KUALA LUMPUR, Dec 23 — From 2019 to 2023, a total of 2,385 permanent medical officers (MOs) and 1,109 specialist doctors (including those who took optional retirement) quit the Ministry of Health (MOH), amounting to 3,494 resignations.
Based on figures provided in Health Minister Dzulkefly Ahmad’s written Dewan Negara reply to Senator Dr RA Lingeshwaran, the number of permanent medical officers who resigned from the public health service declined 61 per cent from 915 resignations in 2019 to 359 in 2023.
However, the number of specialist doctors, including a handful who took optional retirement, quitting the MOH increased 58 per cent in the past five years from 239 resignations in 2019 to 377 in 2023.
The minister’s written parliamentary reply also stated that 4,032 contract medical officers had resigned from the public health service from 2019 to 2023.
In a post on X last Saturday, Health Minister Dzulkefly Ahmad asserted that the over 6,000 medical officers quitting the MOH in the past five years included 3,200 contract officers who resigned to transition to permanent positions.
However, his written Dewan Negara reply to Dr Lingeshwaran specifically stated that the 924 contract medical officers who quit in 2023 excluded 1,086 officers who resigned to shorten their contract service to accept permanent appointments.
The data on contract medical officers’ resignations from 2019 to 2023, as per Dzulkefly’s written parliamentary reply, also matches the annual figures provided previously by Dzulkefly himself and his predecessor, Dr Zaliha Mustafa.
On March 19 this year, Dzulkefly told Dr Lingeshwaran in a written Dewan Negara reply that 3,046 contract medical officers quit between 2021 and 2023, giving the specific figure for each year: 768 in 2021, rising to 1,354 in 2022, and dropping to 924 in 2023.
The health minister did not say in his written reply then, or after media reports were published, that the data included those who technically “resigned” to accept permanent appointments. His written parliamentary reply had, instead, put those yearly resignation figures in the context of low percentages of the overall contract medical officer workforce.
When asked for clarification, the minister’s office told CodeBlue that the 3,200 figure on contract medical officers who “resigned” technically in their transition to permanent status was from the past five years, whereas Dzulkefly’s latest written parliamentary reply to Dr Lingeshwaran only provided the 2023 figure on such transitions.
(Editor’s note: the 1,086 resignations for transitioning to permanent was specified separately as an exclusion to last year’s 924 resignations in a footnote of a table on the resignations data. This table footnote followed the second paragraph of the written parliamentary reply that listed technical “resignations” to accept permanent positions, among other reasons for quitting the service like getting job offers to work as public university lecturers, private sector work, personal reasons, competency issues, and health problems).
CodeBlue concludes that the data on contract medical officers quitting the MOH appears to be completely unreliable, given the apparent discrepancies or incomplete data. Let’s take two scenarios:
Assuming that, as per the December parliamentary reply, 4,032 contract medical officers resigned from 2019 to 2023 and there was an error in the exclusion of 1,086 “resignations” for transition to permanent and that these actually should be included in the total resignation data (beyond the year 2023), that means only 832 contract medical officers quit the service in five years (4,032 minus 3,200). These 832 actual resignations of contract MOs are far below the 2,385 resignations of permanent MOs and 1,109 resignations of specialist doctors (including optional retirements) in that period — an incredulous finding that merits an explanation from the MOH.
Another scenario: assuming that the 1,086 “resignations” for transition to permanent are correctly excluded from last year’s 924 resignations, that means the 3,200 figure cited in Dzulkefly’s X post applies to all other years except 2023 because, unlike Schrödinger’s cat, something cannot exist in two different states of being at the same time. But if 3,200 contract medical officers “resigned” between 2019 and 2022 to transition to permanent, this exceeds the 3,108 total resignations in those four years. Another conundrum.
In a nutshell, something is wrong with the data somewhere. If indeed 3,200 contract MOs “resigned” to transition to permanent in five years, then the total resignations of some 4,000 are too low (4,000 plus is the actual base rate for comparison, not 6,000 plus as this includes permanent MOs).
According to the health minister’s written reply, the MOH had 298,853 health care workers under its employ as of June 30, 2024. This comprised 266,133 permanent health care workers and 32,720 contract health care workers.
Of these, 44,155 are medical officers, while 7,638 are specialist doctors, totalling 51,793 doctors in the public health service.
Based on a breakdown of the number of medical officers and specialist doctors in the public health service as of last June 30, Selangor had the highest at 7,720 doctors, followed by Johor (4,544), and Kuala Lumpur and Putrajaya combined (3,936).
The states or federal territories with the lowest number of government doctors were Labuan (189), Perlis (804), and Melaka (1,780).
There is no data on the number of doctors in clinical roles.
In his post on X last Saturday, in response to nephrologist Dr Rafidah Abdullah who posted a news report on more than 6,000 medical officers and specialist doctors quitting MOH in the past five years, Dzulkefly touted the Rakan KKM programme, with a so-called “premium economy” wing in government hospitals, as a “game changer” to reduce the attrition rate of health care professionals. Rakan KKM has yet to launch.
“Short-term measures include salary adjustments, flexible work schedules, and permitting locum practices. We shall remain committed to continually improving the work-life balance and overall welfare of our medical professionals,” Dzulkefly added.
He also expressed commitment to establishing a Health Service Commission to regulate health care professionals separately from other civil servants.
“You surely understand the kind of pushback we have to mitigate and overcome,” Dzulkefly told Dr Rafidah.
