KUALA LUMPUR, Sept 2 — The Public Service Department (JPA) has disclosed the cost of creating new positions in the Ministry of Health (MOH) for five main service schemes: doctors, dentists, pharmacists, nurses, and medical assistants.
According to data tabled to the Health parliament special select committee (PSSC) at a hearing last February 27, JPA estimated financial implications of RM3,972,642,668 to approve 51,354 new positions (without trade-offs) for medical officers, dental officers, pharmacy officers, nurses, assistant medical officers (AMOs), and other staff in the MOH from 2019 to 2024.
JPA’s financial estimates covered the creation of positions for new health care facilities, as well as positions approved by a Cabinet memorandum on January 19, 2022, under Prime Minister Ismail Sabri Yaakob’s administration for the years 2022 to 2024.
Below were the estimated financial implications for the approval of new positions in the MOH from 2019 to 2024, totalling under RM4 billion:
- Medical officers: RM1.3 billion for 8,927 positions
- Others: RM1.2 billion for 19,352 positions
- Nurses: RM838.4 million for 15,064 positions
- Pharmacy officers: RM307.7 million for 2,188 positions
- AMOs: RM221.6 million for 4,568 positions
- Dental officers: RM176.5 million for 1,255 positions
Excluding the 19,352 positions for other service schemes in MOH, such as medical laboratory technicians, assistant pharmacy officers, health care assistants, and admin assistants (clerking/operations), the highest number of positions approved was for nurses with 15,064 positions.
Doctors, however, comprised the biggest chunk of costs at RM1.3 billion estimated for 8,927 medical officer positions.
The average cost per position came up to RM140,628 for medical, dental, and pharmacy officers – the same for all three schemes. Nurses were estimated to cost about RM55,654 per position, whereas AMOs were estimated to incur RM48,515 per position.
New facilities comprised about 83 per cent of the 51,354 new approved positions.
According to 2009 BPO guidance, “financial implications” comprise salary and fixed allowances (like public service, entertainment, and housing allowances) for one position for a period of one year. Salary calculations for estimated financial implications use the middle salary point of the P1 stage (first salary scale for a particular job grade).
JPA Considers Positions For New, Upgraded Health Facilities Every Year
Norazlin Alias, senior deputy director of JPA’s staffing and organisation division (BPO), pointed out to the Health PSSC that 5,185 positions were added for the MOH in 2020, marking a reversal of previous eliminations of certain less critical positions (not doctors or health workers).
“But starting in 2020, due to the needs of the MOH, we saw that although the current policy did not allow for an increase in positions, we submitted a policy paper to the prime minister at that time to create additional new positions to meet the needs of MOH facilities,” Norazlin told MPs last February 27.
“That’s why there was an increase of 5,185 positions. These cover various service schemes and grades to fulfill functional requirements.”
She explained that 4,957 new positions were approved for the MOH in 2021 without trade-offs, plus 3,265 additional net positions in 2022. “‘Net’ means there were applications for an increase and other applications for upgrading, which were a trade-off and the like. So that’s why the ‘net’ doesn’t look a lot, but we actually fulfilled many needs.”
In 2023, the government used Cabinet decisions in 2022 that approved the creation of 1,500 total positions from 2023 to 2025 for medical, dental, and pharmacy officers across the three schemes.
“Apart from that, in fact, every year, especially starting from 2020, JPA has considered the need for new positions to meet the requirements of new and upgraded facilities. So that is something we have indeed taken into account,” said Norazlin.
The JPA official pointed out that although the 2022 Cabinet memorandum only focused on three service schemes – doctors, dentists, and pharmacists – JPA would look at an entire set of health care worker needs for new or upgraded health care facilities and create the necessary positions, such as nurses and medical assistants.
“So far, the MOH has never not received positions every year, even though some agencies had to trade off 200, 300 positions for the creation of other more critical positions,” said Norazlin.
She added that 1,295 new positions were approved for the MOH this year as of last February. “If there are facilities that reach 80 per cent completion [of construction], then we’ll prepare positions for the related purposes.”
According to Norazlin, JPA works with the Economy Ministry at an early stage to identify staffing needs for the planning of new facilities.
“So we always give the necessary consideration to critical sectors like MOH.”
Noor Azman Abdul Rahman, division secretary of the MOH’s Human Resource Division (BSM), told the Health PSSC at the same February 27 meeting with JPA officials that the permanent appointments of 4,000 plus contract doctors last year, plus another 3,000 permanent appointments planned for this year based on vacancies, were for existing positions, not new ones.
“It’s not an increase [of positions]; it means they’ll be appointed on a permanent basis. The increase will come from university graduates, who will be appointed for housemanship,” Noor Azman said in response to Health PSSC member Young Syefura Othman (PH-Bentong).
The never-before-seen JPA data was revealed in the Health PSSC’s 455-page report titled “Proposal to Form a Health Service Commission” that was tabled in the Dewan Rakyat last August 27.
