I am a specialist at a government hospital and hold various posts in professional bodies and associations. After listening to the January 17 town hall on the Waktu Bekerja Berlainan (WBB) pilot shift system, I have decided to summarise how the Ministry of Health (MOH) has been systematically neglecting and bullying government doctors:
Confusing Statements
The recent circular on WBB was signed and stamped by an MOH official, with a date of release and date of execution of the policy. Simply telling us that this was a “proposal and not confirmed” is obviously not telling the truth.
It reminds me of how MOH made up a false example of a “Dr Ali” with a high salary to confuse the public into thinking that doctors are being unreasonable.
Disrespect
Organising a townhall within 24 hours after a social media outcry is hardly a sincere effort in engaging doctors. Organising it after policymaking also reflects the approach of our administrators in listening to doctors on the ground.
The health minister stated during the townhall that “the DG is like a Hindustan hero – might lose in the first few rounds but will eventually win.” Such jokes are completely distasteful and shows a complete lack of respect towards government doctors.
Selective Policymaking
It is no secret that the number of doctors is reducing, given data from the Malaysian Medical Council (MMC) that house officers reporting for duty are dropping at an alarming rate. Does it make sense then, to even pilot a policy that requires additional manpower?
How would this work in all other hospitals even if the pilot project succeeds? If a department has an abundance of doctors to run this new system, that proves that maldistribution is truly present among hospitals.
Haphazard Engagement
The “engagement” that was done with medical officers over the one year is debatable. I do not believe that true engagement was done; nor were stakeholders like associations representing doctors called together.
45 Hours Of Work
With the excuse of reducing workload, the suggestion of a 45-hour work week has been brought up. To properly execute this, MOH needs to compensate for every hour worked more than these 45 hours. If not, then we should revert to the old 24-hour calls, but with increased on-call claims.
18-Hour Shifts
Two hours of rest within 18 hours is completely impractical and cannot be applied to doctors of many disciplines that work based on patient load. How can you expect a surgeon to take a break halfway during surgery? Can you tell a baby to stop being delivered because you need to take your one-hour break?
I suggest the 18-hour shift be enforced for all government departments. Perhaps all counters can be opened from 3pm to 9am the next day with a similar WBB system.
Hidden Restrictions
Hidden within the WBB system is also a sentence that requires doctors to work 33 hours straight – when you are covering a colleague who is ill or cannot work. You would have to work overnight till the next day 5pm to claim an active call; if you go home at 9am, you will only qualify for a passive call despite having been at work for more than 24 hours.
It is obvious that MOH is not sincere in actually reducing working hours.
Unwilling To Spend Money
At the end of the day, the government of Malaysia is unwilling to spend more money on doctors. If not, the RM200 on-call claim can simply be increased to RM255, or from RM220 to RM285; you get the idea. Increase it for all doctors in all hospitals.
There is no need to waste one year doing “libat urus” – it can be done in minutes. But due to the lack of money (or lack of willingness to spend that money), we now have a “cost savings” policy.
Brain Drain
Brain drain is set to further increase after this. The general public can expect longer waiting times, suboptimal care, delayed surgeries, and perhaps even increased medical errors due to the lack of health care manpower.
Whatever justification given for this impractical policy, the fact stands that doctors are unhappy and more will choose to leave government service.
To be accountable and responsible for all these failures, Health Minister Dzulkefly Ahmad, Health director-general Dr Muhammad Radzi Abu Hassan, and those in the top administration of the MOH should resign immediately.
Do not make a mockery of our public health care system. Make way for leaders who are more capable and sincere in true engagement of all stakeholders for the sake of the country’s health care system.
The author is a specialist doctor at a government hospital. CodeBlue is giving the author anonymity as 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.
