KUALA LUMPUR, Aug 10 — Bandar Kuching MP Dr Kelvin Yii has suggested several long-term solutions to deal with the issues currently faced by the country’s contract doctors.
During a talk on the “Hartal Doktor Kontrak” issue organised by the Wisdom Foundation, Dr Yii said that the biggest issue right now is the transparency of selecting doctors for permanent positions, adding that getting to the root of this problem would address much of the contract doctors’ dissatisfaction now.
“I said this before the announcement from the prime minister on the extension of the contracts. The root issue we have to overcome is the criteria for permanent placement is not transparent and there is no accountability.
“We do not know how one is selected for permanent posts. If it is not transparent, there will be cases where the use of ‘cables’ or contacts results in their selection of permanent positions, and I won’t name names, but I know many that because of ‘cables’ that they get these posts,” he said.
Dr Yii added that another problem is the lack of specialist doctors, adding that the two-year extension would not be enough for young doctors to pursue their chosen specialist fields, adding that 10 years would be a more realistic amount of time.
He added that current Health Minister Datuk Seri Dr Adham Baba went through the same system, and should be aware that the extensions given are insufficient for young doctors to earn their stripes.
“To me, if they (doctors) request for HLP (Hadiah Latihan Persekutuan — a paid study of a specific medical specialty), they should extend their contracts for a longer period so that they can finish their course and be gazetted.
“Because being gazetted takes time. And if they managed to finish their course in the time frame given, they should be given permanent positions immediately,” he said.
Dr Yii then shared several long-term suggestions to better improve the healthcare system in Malaysia and benefit those to work in it, including a clear substanding review of all the human resource needs in the Health Ministry.
“The ministry needs to do a survey. How many doctors do we need in government hospitals, in learning hospitals and the private sector? Once we know the number of doctors we need, then we make the placements based on the need.
“And it’s not only for now, but for the long term so that we can make a budget and policy on permanent postings. But we need a comprehensive review first,” he said.
Dr Yii added that the specialist programme also needs an overhaul and the training of specialists in the country should be relooked.
“If we look at other countries, specialist training is much faster, more comprehensive because it’s very specific, and I think that is what is needed.
“For example, if you want to be a surgeon, you don’t need to learn about infectious diseases. Of course, it is good to know, but then you specialise, and you focus on what you want to do. This would reduce the time needed for master’s programmes, then you can have more people,” he said.
He also said that there needs to be a medical school entrance policy to focus more on the quality of doctors being produced instead of just quantity.
“This has been debated, it is controversial. I know some people are not happy about it but I think in the long term, especially if there are way too many graduates, we may have to re-look at this entrance exam,” he said.
He also said the placement of doctors should be moved from the Public Service Department (JPA) to solely under the Ministry of Health as the ministry would know better on the needs and demands of the medical industry.
“The Health Ministry knows best the needs of doctors and medical officers in every district hospital in the country. We cannot let the JPA make that decision.
“We must take this whole scheme out of the JPA system and put it back under the Health Ministry,” he said.
On July 26, hundreds of junior doctors and medical officers in several public hospitals nationwide staged a walkout to express dissatisfaction with their current treatment in the government health system.
The move was organised by Hartal Doctor Kontrak at least as early as last month — “Hartal” itself reportedly being a Gujarati word meaning mass protest or strike.
According to the movement, the problem started when the Ministry of Health implemented a system in 2016 that offered junior doctors contractual positions after finishing their housemanships — as opposed to the full time positions offered to their predecessors.
Aside from the reduced pay and benefits even though they work the same hours, the contract doctors are also faced with an inability to further their specialisation as master’s programmes in public universities are reportedly only granted to permanent civil servants.
These problems were further brought to light during the Covid-19 pandemic where doctors are currently being overworked to tend to the sick.
As a solution, on July 23, the Cabinet said it had agreed to appoint medical officers, dental officers and pharmacists by contract for a period of two years once they have completed their compulsory service to ensure continuity of service and preparation for pursuing specialist studies.
The Cabinet also agreed to extend the contractual appointment to a maximum of four years for medical officers and dental officers who are pursuing specialisation studies during the contract period of the first two years.