of its diminishing workforce.
Yet, despite growing discontent among doctors and other health care professionals, the government continues to ignore the most pressing issues.
The clearest example of the government’s indifference is when Health Minister Dzulkefly Ahmad told reporters last August 24 that he would raise Hartal Doktor Kontrak’s (HDK) demand for an increase of doctors’ on-call allowance for Prime Minister Anwar Ibrahim’s “consideration”.
This statement seems to contradict Dzulkefly’s own remarks six months ago in February, when he said that the Cabinet has already decided on the issue and that the new on-call allowance rate would be announced “soon”.
Why would the health minister need to bring this up to the Prime Minister again if the Cabinet has already made a decision? This kind of double-speak shows that despite previous advocacy efforts from HDK and the Malaysian Medical Association (MMA) across successive health ministers, the government isn’t serious in heeding their demands.
Therefore, it’s time to take a stand. If that means organising strikes to force the government’s hand, so be it. The time for polite requests has passed. Now is the time for decisive action.
I would also like to plead with members of the general public to support our cause. Doctors and patients should not be fighting with each other – our anger should be targeted at the government.
Should the medical profession organise a strike, I am certain that organisers will do their best to prevent patient harm. After years of inaction from political leaders across different administrations, we have now come to this point of desperation where only a doctors’ strike can get the government to take our concerns seriously.
If things don’t change, doctors will continue to quit the public health service or leave the country altogether. Such harm to the health care system is mostly irreversible, compared to the short-term pain of walkouts from work.
In a nutshell, it is better for disgruntled doctors to stay in the system and fight for their rights through strikes, rather than to quietly resign from the health service in droves.
The Injustice Of Current On-Call Allowances
The on-call allowance rate is a sore point for many doctors working in government hospitals. As it stands, Malaysian doctors are paid a meager RM9.16 per hour for a 24 hour weekend on-call.
This is a pittance compared to the workload, responsibilities, and stress that come with the job. For a profession that demands long hours, including nights, weekends, and public holidays, this rate is nothing short of insulting.
We can look at neighbouring countries to see just how far behind Malaysia has fallen. In Singapore, a junior doctor’s on-call rate can reach up to S$200 (approximately RM680) per night, while in Brunei, doctors receive between B$100 and 200 (RM340 to RM680) per call.
These figures make Malaysia’s RM9.16 per hour seem almost laughable. How can we expect to retain our best talents when they can simply cross the border and earn substantially more for the same kind of work?
HDK and MMA Must Organise A Strike
HDK and MMA should list specific demands to the government – some of which have been made, like a raise in doctors’ on-call allowance rate to RM25 from RM9.16 hourly – and threaten a strike if their demands are not met by a certain date.
Perhaps a suitable deadline would be September 30, so that the government will include funding for on-call allowance and additional salary raises for doctors (beyond the 15 per cent for civil servants across the board) in the upcoming Budget 2025, scheduled for tabling in mid-October.
Social media campaigns are valuable for raising awareness, but they do not generate the same level of urgency as physical action. A well-organised strike has the power to disrupt the status quo and force the government to confront the issues at hand.
HDK’s earlier strike in 2021 was successful in bringing attention to the plight of contract doctors, but the government has grown complacent. Fear is a powerful motivator; without the threat of strikes, there is little to compel the government to act.
A Crucial Time For Demands: The Consequences Of Inaction
This is not just a fight for better pay; it is a fight for the future of health care in Malaysia. The strain on doctors is evident. Long hours, insufficient rest, and inadequate compensation are taking their toll, leading to burnout and a mass exodus of talent.
According to a survey by MMA, nearly 70 per cent of doctors have considered leaving the public sector due to dissatisfaction with their working conditions. Many of these doctors are moving to private practice or emigrating to countries like Singapore, Brunei, and Australia, where their skills are better recognised and rewarded.
Malaysia’s health care system is already stretched thin; without immediate action, it is at risk of collapsing. The government must be made to understand that doctors are not just another group of civil servants – they are the backbone of the nation’s health care system.
Without doctors, the entire system will crumble.
Doctors Are Not Just Civil Servants: The Need For Proper Recognition
One of the most baffling aspects of the current situation is the government’s tendency to lump doctors in with other civil servants. This categorisation fails to recognise the unique challenges and lifesaving responsibilities that come with the medical profession.
Doctors are not pencil-pushers or bureaucrats; we are highly trained professionals who hold the lives of patients in our hands. The level of skill, dedication, and sacrifice required to be a doctor far exceeds that of most other civil service positions.
Yet, when it comes to compensation, doctors are treated as though they are no different from any other government employee. This approach is both short-sighted and dangerous.
The government must understand that if it wants to provide quality health care, it needs to invest in its doctors. This means not only increasing on-call allowances, but also providing better salaries, benefits, and working conditions.
Let’s make a comparison again with our neighbours. In Singapore, doctors are among the highest-paid professionals in the public sector. A specialist in a Singaporean public hospital can earn up to S$15,000 (RM51,000) per month, while a general practitioner earns around S$6,000 to S$8,000 (RM20,000 to RM27,000) per month.
In Brunei, doctors earn between B$4,000 and B$10,000 (RM13,000 to RM34,000) per month, depending on their specialisation and experience.
In Malaysia, however, a government doctor’s salary starts at around RM5,000 per month – barely enough to cover the cost of living, let alone the years of education and training required to reach that level.
The Time For Action Is Now
So, what can be done? The answer is simple: doctors must unite and demand the respect and compensation they deserve.
If that means strike action, so be it. A strike is a legitimate form of protest, a way to show the government that the status quo is unacceptable.
Vague demands and social media posts will not bring about the change that is needed. What will make a difference is a unified, organised effort that forces the government to listen and act.
The Malaysian health care system is at a crossroads. We can either continue down the path of underfunding and neglect, or we can stand up and demand the changes that are necessary to save it.
The choice is ours, but time is running out. If we do not act now, the consequences will be felt for generations to come.
The author is a medical officer at a public hospital in the Klang Valley. 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.
