A medicinal townhall ahead

Dr Zaliha, the new Health Minister, has a huge job to cure the many ailments in the healthcare system. The townhall today is just the start of the consultations.

AFTER repeated calls and demands, Health Minister Dr Zaliha Mustafa is ready to meet disgruntled doctors at a town hall session today.

All hopes are now pinned on Dr Zaliha.

Can this doctor bring about the much-needed reforms to cure the ailing healthcare system?

The problems are many.

The shortage of manpower continues to burden the healthcare system. Just look at the surge of patients in emergency departments. The bed shortage is acute, too.

The contract system, introduced in 2016 to address the glut of medicine graduates, may have worked at the time, but now it has become a bane that has taken the healthcare system to the brink of collapse.

Doctors with little sleep, 36-hour workdays, patient overload, mental breakdown and exhaustion, are being pushed beyond their limits.

Complaining about their quandary itself has become a problem.

A gag order is in place, restricting Health Ministry staff from making public statements, including on social media.

Healthcare workers are also claiming that there is a witch hunt against those who speak to the press, so it is very important that Dr Zaliha and the ministry’s leadership ensure that those who speak up at the townhall session will not be targeted.

At least two healthcare workers who have spoken to this writer over the past month about the reality on the ground have expressed fear over potential “disciplinary action” if they were found out.

Despite this, many aggrieved healthcare workers have risked their jobs by going on social media and even to the press, to voice their problems.

These are not things to be taken lightly. We must take care of the morale of the healthcare workers, many of whom are planning to quit or have already quit.

It is no secret that staffing is among the major problems in the healthcare sector, aggravated by the contract system.

The ministry alone cannot be blamed for this debacle, which cuts across several agencies and ministries, including the Public Service Department (PSD), Public Service Commission and Finance Ministry.

Perhaps it is time that higher quotas for vacancies be given to the Health Ministry, instead of the fewer than 5,000 placements.

These 5,000 places are divided between doctors, pharmacists and dentists.

As former deputy health minister Dr Lee Boon Chye said recently, the whole process of hiring may take years from the time a healthcare facility submits a request for additional workers.

It took a pandemic to expose the cracks in the system.

Desperate healthcare workers had to send out SOS calls as hospitals and clinics overflowed with patients.

The pandemic may have abated, but the problem has not gone away, and the shortage of manpower continues.

“This is the reason why there is overcrowding and long waiting times for patients. At the same time, many contract doctors cannot get permanent posts,” said Dr Lee.

It’s not just doctors. Contract pharmacists have the same problem, with a shortage of pharmacists.

“PSD’s bureaucracy has been there since independence, and there have hardly been any reforms in the hiring system,” added Dr Lee.

The hiring mechanism also needs to be reviewed.

Many healthcare workers, particularly contract pharmacists, say a short interview should not be used to decide if they deserve a permanent job.

“How can a few minutes at the interview be used to evaluate the work we have done?” asked one contract pharmacist.

One possible solution could be on-the-job evaluation, where superiors could assess if a healthcare worker should be offered a permanent position based on their performance.

Recently, there were rumours that healthcare workers were planning an unannounced strike.

It is not known if there was indeed a strike planned, but bear in mind that such actions are usually considered a last resort when there are no other solutions in sight.

From what we know, what all healthcare workers really want is a healthy engagement with the top leadership and to be provided a platform to voice their grievances. And, of course, a solution to their predicament.

Dr Zaliha has done well in inviting healthcare workers to come forward to meet her and discuss the issues.

As a doctor herself, she would know and understand their grievances.

The well-being of doctors is very important. Dr Zaliha could consider shorter shifts, in line with the 48-hour week that most other sectors comply with.

Besides the long hours and manpower shortage, another big grievance seems to be bullying.

If it does exist, measures must be taken to address the matter.

The seniors, too, have to drop their archaic mentality of “you have to go through what we went through”, “the trial by fire”, and stop calling juniors the “strawberry generation”, that breaks easily under pressure.

To be fair, Dr Zaliha has only been in office for two months and has inherited a host of legacy issues.

The townhall is a start, and it is hoped more two-way engagements are held between MOH’s top leadership and healthcare workers. It is also important for the townhall session to be extended to other healthcare workers, such as pharmacists.

They say that health is wealth. If we are to prosper as a nation, we cannot afford to let our healthcare system crumble.

The ministry needs to ensure that doctors have a safe space to express their problems and be assured that the ministry’s leadership is not beyond reach.