A movement to save the healthcare system of Malaysia


WHAT is the fuss about Malaysian contract doctors?

Doctors in Malaysia were appointed directly to permanent service in the past. This permanent position is crucial in terms of a doctor’s career progression and professional development.

The government of Malaysia, however, switched to contract hire basis in December 2016, citing shortened post-graduation/pre-employment waiting period as a reason.

The opinions of the Malaysian Medical Association (MMA) regarding the switch to contract hire were not sought prior to implementation

We had raised the alarm about issues surrounding this switch several years ago.

The government has had five years since December 2016 to revamp the system to ensure that specialist training programmes remained accessible to contract doctors. However, there has yet to be any substantial reforms to be seen.

With the first batch of contract doctors ending their current contract in December 2021, time is running out and we must act now.

But isn’t the contract system implemented widely in other countries such as the United Kingdom?

Yes, other healthcare services around the world practise contract hiring of their doctors – a frequently quoted example would be the National Health Service (NHS) in the United Kingdom.

However, it must be noted that the contract system in the NHS is vastly different from that in Malaysia.

NHS contracts are awarded with fully transparent criteria and at sufficient lengths to complete specialisation. Their training programmes are also well-established, to the point that Malaysia has adopted their Royal College papers as part of our parallel pathways.

The issue with the Malaysian contract system is that there is:

a) no transparent criteria with regard to selection for permanent post and/or contract renewal; and

b) no proper plan for career progression due to short contract periods vis-a-vis long training specialisation periods.

Okay, so it’s about the career of doctors. How does it affect me in any way?

The Malaysian healthcare system is world-renowned for its accessibility. With a mere RM1, a Malaysian citizen can walk into any hospital or health clinic to have a medical consultation.

Subsequent investigations and treatment are also heavily subsidised.

However, if you have visited any public healthcare facility in the past few years, you would have noticed considerably long waiting times with shorter consultation periods. This is because our public health facilities have been underfunded and understaffed for far too long.

With a five-year limit on a doctor’s lifespan in the public healthcare system, batch after batch of junior medical officers will be pushed out into the private sector.

Accompanied with the natural trend of senior consultants reaching retirement age, we will see a dwindling supply of experienced physicians and surgeons available to provide specialist care.

Faced with a ceiling on their professional development, junior doctors will also be pushed overseas to further their training. This will exacerbate the brain drain of our nation’s brightest talents.

The effects of the current contract hire system might take years to manifest. Nevertheless, the time to reverse it is now.

The training period prior to becoming a fully fledged medical specialist takes on average five to seven years. It will be too late if we wait any longer.

Wow! That sounds serious. As the professional body for doctors, what is Malaysian Medical Association doing?

MMA has been engaging various governmental agencies over the past five years to resolve these issues. We have thus far been successful in pressuring the government to promote contract medical officers to the paygrade of UD43, similar to their counterparts in permanent service.

The main issues – lack of specialisation pathways and adequate contract lengths – however remain unresolved. This is not for lack of trying. A full timeline of MMA’s efforts can be found here.

Oh ya, I heard about the hartal! Was that part of MMA’s host of initiatives?

The hartal was initiated by a group of independent contract doctors who are not affiliated to MMA. Neither was MMA consulted in its planning and/or execution.

While we acknowledge and agree that the system needs to change, MMA does not condone a strike, especially during the Covid-19 pandemic.

As doctors, our first and foremost guiding principle is still to do no harm.

We will continue to exhaust all possible avenues in our endeavour to resolve these issues.

At the time of writing, we have met the minister of finance and are awaiting the government’s response to our open letter dated June 23.

In the meantime, to show support for our junior doctors, we will be calling a Code Black – a demonstration of solidarity starting on July 1, culminating in a Black Monday on July 12.

Code Black? What is that?

In hospital lingo, Code Black refers to a hospital emergency denoting a threat to personnel, or a suspicious or bomb threat.

The contract healthcare worker situation is a ticking time bomb. If it explodes it will affect the lives of all Malaysians. Not only will the livelihoods of our contract healthcare workers be ruined. Your healthcare service, the quality service that has sustained Malaysia over six decades since Merdeka, will be affected.

Hence, we call for Code Black. Remove this threat before it reaches the point of no return!

Twelve days of Code Black with a Black Monday? How can we contribute?

Over the 12 days of protest, we call for all Malaysian individuals and corporations to join in, and make your voices known.

On July 1:

a) Change your personal profile pictures to black or monochrome;

b) Change your company/institution logo to black or monochrome; and

c) Visit MMA Schomos Facebook page for latest information and updates regarding contract doctors and help to share the news.

On July 12:

a) Go to work as usual wearing black;

b) Hold a placard saying “We stand with contract healthcare workers” only; and

c) Post pictures on social media with the hashtags #saveMYcontractHCW, #CodeBlackMY and #BlackMondayMY only.

Is there any other significance to the colour black?

Over the past few years, many young, bright, talented doctors have left the country for greener pastures. These young talents have the potential to become specialists and contribute to the rakyat.

Instead of contributing to the (motherland) nation, they are instead allowed to slip through our fingers to places with better working conditions, job security and remuneration.

The wearing of black symbolises the mourning of the bright young talents we have already lost to other countries, in addition to mourning the slow death of hope for contract healthcare workers left in Malaysia.

I still have some questions that are unanswered. Who can I ask?

We can be found at the following social media platforms. Feel free to follow these pages and engage us further via DM!

Facebook: https://www.facebook.com/MMA-Schomos-101568508523307/

Instagram: @mmaschomos

Email: [email protected] – June 28, 2021.

* MMA is the premier organisation for the medical profession in Malaysia.

* This is the opinion of the writer or publication and does not necessarily represent the views of The Malaysian Insight. Article may be edited for brevity and clarity.


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