Of doctor shortages, ailing hospitals and reduced maternity leave

 

Recently, a district health office was forced to cut down the maternity leave entitlement of doctors in 15 health clinics from 90 days to 60, owing to a shortage of medical officers. This is unprecedented.

The directive, which took effect on June 27, was made after seven medical officers attached to some of the 15 health centres in Selangor’s Hulu Langat district went on maternity leave simultaneously.

The problem was compounded when officers instructed to stand in for them rejected their placements.

This instruction is made due to a critical shortage of medical officers in all health clinics which has affected the delivery of health services to customers,

 the circular said.

However, on Tuesday, health minister Dzulkefly Ahmad rescinded the directive, following protests from medical staff.

The issue is just another symptom of the underlying problems faced by public hospitals nationwide and affecting the delivery of public health.

Medical officers and housemen are struggling to cope and quitting for a variety of reasons. Many are working under huge stress and struggling with mental health issues.

The situation exposes the government to potential negligence and malpractice lawsuits. In fact, many horror stories have come to light, but many others go unreported, or are covered up by the authorities.

Hospitals in Johor are rumoured to have lost a number of doctors over the last few months with one believed to have seen 11 departures in a single month.

A number of hospitals are known to be waiting for fresh postings of medical officers – expected to take place only after October – to resolve the situation.

In the meantime, hospitals may well see only one doctor on the main call, placing a huge burden on that doctor to man the ward singlehandedly overnight.

That arrangement may be manageable if there was another doctor on 

passive call

, ready to help out if needed. But without that option, medical officers are left running around doing almost everything, at times for 36 hours at a stretch.

Hospital Sungai Buloh in Selangor is known to be suffering from a serious shortage of doctors, leaving those still on staff overworked.

Redeployment as a temporary solution

Senator RA Lingeshwaran, a former director at the Sungai Bakap Hospital, said the authorities should have undertaken a redeployment of resources instead of seeking to implement a cut in maternity leave.

His argument is simple. There are 8,000 medical officers in Selangor, the largest number in a state in Malaysia. So, the state health department could have asked for volunteers to serve three-month attachments to the 15 health centres in the district.

This practice can be invoked as a stop-gap measure to deal with short term vacancies, including in situations where medical officers intend to go on maternity leave.

For its part, the health ministry’s human resources department must ensure an appropriate gender balance in hospitals.

It should also work proactively to approve appointments and postings, while health ministry officials must be empowered to make quick decisions on such matters.

The ministry should avoid being bogged down by excessive bureaucracy and obsolete procedures. It must instead work to minimise the rapid loss of doctors from the public healthcare system. After all, peoples’ lives are at stake.

Keeping them in service

Currently, keeping medical officers in service seems to be the biggest challenge facing the government. Wages are not commensurate with the long hours put in and the heavy responsibilities they are saddled with every day. Low on-call allowances have been a bone of contention for several years now.

Talk has it that new rates will be introduced in the upcoming salary revision for civil servants, with details expected when Budget 2025 is tabled in October. The new pay scheme will only come into effect next year.

Hopefully the budget will also address long waiting periods of between six months and a year faced by those who have completed their housemanship before they are offered permanent placements.

Many who quit the government service are said to be from this group. Classified as 

floaters

, they are tired, having had to wait for anywhere between seven months and a year to be placed as housemen previously.

Let’s hope new and effective short and long term measures can be put in place to stem the loss of doctors in public healthcare. - FMT

The views expressed are those of the writer and do not necessarily reflect those of MMKtT.