The Ivory Tower of the Ministry of Health (MOH) is in damage control mode. This may pose a danger to dissenting voices on the ground, as the top management is not forgiving when it comes to its image.
Many emotional articles have been written about Waktu Bekerja Berlainan (WBB). Even Dr Musa Nordin’s article is full of emotion.
Understanding The Medical Advisory & Action Committee (MAAC)
If MAAC is an appointment and special privileges committee for the Head of Services, who are the Heads of Services? For now, the ground will say “Yes Man/Woman” to the Director-General of Health.
MAAC comprises doctors, but they lack the intention of the quote used by our health minister in a paraphrase of Abraham Lincoln, “By doctors, for doctors.” It is actually by administrators, for administrators.
They do not represent all of us because we did not vote for you. What we may miss is a “nice person does not always make a good leader.” Doctors in MAAC are nice, but not all are leadership material or good functioning in think tanks.
But MAAC members are so powerful that when they decide something, even State Directors who understand service better at the state level must follow. Take, for example, the reshuffling of specialists.
This change in organisation occurred quietly, but it is a poisoned apple. We used to have discussions at KPK Khas, Dasar dan Pembangunan Kementerian Kesihatan for any new interventions, but now we have an MAAC layer that allegedly repressents all services, i.e. doctors, thus bypassing normal engagements.
No Empathy Towards Loss Of Income
Why are we making noise? A pilot project will only be launched if we feel it may be successful. No one will declare pilot projects to be a failure.
So, when the MOH, especially the Director of the Medical Development Division, issues a directive for implementation of a pilot project, the Ivory Tower will ensure it is successful. Especially more so now.
This means that doctors will go on to lose between RM500 and RM1,000 monthly income from on-call allowance. This loss of income is significant, especially to the target group of medical officers and junior specialists. Why? They are building a family.
It does not affect consultants from the JUSA grade because they will still enjoy passive calls from the comfort of their home and on-call claims.
What Is Missing In WBB?
What is missing in WBB is a concrete plan to run services for 16 hours, making up for an additional load of patients. It involves all layers of professionals – from consultants to medical officers and allied health professionals working in shifts of eight hours.
The block that we see now are from the following services where the specialist and service maintains 8am-5pm working hours.
- Radiology
- Pathology
- Elective Operating Theater services except for some hospitals
- Stroke services
- Interventional Cardiology
- Haemodialysis Services
- Endoscopy Services
What this means is that after 5pm, they will only cater for emergency cases. Who decides what are emergency cases? Well, they themselves. Here lies the pitfall within MOH Services.
Patients cannot be discharged because they’re waiting for radiology imaging and reporting, histopathology examinations, operation theatre times, and much more.
Such services should be targeted as a priority to ease the backlog in patient care.
Why Changing Working Hours Will Not Ease The Backlog
The backlog has resulted in opening new areas for patient care that are not intended for patient care. For example, MOH is very proud of its “Corridor Medicine.”
Why do I say it is the pride of the MOH? Because they do not have a concrete plan to address the presence of “Corridor Medicine.” Instead, they are helping to make it as part of in-patient service.
MAAC Has No Strategic Plan, That’s Why Doctors Are Fighting
Specialists by Administrators for Administrators need to take care of their “periuk nasi.” Why not take representatives from the Academy of Medicine Colleges to be part of the MAAC? They are Specialists for Specialists by Specialists.
There is no strategic plan in WBB implementation. What will it achieve in five years – improvement of service or cost-cutting?
If you cut our allowances, where are you channeling the money to? Even our prime minister, when taking away subsidies, gave a plan on where the savings will go.
It is sad to see the health minister defending the move – taking away RM500 to RM1,000 monthly (this may be an underestimate) – as a “game-changer” without a concrete strategic plan. The affected doctors are within the M40 group.
Whatever said, we are just servants in the civil service. At the end of the day, with arahan keluar, we will still follow it, even if it’s not very logical, because THE IVORY TOWER SAID SO.
The author is a specialist doctor at a government hospital in the Klang Valley. CodeBlue is giving 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.
