CODE BLACK (1/7-12/7/2021) AND BLACK MONDAY

 Here is some clarification from some medical folks about the Contract Doctors issue.  I have some commens at the end.

FAQs FOR THE MALAYSIAN PUBLIC ON CODE BLACK (1/7-12/7/2021) AND BLACK MONDAY

(12/7/2021) - A MOVEMENT TO SAVE THE HEALTHCARE SYSTEM OF MALAYSIA

1) 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 5 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.

2) But isn’t the contract system implemented widely in other countries such as the UK?

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 the contract system 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 our Malaysian contract system is that there is:

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

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

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

Our 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 subsidized.

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 5-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 5 to 7 years. It will be TOO LATE if we wait any longer.

4) 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 5 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 -

https://bit.ly/ContractDoctorTimeline

5) 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 with the Malaysian Medical Association. 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 this COVID19 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. As of writing, we have met with the Minister of Finance and are awaiting the Government’s response to our Open Letter dated 23 June 2021

[https://www.facebook.com/101568508523307/posts/199852672028223/?d=n].

In the meantime, to show support for our junior doctors, we will be calling a CODE BLACK - a demonstration of solidarity starting on 1 July 2021, culminating in a Black Monday on 12 July 2021.

6) 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 6 decades since Merdeka, will be affected. Hence, we call for CODE BLACK. Remove this threat before it reaches the point of no return!7) 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 1 July 2021

a. Change your personal profile pictures to BLACK or monochrome

b. Change your company/institution logo to BLACK or monochrome

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

On 12 July 2021

a. Go to work as usual wearing BLACK

b. Hold a placard saying “We stand with Contract Healthcare Workers” only

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

#BlackMondayMY only

8) 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 also 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.

9) 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: schomos@mma.org.my

#saveMYcontractHCW

#CodeBlackMY

#BlackMondayM

My comments :

Its like this ok. Doctors are usually the best and brightest of any society. To enter any medical school you must be a top scorer in your high school examinations. They are indeed the country's top academic talent as well.

Plus medical school is tough. It takes five years now to produce one medical doctor. Whether our doctors graduate from private medical schools or from public medical schools it costs about RM500,000 to produce every medical doctor.  

In private medical schools the public pays out of its own pocket for the medical degrees of its sons and daughters. 

In heavily subsidised government universities or public medical schools, it costs the Malaysian public (taxpayers funds) about the same RM500,000 to educate one medical doctor.  

So whether it is public or private medical education, it costs the Malaysian economy about RM500,000 or more to educate one medical doctor.

That is a lot of human, monetary and economic resources of the country to produce each and every doctor. 

• Only top scorers and brilliant academic achievers enter medical school
• FIVE years of intensive medical training
• At a cost of over RM500,000 to produce each medical doctor

Without a doubt ALL THESE doctors are our national assets. Kesemua doktor muda ini adalah aset negara kita.  We cannot simply allow so much human talent, monetary resources and economic inputs that have been spent to produce these doctors to go to waste. 

The Government must do everything in its power to make things easy for these young doctors to progress along their medical careers in the smoothest manner possible. 

And now the Minister of Health (who said last year that drinking warm water / hot water can kill the Covid infection)  says it is difficult to give these young doctors permanent posts because the Minister is afraid of "audit reprimand" ??

A Minister afraid of Audit Reprimand? Just take it to the Cabinet and get Cabinet approval. Apa susah sangat?

I believe that if there is a will, then there will be a way.  The Minister and the Government must just put their minds to it.  I am sure the Government can achieve  wonders to help our young doctors.

Why do I say this? Why do I believe this?

Because here is a recent example  of  a  Civil Servant who was promoted THREE TIMES in under TWO YEARS  and who has now become the Top Civil Servant in her Ministry.

This is the fantastic story of Datin Nor Zamani binti Abdol Hamid who has recently been promoted to become the Ketua Pengarah Pendidikan of the Ministry of Education or MOE.

• The talk is that in May 2020 she was promoted to Pengarah Bahagian Kurikulum. 
• Then after that in another SIX months (Nov 2020) she was promoted again to Timbalan Ketua Pengarah Pelajaran Malaysia.
• Then recently this year 2021 she has been promoted to Ketua Pengarah Pelajaran Malaysia. 

There must also be a promotion in her salary scale, possibly Jusa C to Jusa B to Jusa A or something like that (maaf kalau tersilap eja). 

I also forgot to mention that Datin Nor Zamani is the wife of the Minister of Health.  

So congratulations to the Minister of Health for his wife's TRIPLE PROMOTION in just two years.  Tahniah brader.  Tahniah besar.

Oops I almost forgot -  congratulations are due to Datin Nor Zamani on this really fantastic series of promotions since May 2020. 

• Datin Zamani must be a really super talented person. 
• Which is the only reason why the Government recognised her super talents and has promoted her to the top position in her Ministry. 
• We must appreciate our talented manpower resources. Tahniah Datin. Tahniah besar.

It is very difficult to compare the super achiever Datin Zamani with our young doctors who are certainly high academic achievers, who have completed FIVE YEARS of rigorous and often tough medical school and who have used up easily RM500,000 of monetary resources to become doctors.

N'theless, just like Datin Zamani,  these young doctors are also our national assets. Harta negara. Surely the Government can find a way to preserve and nurture such talented human resources?  

Artikel ini adalah pandangan penulis dan tidak semestinya mewakili MMKtT.