THE shortage of doctors in government hospitals, especially in smaller facilities, needs to be addressed soon before the situation becomes much worse, said serving government medical practitioners.

Although the country produces a high number of graduate doctors, most don’t continue to serve in the government sector after their two-year housemanship because of higher salaries in the private sector, they said.

Several doctors told The Malaysian Insight that they are overworked because of the shortage of doctors and are worried that things would get worse.

One doctor in Kepala Batas said the shortage has been a recurring issue since he started serving in 1990.

“I have seen the influx of patients in this hospital since I first started working but at the time, we understand that Malaysia lacked doctors.

“But with the increasing number of doctors (today), we need more of them to treat more patients because of the lack of staff in the public hospitals,” he told The Malaysian Insight.

This issue was identified by the auditor-general in the 2018 report on the Ministry of Health, which found that there was a shortage of doctors in the emergency and trauma departments (ETD).

ETDs nationwide were congested with the number of patient visits exceeding the standard of care, it said.

The audit also found that ETDs experienced a shortage of staff between 11.6% and 53.1% compared with the number of internships required by international standards.

It also found that ETD personnel faced high task load, lack of medical equipment, limited space and ICT inability.

However, the doctor from Kepala Batas said the audit report did not reveal the full truth.

“The reality is that every department is facing a shortage of staff to tend to the patients.

“Obviously, this is because many doctors choose to work in private hospitals or clinics because they can get higher salaries.

“Doctors who undergo two-year training in government hospitals prefer to work in clinics because of higher salaries and physicians go to private hospitals because of the high salaries.”

According to the doctor, the government won’t be able to deal with this problem in the future unless Malaysia emulates the health system in the United Kingdom.

“The UK uses the National Health Service (NHS) system to tax every citizen 1% for health services. As a result of the tax, the government will then increase the funds depending on the tax revenue.

“With this method, the health service system will constantly improve and can address the problems reported by the audit department,” he said, adding that nations like Taiwan are already adopt the NHS model.

Penang Hospital cardiologist Dr Shahul Hamid said the shortage of staff and equipment is widely seen in smaller hospitals.

“In large hospitals, there is no shortage of staff and facilities are usually adequate.

“These problems often occur in small hospitals, such as in Kulim, Baling or Bukit Mertajam. Due to the large number of patients, these hospitals are crowded and medical facilities inadequate,” he said.

Touching on the shortage of staff, he said Malaysia had enough number of doctors but most were only offered to work contractually.

“There are doctors here but with no jobs. The doctors are still working but on a contract basis. There are not enough doctors in public hospitals because of the lack of government-provided care.”

In fact, he said the government is no longer able to absorb all the medical graduates who are among government-sponsored students.

Health Minister Dr Dzulkefly Ahmad said last month the absorption of students who had completed the training is subject to vacancies.

The maximum term for a contract is five years, where three years are for graduate training and two years for compulsory service.

As of November, 6,307 graduates were offered contracts and another 1,152 are still waiting for jobs.

A trainee doctor at Hospital Seberang Jaya said the shortage of doctors has caused many staffers to work longer hours.

Working longer shifts is normal because of the lack of staff but now, the hospital is also handling referral cases from three different other hospitals.

“In my opinion, the ratio between a doctor and a patient is greater than 1:2.

“This is because Seberang Jaya Hospital has to deal with cases involving Bukit Mertajam Hospital and Sungai Bakap Hospital.”

The number of patients is expected to continue to rise as the government deregulates consulting fees or charges of private clinics and dental clinics.

With the abolition, private medical practitioners will be able to determine the rates of consultation fees imposed on patients and are expected to increase treatment costs.

It was reported that MCA Youth demanded that the government reinstate the services of the 1Malaysia Clinic to provide services to the lower-income group.

Groups like the Penang Consumer Association (CAP) is also demanding the government raise funds for public hospitals to improve facilities.

CAP president Mohideen Abdul Kadir said the government will have to overcome the move of specialist doctors to private hospitals offering higher salaries after receiving training at government hospitals.

The government also needs to add more clinics across the country so patients need not visit hospitals alone. – December 30, 2019.