The Ministry of Health (MOH) has unveiled its latest pilot initiative, the “Waktu Bekerja Berlainan” (WBB) shift system, under the pretense of reforming on-call schedules and improving work-life balance for doctors.
However, this policy is nothing short of a scam, a blatant attempt to rip off doctors’ hard-earned salaries while masking its true intentions under a thin veneer of modernisation.
The WBB system is not only unfair, but also a testament to the government’s disregard for the wellbeing and dignity of its health care workers in our already vulnerable and collapsing system that us catering to the needs of Malaysians.
Unfair And Unjust: The Reality Behind WBB
The WBB system has been promoted as a game-changer for Malaysia’s public health care sector. Yet, a closer examination reveals its deeply flawed and exploitative in nature. Consider the following injustices:
Limited On-Call Eligibility: Under WBB, only weekend and public holiday shifts qualify as on-call duty, with weekday night shifts (3pm-9am) excluded from any on-call allowance.
This policy effectively forces doctors to work beyond regular hours for free, undermining the principle of fair compensation for labour. This effectively worsens the current problem instead of approaching the problem and attempting to fix it.
Passive vs. Active ETAP Allowances: Doctors on WBB shifts who work grueling hours are subjected to the insulting “Passive ETAP” allowance for the first nine hours, which is a pittance compared to their actual workload.
Meanwhile, the so-called “Active ETAP” allowance of RM275 for medical officers and RM315 for specialists is only granted under extremely restrictive conditions, leaving many doctors undercompensated and severely undervalued.
Graveyard Shift Exploitation: The WBB system’s second group — doctors working from 12am to 9am on weekdays — will receive no additional compensation for these punishing graveyard shifts.
This lack of pay disregards the well-documented health risks associated with night work, including sleep deprivation, burnout, and long-term health issues.
Disparity In On-Call Allowances: For doctors not working under the WBB system, on-call allowances are lower, with medical officers receiving RM220 and specialists RM250 per shift.
The discrepancy between WBB and non-WBB rates is unjustifiable and creates unnecessary division within the health care workforce.
A Scam Disguised As Reform
The ministry has shamelessly boasted as if they increase the on-call allowance by 200%, when in reality, it’s just a paltry 84 cents! How absurd is that?
The actual increase amounts to a mere 84 cents, raising the hourly rate from RM9.16 to RM10. This paltry adjustment is limited to specific hospitals and departments, with a labyrinth of rules restricting claims.
Far from being an improvement, WBB systematically reduces doctors’ incomes by cutting on-call opportunities and complicating compensation processes.
A Deceptive Facade
The WBB system’s primary purpose appears to be cost-cutting rather than improving working conditions.
By redefining on-call duties and narrowing eligibility for allowances, the MOH effectively slashes doctors’ overall earnings while portraying itself as a progressive institution.
This practice not only erodes trust, but also reveals the MOH’s true priorities: saving money at the expense of doctors’ welfare.
The Human Cost Of WBB
Impact on Doctors’ Mental and Physical Health: Doctors are already burdened with long hours, high-stakes decision-making, and the emotional toll of caring for patients in often dire circumstances.
The WBB system exacerbates these stressors by adding financial strain and increasing workloads without adequate rest.
The physical and mental wellbeing of doctors is critical for ensuring high-quality patient care, yet WBB ignores this fundamental truth.
Driving Talent Away: The exodus of Malaysian doctors to foreign health care systems is accelerating, and WBB will only intensify this trend. Why should talented professionals remain in a system that devalues their contributions and exploits their labour?
Countries like Singapore, the United Kingdom, and Australia offer better pay, working conditions, and professional respect. Malaysia risks losing its best and brightest unless immediate action is taken to reverse policies like WBB.
Patient Care at Risk: Overworked and underpaid doctors are more prone to errors, which can have devastating consequences for patients especially in life and death situations.
By stretching an already thin workforce even further, WBB compromises the quality of care that patients receive.
The MOH’s failure to address manpower shortages compounds this issue, placing both health care providers and patients in jeopardy.
Policymakers Must Be Clinicians
One of the fundamental flaws of the WBB system is its detachment from the realities of clinical practice.
Policymakers who devise such systems often lack firsthand experience of the challenges faced by doctors. They do not understand the physical and emotional toll of 24-hour shifts, nor the intricacies of balancing patient care with administrative demands.
Decisions affecting health care workers should be made by those who have walked in their shoes. Clinicians must be at the forefront of policymaking to ensure that reforms are both practical and fair.
A Call To Action
Prime Minister Anwar Ibrahim and the MOH must take immediate steps to address the injustices of the WBB system and restore fairness to the public health care sector. Here are the urgent measures required:
- Suspend the WBB Pilot System: The implementation of WBB should be halted until a thorough review is conducted, with input from frontline health care workers.
- Increase On-Call Allowances Substantially: A meaningful increment in on-call allowances is long overdue. The current rates do not reflect the sacrifices and workload of public sector doctors.
- Develop Policies with Clinician Input: Clinicians must be actively involved in crafting policies that affect their work. Their insights and experiences are invaluable in creating sustainable and equitable systems.
- Address Manpower Shortages: The government must prioritise hiring and retaining health care professionals to alleviate the burden on existing staff and improve patient care.
- Provide Fair Compensation for All Shifts: Doctors working beyond their regular hours, especially during graveyard shifts, must receive fair and consistent compensation.
Conclusion
The WBB system is a sham reform that exploits the very doctors who are the backbone of Malaysia’s health care system. It embodies the MOH’s insensitivity to the realities of clinical work and the sacrifices made by health care workers.
If left unaddressed, this policy will drive more doctors out of the public sector, leaving an already fragile system on the brink of collapse.
Prime Minister Anwar Ibrahim, your leadership is crucial in resolving this crisis. Doctors and patients alike are counting on you to champion fairness, dignity, and justice in our health care system.
The time for action is now. Reverse the WBB policy and show that Malaysia values its doctors and the critical role they play in safeguarding the nation’s health.
The author is a medical officer 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.
