Stop bleeding in health sector

LETTERS: SOME Health Ministry policies, including the contract system of 2016, are thought to be the harbinger of the perceived shortage of junior medical doctors. It's not a new problem.

Recently, a frustrated medical officer said the healthcare system was on the verge of collapse, but this person didn't offer solutions.

I'd like to offer insights into the issue of uneven distribution of the healthcare workforce and try to be part of the solution.

The ideal ratio for doctor to the population is one for every 400, as recommended by the World Health Organisation.

The ratio in 2021 stood at 1:420. This seems to suggest that we are not desperately short in terms of numbers.

Put in another way, there are 2.4 doctors for every 1,000 persons in Malaysia.

This compares favourably with other Asean countries. Singapore, Brunei, Thailand and Indonesia have 2.7, 1.6, 0.9 and 0.6 doctors per 1,000 population respectively.

But in Malaysia, there is a gross mismatch of the number of doctor servicing the population, with over-representation of doctors in the Klang Valley versus rural areas, Sabah and Sarawak.

We have failed to distribute the doctors equitably and justly to serve the healthcare interests of Malaysians.

The chronic omission and commission of their basic duties has triggered the anger of junior doctors, who felt betrayed with unfair salary schemes, benefits and unjust career pathways.

This led to them to seek greener pastures.

Many of the ministry's woes can be mitigated, if not solved, by technocrats in the ministry showing civility and decency, with a sense of urgency and best practices, at virtually zero cost.

They could:

RECTIFY the maldistribution of the medical workforce. I am led to understand that the paediatric sector has virtually solved its manpower distribution with an ingenious data- driven, doctor-to-workload norms, which can be improved, refined and digitalised for other disciplines;

WITH artificial intelligence and algorithms, the movement and rotation of doctors can be fairly and promptly decided.

Data driven with a prolific health information system would empower the ministry to better forecast medical manpower needs and better allocate medical personnel.

The ministry can take the cue from multinational corporations about manpower distribution, just like we learnt about safety culture from the airline industry;

IF we cannot stop, then minimise the discrimination in the selection process by decision makers, including director-general, deputy D-Gs in states, directors, heads of services, consultants and administrators.

We do this by having a clear selection criteria for promotions, transfers, entry to postgraduate programmes and obtaining scholarships; and,

GIVE a fair and competitive salary scheme and promotion schedule for junior doctors. The selection criteria for permanent and key public sector positions (Jusa) posts must be made known.

Other non-financial incentives, such as posting of choice upon completion of service to an underserved location, should be considered.

Attractive travel fares or priority seats should be explored to facilitate and incentivise the relocations of doctors to underserved locations in rural areas of Sabah and Sarawak.

The health minister should ensure the authorities act promptly and justly in dealing with the depleting medical human resources and its adverse effects on healthcare services.

The dissatisfaction index and attrition rates of the healthcare human capital are worrisome and must be addressed urgently.


Kuala Lumpur

The views expressed in this article are the author's own and do not necessarily reflect those of the New Straits Times

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