Sin Chew Daily

With daily new infection numbers staggering and more and more people have succumbed to the coronavirus, hospital beds in tight supply and the country's healthcare system under growingly heavy pressure, our frontline medical personnel have given their best over the past 18 months since the onset of the pandemic here.

Among them there is this group of contract doctors and healthcare personnel who are still fighting for their own benefits, employment and further study prospects, while struggling on the frontline saving lives.

They are suffering problems such as unfair remunerations and benefits, and lack of employment assurances, thus the "Code Black" and "Black Monday" campaigns to make their voices heard. Such campaigns have secured the endorsement of many senior doctors as well as strong support from the general public.

Both PM Muhyiddin and health minister Adham Baba said last week the appeals of the contract doctors would be brought to the cabinet meeting, but so far we have not heard of any decision from the government. 

Following the expiry of the contracts of these doctors in December, it is understandable that they are becoming increasingly worried.

Hartal Doktor Kontrak has revealed that many contract doctors have felt physically and mentally drained, and have to quit their jobs giving only 24 hours of notice.

On July 1, Hartal issued an ultimatum to the government with the hope they can be provided permanent posts and that the government will publish the clear permanent posting selection criteria, threatening to take stern actions if the government fails to do this, by taking leave starting July 26 until their demands are met.

Let's take a look at how this whole thing has come about.

The health ministry introduced the contract system in 2016. Prior to this, doctors enjoyed lifetime hiring until their retirement.

From what we understand, the measure was meant to downsize the civil service workforce and only the best get to be rehired.

To be honest, the contract system is a very reasonable human resource management policy, but the thing is, it has also restricted the career development of these doctors who will only get a five-year contract which is not sufficient for their specialist training which typically requires five to ten years.

Upon the expiry of their contracts, the government can choose not to renew their contracts, making it difficult for these doctors to plan their own career future.

As of July 2020, only 3.3% of contract doctors were eventually offered permanent positions.

With more and more medical graduates joining the increasingly competitive job market, these contract doctors may end up losing their jobs or having to switch line.

Moreover, they are not allowed to pursue a postgraduate degree at a local university as one of the requirements is that the applicant must be a doctor with a fixed position.

It is learned that some 23,000 contract doctors are therefore denied of the opportunity to gain access to specialist medical training, resulting in a severe shortage of specialist doctors in the country.

The responsibility of a contract doctor is the same as that of a resident doctor, especially during the pandemic when contract doctors do not have the privilege to choose not to work at high-risk positions.

Like resident doctors, they are also making selfless contributions towards the country and people even though their remunerations and welfare are vastly different. Contract doctors not only draw significantly lower salaries than resident doctors, they are also not entitled to salary increments, allowances, study leave, government loans and other perks.

Some people may feel that these contract doctors should not exert pressure on the government during the current trying times. Having said that, their problems have not been established overnight but have been around for some years.

The government has failed to honor its promises, but these doctors need to feed their families too, and they hope they can advance their career dreams some day.

The pressure that comes with the pandemic has further intensified their anxiety and restlessness, and the government is duty-bound to give them a due reply soonest.

The government should map out short and long-term solutions to alleviate the anxiety of these contract doctors. For short-term solutions, the government should draw up more reasonable contract tenure to allow these doctors to complete their specialist training.

Statistics show that the ratio of specialists to the country's population is 4:10,000, far behind the OECD average of 14:10,000.

Increase in the number of specialist doctors signifies a lift in the country's healthcare quality, which is of particular importance against the backdrop of an increasingly aging Malaysian society and dramatic rise in the number of people suffering from chronic illnesses.

The government has the obligation to provide high quality yet affordable public health services to all Malaysians.

The extended contract period should be accompanied with a fairer contract such that these contract doctors can be retained to serve in the public sector while enjoying equal benefits offered to resident doctors. This will stem the outflow of talented doctors to the private sector or even overseas.

As for the long-term plan, the health ministry and PSC should work together to draw up more reasonable solutions, including the establishment of an independent committee tasked with the responsibility of planning the personnel and equipment needs of our public healthcare system while managing the recruitment and promotion of health workers nationwide.

Additionally, the health ministry must also work with the higher education ministry to optimize the admission of medical school students, including discontinuing sponsorship for students to study at institutions here or abroad that are not of superior quality.

The government should draw up workable short and long-term solutions to boost the morale of doctors while implementing positive reforms in the healthcare system's human resource structure.