Amid growing unrest among medical doctors on social media over the recent e-placement exercise, concerns have intensified regarding the abrupt withdrawal of relocation allowances following changes in contract status, the demotion of doctors to lower ranks despite having served in the same positions for years, and placements that disregard family proximity and essential support systems.
These developments point to a deeper, often overlooked issue: who ultimately bears the cost of the continuous reshuffling and placement decisions made by the higher management within the Ministry of Health (MOH)?
It is understood that the rotation of civil servants is part of the government’s broader strategy to combat corruption, aligning with the reform measures championed by Prime Minister Anwar Ibrahim under his anti-corruption agenda.
While the anti-corruption motive behind civil service rotations is both necessary and laudable, its wholesale application in clinical contexts may require a more tailored approach–Is it truly pragmatic to impose such rotations on health care professionals–medical doctors, dentists, pharmacists, and others whose work depends on continuity of care and trusted, long-term relationships with their patients, often spanning from childhood through to old age?
As Malaysia moves towards becoming an ageing nation–with 11.6 per cent of the population currently aged 60 and above in 2024 and this figure projected to rise to 17.3 per cent by 2040, there is an urgent need to realign and revamp our health care system to meet the evolving needs of society.
This demographic shift underscores the critical need to reorient health care services toward strengthening primary care, particularly through facilities such as Klinik Kesihatan, as outlined in the Health White Paper.
This urgency has also been echoed by the Prime Minister, who has highlighted the critical need to invest in both health and social systems to adequately support the demands of an ageing population.
Community-based interventions are central to this transformation. Medical doctors, who are familiar with their patients’ baseline health status, are more likely to detect early signs of abnormalities.
Pharmacists, who have longitudinal insight into patients’ medication histories, can play a vital role in ensuring safe and effective therapy. Allied health professionals, through consistent engagement with communities, can deliver targeted interventions that support functional independence and promote a better quality of life especially among the elderly and those with chronic conditions.
On the other side of the table, patients who have been under the care of the same medical doctors over the years often develop a strong rapport, built on trust and mutual understanding.
They take comfort in knowing that their doctors are familiar with their medical histories and are committed to acting in their best interests. Such meaningful relationships cannot be formed overnight; they require time, consistency, and continuous engagement.
When continuity of care is disrupted, particularly through the frequent reassignment of health care professionals, the foundations of regular follow-up and treatment adherence may be compromised–placing both patient experience and clinical outcomes at significant risk.
Consider, for example, an elderly patient with limited formal education, multiple chronic health conditions, and a five-year history of consultations with the same doctor at a Klinik Kesihatan.
If this patient is suddenly seen by a new doctor unfamiliar with their medical background, there is a risk that their symptoms may be misunderstood or dismissed especially if their chief complaints are vague or not clearly indicative of any specific disease. This scenario underscores the importance of continuity in patient-doctor relationships, particularly for vulnerable populations.
Reshuffling existing health care and allied health professionals amid an ongoing workforce shortage is a decision that warrants serious reconsideration, especially given the rising demands of an ageing population and the increasing unaffordability of private health care, as reflected in the growing patient load and prolonged waiting times in public facilities.
Frequent disruptions risk undermining both the collaborative relationships among health care professionals and the therapeutic bonds between providers and patients. When intra-professional coordination and patient trust are constantly reset, the continuity, integrity, and overall effectiveness of the health care system are inevitably compromised.
It is also noteworthy that a recent reshuffling involving psychology officers within the MOH resulted in several inter-agency transfers. Senior officers from the MOH were swapped with psychology officers from other departments, such as the Royal Malaysian Police and the Welfare Department.
Many of these incoming officers, however, lack clinical health care experience and were assigned to demanding clinical roles within MOH facilities. This development raises serious concerns about service continuity, role suitability, and the overall quality of mental health care delivery in the public health system–particularly in light of the well-documented shortage of psychiatrists in public health care, as highlighted in a recent CodeBlue article.
We echo the concerns raised in a recent CodeBlue article, urging the government to uphold its health care commitments and take swift, concrete action to resolve the ongoing issues affecting contract doctors, as well as the reshuffling of medical and allied health professionals.
One proposed solution is the establishment of a National Health Services Commission, separate from the Public Services Commission and similar to the existing Education Services Commission.
Such a body would allow health care professionals to manage their own affairs, with greater autonomy, continuity, and accountability in workforce planning and service delivery.
Health care is a fundamental human right–not a bargaining chip for administrative convenience. The MOH must act with conviction and urgency, while Members of Parliament must advance the necessary legislative reforms to establish a National Health Services Commission.
Such a body would be better equipped to manage and strengthen our health care system with the continuity, autonomy, and equity it urgently requires.
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.
