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Monday, July 26, 2021

'Government gave doctors Hobson's choice'

 Between 4,000 and 5,000 government contract doctors will stage a walkout at major hospitals nationwide, from 11am onwards, and will not return to work for the rest of the day. -NSTP/MIKHAIL ONG

The government must come up with comprehensive and immediate short-term and long-term plans to allay concerns raised by contract healthcare workers and provide them with a fair career path.

Medical experts said they do not condone the scheduled nationwide "Hartal Doktor Kontrak" strike during the Covid-19 pandemic, especially at a time when the healthcare system is under severe strain due to a shortage of resources and manpower.

They, however, said the Health Ministry and Public Service Department (PSD) should not use the pandemic as an excuse to delay talks to address the issue in totality.

Malaysian Public Health Physicians Association president Datuk Dr Zainal Ariffin Omar said the government should set up a special independent committee to examine the problems faced by contract doctors and propose better and fairer solutions.

This, he said, would be a preferred approach instead of the government relying solely on the Health Ministry and PSD for recommendations which might not accurately reflect the situation and plight of contract doctors on the ground.

Malaysian Public Health Physicians Association president Datuk Dr Zainal Ariffin Omar
Malaysian Public Health Physicians Association president Datuk Dr Zainal Ariffin Omar

"We do not condone any action that will jeopardise the lives of patients and potentially cause a major disruption to our healthcare system. But we respect the right of any group to air and voice their grouses towards unfair treatment, as long as it is within the law and ethics," he told the New Straits Times.

He was commenting on the "Hartal Doktor Kontrak" strike scheduled for today, where between 4,000 and 5,000 government contract doctors will stage a walkout at major hospitals nationwide, from 11am onwards, and will not return to work for the rest of the day.

The campaign representative, Dr Umar Baraka, had given his assurance that the walkout will be done only after the contract doctors had handed over their tasks to their permanent colleagues, without jeopardising the patients' care.

On Friday, Prime Minister Tan Sri Muhyiddin Yassin announced that the Cabinet agreed to appoint medical officers, dental officers and pharmacists on a contract basis for two years once they have completed their compulsory service.

"Hartal Doktor Kontrak" however, said while the government had acknowledged the problem, it came up with "rather short-sighted" solutions that did not address the real issues.

Dr Zainal agreed that the offer by the government was "inadequate and not satisfactory" to the contract officers.

"Long-term solutions call for health reforms with the National Healthcare Commission/Authority."

He said the government should also take into view Malaysia's long-term healthcare needs, where the country could face a lack of specialists should it fail to offer clear career and postgraduate pathways to specialisation.

He added that besides job security, contract healthcare officers should be given equal and fair treatment, and there should be transparent criteria for permanent positions.

Former Malaysian Medical Association president Datuk Dr N.K.S. Tharmaseelan questioned the Health Ministry for procrastinating and failing to table constructive plans to alleviate the misery of the contract doctors despite pleas and substantive justification given to scrap the contract conditions.

"The government has given the young doctors a Hobson's choice, where it will be contract and nothing else.

"The ministry and PSD have taken advantage of the pandemic by stonewalling progress on the talks to address these issues.

"The talks have been ongoing for years while the contract services have become more burdensome and insecure. There is a lack of transparency.

"Doctors have their contract services terminated for unfathomable reasons even after being certified upon completing their mandatory housemanship satisfactorily.

"Why the contracts have not been extended is not explained.

"The opacity by the ministry added to the whims and fancies of the PSD, and has made doctors' lives dangle on tenterhooks all through their housemanship training."

Dr Tharmaseelan also described the plan to employ medical personnel on a contract basis for two years as a "very short-sighted solution" and criticised the government for failing to comprehend the issue.

By placing the doctors on contract, he said not only was their future compromised, but also the healthcare system.

"Malaysia's healthcare system has always been acknowledged as one of the best in the region, and an international centre for health tourism, which is a result of a very well-planned structure for doctors to be trained and become specialists.

"But over the last decade, knee-jerk responses by the ministry and the government have resulted in the slow deterioration of standards in the healthcare provided.

"Previously, a doctor will need to do housemanship for two years, followed by another three-year compulsory stint.

"In those five years, they would have been trained all around and become a very competent doctor.

"Can you imagine if a doctor, upon completing a two-year housemanship with just six months in a speciality, has his or her services terminated?

"Their lack of competence, added to the lack of confidence, will see the health system rotting to the core in both the public and private sectors."

More importantly, he said contract doctors would not be able to specialise, as specialist training mandates they work in that speciality for a minimum of three years before being able to sit the exams to become specialists.

Dr Tharmaseelan said the government should explain why permanent services were replaced by contract services for doctors.

"It seems apparent that the government was doing away with permanent contracts due to the added financial commitments like job promotions and allowances, which can only be given to permanent officers, or to avoid the pension scheme for permanent officers.

"This confirms the widely held view by doctors that financial considerations were the main reason for placing doctors on contract.

"It is an easier way of terminating doctors' services and saving some expenses at the cost of the health of the nation."

Malaysian Pharmacists Society president Amrahi Buang said it was high time the government resolved this issue in totality.

"MPS does not condone the strike if it involves contract pharmacists. But steps must be taken to resolve the issue." - NST

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