I am a medical officer serving in the Ministry of Health (MOH) and am writing to urge your publication to immediately highlight a critical and unfair oversight in the national discussion surrounding the on-call allowance (ETAP) review.
While attention is focused on hospital doctors, medical officers in rural and remote public health clinics (Klink Kesihatan, or KK) are facing a systemic undervaluation of their high-risk workload and risk being completely excluded from meaningful pay reform.
We fear our specific plight will be entirely ignored in the upcoming review.
The Financial Inequity: Devaluing Doctors’ Time Since 2012
The current ETAP rate for passive call has not been reviewed since 2012. The rates of RM130 (weekdays) and RM140 (weekends) for duties exceeding four hours are financially irrelevant when compared to the market rate:
- A medical officer performing locum duties in the private sector earns between RM40 to RM45 per hour.
- The current ETAP rate for a 24-hour shift often nets the equivalent of just RM5 to RM9 per hour.
This extreme disparity is most severe in the rural setting.
The Extreme Reality of Rural KK On-Call
The workload during on-call hours in a rural KK is unsupported, high-stakes, and often requires single-person management of critical cases:
- Critical Management: We handle severe trauma (including road accidents), cardiac emergencies, haemorrhage, and critical obstetric cases (including deliveries) as the sole medical officer.
- Extreme Duration: These shifts routinely extend beyond nine hours. The most challenging cases, particularly those involving long-distance ambulance transfers to referral hospitals, frequently push our continuous duty to over 15 hours. This exposes us to the same fatigue risk as a 24-hour hospital shift, but with fewer resources and poorer compensation.
Key Proposals For Fair Restructuring
To rectify this injustice, I have formally proposed to the Malaysian Medical Association (MMA) and Hartal Doktor Kontrak (HDK) two immediate actions:
- Comprehensive Rate Increase: We advocate for a new ETAP rate to be set at RM25 per hour (RM600 for a 24-hour shift) for all medical personnel. If this comprehensive rate cannot be immediately implemented, a minimum increase of 50 per cent to RM330 per shift must be implemented immediately.
- Tiered Compensation System: A tiered compensation system based on actual hours worked must be introduced to reward extreme commitment:
- Category A: Duty exceeding 4 hours.
- Category B: Duty exceeding 9 hours.
- Category C: Duty exceeding 15 hours, specifically compensating for the most demanding and lengthy rural transfers.
CodeBlue’s immediate coverage is essential to ensure that the principle of “fairness across all tiers of doctors” is integrated into the national discussion before any final decision is made. We urge you to amplify the voices of medical officers serving remote communities.
The author is a medical officer serving at a Klinik Kesihatan in Kelantan. CodeBlue is providing the author anonymity because civil servants are prohibited from writing to the media.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
