The government needs to give more attention to the planning and development of its healthcare human resources, Malaysian Medical Association (MMA) president Dr Azizan Abdul Aziz said.
Dr Azizan said major issues in public healthcare are human resources related including overcrowding, maldistribution of healthcare workers, shortage in specialists, the contract doctor, lack of permanent positions, low wages, burnout and brain drain.
“These issues are yet to be adequately addressed. Firstly, the government needs to give more attention to the planning and development of its healthcare human resources.
“Each public healthcare worker should also have their career pathway planned together with them and given support throughout their work life in government service.
“The lack of certainty in career prospects are among reasons doctors are leaving public healthcare,” she explained.
According to Dr Azizan, from 2017 to 2022, contract doctor resignations went up by an alarming 1,131%.
“At the other end of the spectrum is the alarming rate at which specialists are resigning from public hospitals, with 3 to 4 specialists per week on average resigning over the last 5 years.”
She said an increase in the ‘on-call’ allowance would be a step in the right direction to stem this trend.
More importantly, she said, the country’s healthcare spend needs to be significantly increased o be able to support the development of its human resources, better wages and for the creation of new positions.
“While there has been some progress with regards to the contract doctor issue, with the government’s commitment of 12,800 permanent positions over 3 years, the issue remains unresolved.
“It is important to note that as many as 3000 to 5000 medical graduates will enter the system each year and upon completion of their housemen training, will go on to become contract medical officers,” she said.
Dr Azizan said detailed mapping of the healthcare services and personnel is also needed to resolve the issue of maldistribution of healthcare workers.
“The current disproportionate distribution of healthcare workers nationwide is one of the factors contributing to the issue of overcrowding seen at public healthcare facilities,” she added.
Aside from that, she also suggested that Health Ministry to consider expanding its Skim Madani to include non-communicable diseases (NCDs) management by private general practitioners (GPs) as part of efforts to reduce congestion at public healthcare facilities.
Currently, she said there are over 13,000 well distributed private GPs nationwide, under-utilised in the country’s management of NCDs.
On the issues of bullying in public healthcare, Dr Azizan said MMA had proposed a number of solutions to the ministry.
Among the suggestions were all Heads of Departments (HODs) be held fully accountable for any bullying incidents taking place in their department.
“We hope this can be implemented immediately as it is a move which can be decided quickly without the need for any allocation. Bullying in public healthcare is a serious concern as it can have an impact on the quality of care being delivered,” Dr Azizan added.
Last October, it was reported that about 30 to 40% doctors in the country have experienced some form of bullying before, based on findings of MMA’s Section Concerning House Officers Medical Officers and Specialists and Junior Doctor Network survey.
The survey involving 728 Malaysian public and private doctors found 253 cases of bullying with the highest reported in Sarawak (15), followed by Selangor (nine) and Perak (eight). Meanwhile, 197 cases were from unknown states.
She added it is also paramount for the government to expedite healthcare reforms to the system in line with Health White Paper.
“We hope this will be prioritised in 2024 and beyond until all reforms are achieved. One of the first items on the Health Ministry’s agenda for 2024 should be the setting of milestones for each of the reforms.”
