KUALA LUMPUR, August 29 — A Human Resource Division (BSM) official from the Ministry of Health (MOH) has revealed that raising the on-call allowance for all medical officers would cost an additional RM75 million to more than RM80 million a year.
BSM division secretary Noor Azman Abdul Rahman told the Health parliament special select committee (PSSC) that this was the reason why the initially planned on-call allowance increase of RM55 to RM65 for medical officers and specialists was limited to the Waktu Bekerja Berlainan (WBB) pilot project, instead of giving the raise to everyone.
“As we recall, when we wanted to apply for this allowance increase, we made calculations that if we gave it to all the medical officers involved, the financial implications at that time would result in an additional RM75 [million] to RM80 million a year,” said Noor Azman during a Health PSSC hearing held on February 27 this year in an inquiry into a proposal to establish a Health Service Commission, according to the Hansard published in the parliamentary committee’s report.
“So, at that time, perhaps we wanted to — we also understood the country’s financial position, so we wanted to reduce the implications to only RM20 [million] or RM21 million a year.
“For that reason, we proposed that it be implemented on a pilot basis for certain units or departments first,” he added, referring to the WBB pilot project.
Noor Azman pointed out that Finance Minister Anwar Ibrahim’s Budget 2025 speech in Parliament in October last year had specified that the on-call allowance (ETAP) would be increased by between RM55 and RM65 for medical and dental officers in “certain fields of service and departments” in targeted health care facilities that implement a “new work system” introduced by the MOH.
“If we understand from this, it means that it’s as if not everyone will get it, right? So it’s only the units or departments that implement the new work in the service that will get it.”
Medical officers and specialist medical officers are currently paid ETAP of RM220 and RM250 per shift on weekends respectively. On weekdays, the on-call allowance is set at RM200 and RM230 per shift respectively.
At the same February 27 meeting attended by MOH officials, Public Service Department (JPA) officials told members of the Health PSSC that JPA was not responsible for tying the on-call allowance increase to the WBB pilot project.
Outrage in the medical fraternity over the unpopular shift system, which had proposed 18-hour shifts from 3pm to 9am, forced the Cabinet to axe the WBB project a month earlier on January 24.
“The prime minister already made the announcement, but it [on-call allowance raise] wasn’t implemented. Why do we have to wait for WBB? Isn’t WBB simply a pilot project? That’s the question,” asked Health PSSC chairman Suhaizan Kaiat, who is also Pulai MP.
Mokhtarruddin Buang, principal assistant director of JPA’s remuneration division, explained to parliamentarians that the Budget 2025 speech tied doctors’ on-call allowance raise to the WBB project.
“Actually, at JPA’s level, we didn’t impose any conditions for a pilot if WBB were to be implemented. That pilot was at MOH’s level, not JPA. JPA didn’t set any ruling that said there must be a pilot if WBB were to be implemented. None,” he told the Health PSSC.
The JPA official explained that if there was a future proposal by the committee chaired by former Health director-general Dr Abu Bakar Suleiman, who also serves as clinical advisor to Health Minister Dzulkefly Ahmad, to raise the on-call allowance for all doctors, then this suggestion could simply be tabled to JPA.
However, approval for allocations lies with the Ministry of Finance (MOF), not JPA.
“If MOF says we can cross it for the whole to get an on-call rate increase, then it’s subject to MOF. We can only acknowledge, but the final decision is with MOF, not JPA,” said Mokhtarruddin. “Approval for allocations isn’t at the JPA level, but MOF.”
Suhaizan stressed the need to protect the welfare of doctors and nurses to ensure their retention in the national health service, criticising the “inconsistency” in the initially announced on-call claims increase.
However, Health deputy director-general (medical) Dr Nor Azimi Yunus portrayed WBB as an MOH attempt to improve doctors’ welfare.
“For example, WBB was proposed because they were asking for work-life balance,” she told the Health PSSC at the same February 27 meeting with her MOH and JPA colleagues.
“We tried to arrange it with the hope that they would have days with free mornings and they could go anywhere. In fact, we said they could do locum or whatever if they wanted extra income. But cover nights to get an allowance that we felt could be increased.
“But because people were whacking it these days, YB, in the end it was cancelled. We didn’t get an opportunity to talk about WBB.”
Suhaizan related the views of doctors who expressed feelings of dissatisfaction and unappreciation from the government, as he insisted that their on-call allowance should be increased without having to wait to implement the WBB pilot project.
Norazlin Alias, senior deputy director of JPA’s staffing and organisation division (BPO), told the Health PSSC that although the government might not be able to compete with the private sector in terms of salary, the medical scheme receives among the highest salary scales in the public service compared to other service schemes.
“In terms of allowances, the central agency does look at the need to improve facilities and allowances, especially for the U scheme that always comes with all sorts of requests,” she said, referring to the medical and health service schemes.
At a separate hearing by the Health PSSC on February 6 – prior to the committee’s meeting with MOH and JPA officials – the Malaysian Medical Association (MMA) characterised the current RM220 on-call claim rate for weekends as equivalent to RM9.60 per hour for a 24-hour shift for medical officers.
“It’s even less than McDonald’s,” said MMA president Dr Kalwinder Singh Khaira at the Health PSSC meeting.
The doctors’ group told MPs that an on-call allowance increase should be given to all doctors, not just those implementing the WBB project.
MMA Schomos chairman Dr Timothy Cheng told the Health PSSC that medical officers and specialists in Singapore are paid SG$480 (RM1,576) and SG$1,000 (RM3,283) respectively for one day’s work on a weekend. “This is real because I got friends in my batch working there.”
Dr Kalwinder said doctors were upset after the MOH revealed that the on-call allowance raise was limited to those participating in the WBB pilot project “because they said it was promised lah, even though we weren’t sure about the fine print.”
“The fine print said, ‘a new work culture and work system’, but it was not expected that the work system would only be for a few.”
Dr Kalwinder, who is also the head of the department of medicine at Sarawak General Hospital (SGH), said adopting a shift system in government hospitals required two to three times the manpower.
Dr Cheng told parliamentarians that WBB could work in the neonatal intensive care unit (NICU) at Kuala Lumpur Hospital (HKL) because some 30 additional medical officers were reportedly transferred to that unit.
“Let me tell you ladies and gentlemen that [for] district hospitals in Sabah, some of the hospitals run with 12 people, 13 people. If HKL had an extra 30 people, don’t you think these extra people should be put in district hospitals where they are suffering from working 100 hours a week?” said Dr Cheng, an orthopaedic surgeon at Duchess of Kent Hospital Sandakan (HDOK).
MMA honorary general secretary Dr Vasu Pillai Letchumanan told MPs at the Health PSSC hearing that doctors’ on-call allowance rates should be reviewed every five years, pointing out that the last review was 12 years ago.
“You know something? If on January 1st, the government had said this is your new on-call form, all fill it up, people would have been very happy. I can tell you that, seriously,” said Dr Cheng.
Some five months after this February 6 Health PSSC meeting, Dzulkefly announced in a statement on July 12 that that doctors’ on-call allowance could not be increased because of the MOH’s inability to implement WBB due to staff shortages.
The Health PSSC’s 455-page report titled “Proposal to Form a Health Service Commission”, which was tabled in the Dewan Rakyat last Wednesday, contains the Hansard of all hearings in its inquiry, along with copies of presentation slides by participants.
Although parliamentary special select committee hearings are not broadcast live, whatever is said and presented in these meetings are on the record and usually reproduced in reports tabled in the Dewan Rakyat months later.
