A need to treat our doctors better

The pandemic tested our healthcare system and exposed the need for more doctors, as many have chosen to migrate for better salaries. However, there are also many who do stay, and they deserve to be rewarded.

CONTRACT doctors finally have some good news – there will be 4,263 permanent placements in 2023, up from 3,586 last year.

The announcement by Health Minister Dr Zaliha Mustafa came as many were arguing over the brain drain problem, with even a claim that the best medical graduates are lost to Singapore every year.

While the issue of doctors migrating abroad has been grabbing headlines, there are still thousands who choose to stay and work here.

Why do they do so? For many, it is the love for service and the call to duty.

Take Dr Anna. She is among the 23,000 contract doctors who has been going to work despite the uncertain future, with no guarantee of a permanent job.

“You can say that we have held the fort since the Covid-19 pandemic. The peak of the pandemic was pandemonium. Hospitals were like a jammed conveyor belt.

“Patients were everywhere. We had very limited manpower and supplies, including oxygen, were running out. Initially, there was a shortage of PPEs and some of us juniors had to juggle between a few wards,” she said.

The doctors had to work 36 hours straight, had little or no sleep, faced a heavy patient load and sometimes had to go without a day off for an entire week.

“In some places, doctors were bullied and mocked by seniors when they could not work well or had to seek help as they were mentally or physically exhausted,” she said.

But still, they persevered. They did not know if their contracts would be renewed or if they would be made permanent, but they carried on.

“That’s because the patient needed our care,” said the 30-year-old.

Such fortitude needs to be rewarded.

What the doctors want are better working conditions and a more secure career pathway which will allow them to remain in government service.

Their seniors did not have this problem – they were absorbed into full-time positions before the contract system was introduced in 2016.

The current system does tempt doctors to leave for jobs abroad.

While contract doctors in Malaysia get about RM4,500-RM5,000 (a basic salary of RM3,397 plus allowances), junior doctors in the UK get £30,000 (RM159,000) a year or over RM13,000 a month.

Dr G, who is based in Penang, says the salary abroad is definitely more rewarding. However, he says he is staying because Malaysia needs healthcare staff for its people.

“What would happen to Malaysians? They too need doctors,” he said.

“We can’t leave patients waiting for hours. We have seen how emergency departments are packed to the brim. We are ready to serve but all we are asking for is some certainty about our future,” said the contract medical officer.

“Some of us are not even venturing into specialisation training. All we want is to be absorbed into the civil service. Why not consider automatic absorption?” he asked.

The fact is, the grass is not really greener on the other side. The cost of living abroad is high and many miss the family ties they have here and would return if the salary was better.

Several contract doctors said they chose to migrate simply because they had no choice after their contracts were terminated.

Malaysia is fast becoming an ageing nation, with medical experts warning that healthcare needs will rise too.

More hospitals, clinics and, more importantly, doctors are needed.

Perhaps, it is time the government reviews the contract system and consider reverting to the previous system or at least absorption based on merit.

Or, it could further increase the number of permanent positions.

If indeed there is a glut of medical graduates, it could consider limiting intakes in universities.

The Malaysian Medical Association, meanwhile, feels it is possible to absorb the doctors into civil service.

Its president Dr Muruga Raj Rajathurai said recently that it was just a matter of budgeting.

“If billions are spent on mega projects, I don’t see why the same cannot be done for healthcare services,” he said.

He said Malaysia had been underspending on healthcare, except during the worst days of the Covid-19 pandemic, when the government woke up to the importance of the healthcare system.

The pandemic tested the system, which at certain periods was bursting at its seams with its manpower and resources overstretched and doctors burning out.

Frontliners were keeling over in exhaustion in hospitals and their cries for help went viral on social media and the news.

Pakatan Harapan had pledged a Health Service Commission as part of its electoral promise.

It now remains to be seen if it will take shape.

Some 28,000 specialists are needed by 2030 as Malaysia heads towards becoming an aging nation.

They were only about 13,000 in both the public and private sector in 2021, and just 6,183 in 2019.

Last year, there were 55,981 medical officers employed by the Health Ministry with 23,096 – including 19 specialists – on contract, while the other 32,885 were permanent staff, 5,993 of them specialists.

That’s just 6,012 specialists in the public sector.

The government sector needs more specialists as private healthcare costs spiral.

To his credit, former Health Minister Khairy Jamaluddin did try his best to fix the problem but his time in the ministry is over.

All hopes are now pinned on Dr Zaliha for a concrete solution.