We may have to admit that there is indeed a “haemorrhage” of doctors and other medical professionals including nurses in our public healthcare system, and if we do not stop the bleeding, not only our healthcare system will be compromised, but it will also affect the quality of care provided for our patients in the country.
Recently, the Malaysian Medical Association(MMA) did an ad hoc poll which found that only 5% of public healthcare facilities have adequate manpower, with nearly half of respondents saying that shortages are due to doctors quitting or being transferred out.
Such sentiments are also reflected by data provided by the Ministry of Health(MoH) which shows the number of medical officers(MOs) who didn’t report for duty at their placements for permanent appointments surged 1,333% from 78 in 2022 to 1,118 in 2023. This is an 18-point jump, in just 1 year, from 2% to 20% of doctors offered permanent posts.
MOH data also shows that the number of resignations among contract doctors increased by a whopping 1,131 per cent from 110 resignations in 2017 to 1,354 resignations in 2022. The number of resignations in 2022 among contract medical officers exceeded those in the two previous pandemic years combined at 1,279.
On top of that, that are now fewer new medical graduates reporting to duty as fewer people are studying medicine overall in addition to those not returning to Malaysia after studying overseas for various reasons.
Data shows that the number of appointed house officers(HO) declined by 47% in just four years from 6,136 in 2019 to 3,271 in 2023.
When it comes to nurses, the Health Ministry (MOH) has projected a shortage of about 8,000 nurses in Malaysia for 2023 and 2024, and up to 60% by 2030, and the main driving factor for such brain drain is better salary and security in other countries such as Singapore, Australia and even Dubai.
All these are alarming as we can always build hospitals with bricks and mortar, but it is these medical work force who are needed to run these hospitals.
We are at where we are today due to certain unfavourable policies and a culmination of years of frustration with low pay, poor working conditions, and unclear career pathways in the public health service
Thats is where we need to have a holistic approach to this matter including short term and long-term healthcare human resource planning, which needs to be tailored to meet the specific needs of the population.
On short-term, conducive and supportive working environments should be promoted and any form of harassment or even bullying should not be tolerated.
For that to happen, the current feedback mechanism must be improved, be properly used as a anonymous direct channel to report incidents, and more importantly be seen to have actions taken to effectively address the concerns raised.
On top of that, the mechanism of distribution and transfer of medical personel around the country should be improved and made more transparent. There could be an open data system where MOH shows the need of each medical workers in each State and implementing a better transfer mechanism and support for those thst need to transfer out. This will help reduce the frustrations and issues faced by those that needs to be transferred out and thus reducing the rate of resignations as well.
When it comes to better salary, while i welcome the recent announcement by Prime Minister Anwar Ibrahim on the revision of civil servants salary, i also do hope they look into revising some of the allowances including on-call allowances for our staff. They need to feel appreciated and to ensure their earnings are competitive to the private sector to incentivise them to remain in the public service where about 70% of our population gets their treatment.
On top of that, career progression and talent development has to be developed including giving proper recognition to the parallel pathways to complement the Masters programmes in the local universities. This is to ensure that Malaysian doctors are given an unencumbered opportunity to specialise further as physicians that ultimately cater to the Malaysian population.
On a longer term, the Ministry may need to study the need for a seperate a public healthcare services commission that can manages the human resource in healthcare system.
This is to allow for more flexible decision-making when it comes to how human resource, staff development and talent is managed in the public healthcare system.