Medical associations voice out against injustices of MOH contract system

Various medical associations including Malaysian Medics International (MMI), Malaysian Medical Association (MMA), Islamic Medical Association of Malaysia (IMAM), and Medical Practitioners Coalition Association of Malaysia (MPCAM) have come out in support of contract medical staff.

In a press statement, MMI requested the following from the Ministry of Health Malaysia (MOH): Equal opportunities for competency-based career progression for all Malaysian contract medical officers; extended contract system for currently contracted doctors; and complete transparency in selection criteria [of contract renewal].

The press statement added: “We are overworked and underpaid yet remain at the frontlines of the fight against COVID-19 to uphold the health of the nation, out of patriotic duty. We have pledged to serve the best interests of the rakyat. However, if this situation persists, we will continue to see the deterioration of an already collapsing Malaysian healthcare system. Inevitably, we, the graduating medical students, and junior doctors, will be forced to turn our backs on a system that has failed us, in pursuit of greener pastures where our well-being is a priority.”

MMI said it was pertinent for MOH to place importance on the requests and the issues they covered. In their statement, addressing those requests would “avoid the aggravation of systemic issues such as the chronic lack of specialists, brain drain, and the maldistribution of healthcare workforce and resources between urban and rural areas—all of which will ultimately condemn the health of our rakyat.”

Boycott looming
A strike slated to happen on 26 July calls for all contracted doctors to go on strike as a gesture of solidarity. Known as the Hartal Doktor Kontrak or contract doctor’s strike, the movement’s spokesperson, Dr Mustapha Kamal A Aziz said it has been 5 years since the contract system of hiring doctors was initiated. In that time, MOH has not come up with a concrete plan of action [to improve their job security]. [https://www.astroawani.com/berita-malaysia/doktor-kontrak-tidak-akan-hadir-bertugas-jika-kerajaan-gagal-beri-penjelasan-306114. Accessed on 6 July 2021]

MMA’s Section Concerning House Officers, Medical Officers, and Specialists (SCHOMOS), instead of partaking in the strike, opted to launch its Code Black week on 1–12 July. Both the Code Black and Hartal movements have essentially the same objectives—as a mark of solidarity with contract doctors, and to bring to attention the urgent need to address all issues affecting the welfare of contract doctors. [https://www.thevibes.com/articles/news/32672/mma-announces. Accessed on 6 July 2021]

More aggravating issues
In trying to allay the anger and frustration among contract doctors, MOH released a statement to assure them that they were being hired on a contractual basis due to the lack of open permanent positions, and that those under training have never had their contract  terminated. However, a clause which suggested that Bumiputera staff were being given priority when deciding whom to award permanent positions to, caused an uproar among the medical fraternity. [   https://www.facebook.com/373560576236/posts/10158013181526237. Accessed on 7 July 2021,  https://www.malaymail.com/news/malaysia/2021/06/26/why-single-out-bumiputeras-when-extending-doctors-contracts-medical-group-a/1985226 Accessed on 11 July, 2021]

IMAM, together with IKRAM Health and Malaysian Society for Occupational Safety and Health (MSOSH) released a statement condemning this practice. [http://www.imamalaysia.org/ Accessed on 11 July 2021] An excerpt of the statement stated: The suggestion by a few associations in the press statement smacks of racist nuances, preferring Bumiputera doctors above their colleagues in solving the problem plaguing contract doctors. Apart from a few isolated reports, the medical fraternity in Malaysia has otherwise been blessed with a harmonious multi-ethnic, multi-religious and multi-cultural co-existence. Our teachers and professors have been of all races as has been our patients. The rakyat patients only wish to be treated to the best that we are capable of, no matter the colour or creed of the healer.

Ethnic-based policies have no place in decisions involving contract doctors or other policies in MOH, the statement claimed. They called for contract doctors to be given permanent posts with either pension or employees’ provident fund (EPF) for at least 15 years from graduation as earlier agreed upon by the Public Service Department and MOH. This move will allow contract doctors to become full-fledged consultants during this time period. Additionally, it was noted that there is no other ministry that has contract posts for professionals except for MOH, which makes the situation facing contract doctors even more discriminatory.

A doctor’s take on the situation
Speaking to MIMS Doctor, Dr Raj Kumar Maharajah, president of MPCAM, said it was unlikely to see an instant solution to this problem. “For nearly 2 decades we have warned MOH regarding this impending problem, which is actually due to the mushrooming of medical colleges all over the country and over production of doctors. The approvals were actually given by the Ministry of Higher Education and not MOH.”

Raj said the solution lies in the root cause ie., too many medical colleges. He said: “When I was in college 30 years ago, there were only five medical schools in Malaysia. Now, we have about 40 schools producing 5,000 to 7,000 doctors a year.” The warning calls were there, but all the signs were ignored, he said. 

As the situation arose due to the government’s decisions, it then falls upon the government to clean up its own mess. “They need to create more posts and give these medical graduates jobs and job security. At the same time, we need to cut down on the number of medical schools and medical graduates. The selection process for permanent positions should be made transparent. The selection should be based on performance so that only the best are rewarded. Parents should be advised of the current stalemate and encouraged to advise their children to choose other careers instead.”

As a parting note, Raj called for MOH to have more engagements with stakeholders and listen to the doctors, as they are the ones that know the situation on the ground.