KUALA LUMPUR, Jan 16 — The Waktu Bekerja Berlainan (WBB) shift system seeks to save money by limiting an increment in government doctors and dentists’ on-call allowance to weekends, according to a Ministry of Health (MOH) circular.
Under the WBB system – which will pilot in select departments at seven government hospitals on February 1 – medical and dental officers and specialists are not paid the Elaun Tugas Atas Panggilan (ETAP) allowance for 18-hour shifts (3pm-9am) on weekdays because the graveyard shift is counted as part of a 45-hour work week.
For WBB shifts (3pm-9am) on Fridays or pre-weekends, officers can only claim passive ETAP allowance for the second nine hours of their 18-hour shift (12am-9am). The first nine hours (3pm-12am) are not additionally compensated because these irregular hours are counted as part of the 45-hour work week.
“MOs and specialists will migrate to the Waktu Bekerja Berlainan system with the new ETAP rate for weekends. Savings will be generated from the absence of claims from Monday to Thursday, and from turning active claims on Friday into passive ETAP claims of more than four hours,” reads a footnote under financial projections of the ETAP allowance increment in the first phase of the WBB pilot project.
These financial cost projections were included in WBB guidelines attached to a January 10 circular by MOH medical development division director Dr Mohd Azman Yacob, as sighted by CodeBlue.
The higher on-call allowance of RM275 per shift and RM315 per shift for medical officers and specialist doctors respectively only apply to WBB active calls on weekends or public holidays for 15 or more consecutive hours’ work outside regular hours. This on-call allowance raise is only available to departments or units that implement WBB.
In contrast, non-WBB active calls will only be compensated RM220 per shift and RM250 per shift for medical officers and specialist doctors respectively on weekends and public holidays – RM55 and RM65 lower respectively than WBB active calls. On weekdays, the allowance is set at RM200 and RM230 per shift respectively.
Passive calls are paid at RM130 per shift (medical officers) and RM150 per shift (specialist doctors) on weekdays. For weekends, it’s RM140 per shift (medical officers) and RM160 per shift (specialist doctors). Both the non-WBB active calls and passive calls are the old (or current) allowance rates.
Below are the MOH’s financial cost projections for the first phase of the on-call allowance increase under the WBB shift system in various departments:
- Orthopaedic departments in Melaka Hospital and Raja Permaisuri Bainun Hospital in Ipoh, Perak (two hospitals): RM716,560 a year
- Internal medicine department at Slim River Hospital in Perak: RM142,740 a year
- Emergency departments at Melaka Hospital and Sultanah Bahiyah Hospital in Alor Setar, Kedah (two hospitals): RM372,320 a year
- Neonatal intensive care unit (NICU) and paediatric intensive care unit (PICU) at Tunku Azizah Hospital in Kuala Lumpur (two units in one hospital): RM530,140 a year
- Labour room in the obstetrics & gynaecology department at Putrajaya Hospital: RM256,620 a year
- Oral and maxillofacial surgery at Tuanku Ampuan Rahimah Klang Hospital in Selangor: RM150,800 a year
In total, the projected annual cost of the on-call allowance increment in eight departments across seven hospitals is about RM2.2 million.
Doctors who have to replace someone on WBB on a weekday are only eligible for the old ETAP allowance rate – even then, they need to work 33 consecutive hours from 8am on one day to 5pm the next day. If they work 25 hours until 9am, they can only claim passive ETAP.
The WBB active call allowance of RM275 for medical officers and RM315 for specialists per shift on weekends or public holidays – an increase of RM55 and RM65 respectively from the old rate – translates to just RM18.30 per hour (medical officers) and RM21 per hour (specialists) for a 15-hour shift. Under the old rate, medical officers are paid RM9.16 per hour for a 24-hour shift on weekends.
Health Minister Dzulkefly Ahmad said last August that medical officers would soon receive “joyful news” about a review of their on-call allowance in Budget 2025, when Prime Minister Anwar Ibrahim later announced the RM55 to RM65 increment.
News about the WBB system – which CodeBlue broke yesterday – have enraged doctors in the public health service. Many highlighted insufficient manpower and condemned the abolition of on-call allowance claims from weekday shifts.
Some also said the shift system would only push more doctors to resign from the MOH. In a statement earlier today, Hartal Doktor Kontrak demanded a retraction of the WBB circular, describing the new shift system that has triggered “unprecedented outrage” among the medical fraternity as “exploitative and dangerous.”
In a statement yesterday, the Malaysian Medical Association urged the MOH to expand the on-call allowance increment to all public health care facilities, regardless of the shift system.
