Doctor shortages, struggling hospitals and reduced maternity leave

Recently, a district health office was forced to reduce maternity leave for doctors at 15 health centres from 90 to 60 days due to a shortage of doctors. This is an unprecedented situation.

The directive, which came into effect on June 27, was issued after seven doctors attached to some of the 15 health centres in Hulu Langat district in Selangor simultaneously went on maternity leave.

The problem was compounded when the officers assigned to replace them refused their assignment.

“This instruction is issued due to a critical shortage of doctors in all health clinics, which has affected the delivery of health services to clients,” the circular said.

However, on Tuesday, Health Minister Dzulkefly Ahmad reversed the directive, following protests from medical staff.

This problem is just another symptom of the underlying problems facing public hospitals across the country that are affecting the delivery of public health care.

Doctors and interns are struggling to cope with their work and are quitting for various reasons. Many are working under enormous stress and struggling with mental health issues.

This situation exposes the government to lawsuits for negligence and malpractice. Many horror stories have come to light, but many more go unreported or are covered up by the authorities.

There are rumours that hospitals in Johor have lost a number of doctors in recent months, with one experiencing 11 departures in a single month.

It is known that a number of hospitals are waiting for the allocation of new doctors – which is not expected until after October – to resolve the situation.

In the meantime, hospitals risk having only one doctor on call, which will place an enormous burden on that doctor to manage the service alone at night.

This solution might be possible if another doctor were on passive duty, ready to help if needed. But without this option, doctors have to run around and do almost everything, sometimes for 36 hours at a time.

Sungai Buloh Hospital in Selangor is suffering from a severe shortage of doctors, leaving those still working there overworked.

Redeployment as a temporary solution

Senator RA Lingeshwaran, former director of Sungai Bakap Hospital, said authorities should have undertaken a redeployment of resources instead of seeking to implement a reduction in maternity leave.

His argument is simple. Selangor has 8,000 doctors, the most of any state in Malaysia. So the state health department could have asked for volunteers to do three-month internships at the district’s 15 health centres.

This practice may be invoked as an interim measure to address short-term vacancies, particularly in situations where doctors intend to go on maternity leave.

For its part, the human resources department of the Ministry of Health must ensure an appropriate gender balance in hospitals.

The Ministry of Health must also work proactively to approve appointments and postings, while Ministry of Health officials must be empowered to make swift decisions on these matters.

The ministry should avoid getting bogged down in excessive bureaucracy and outdated procedures. Instead, it should focus on minimizing the rapid loss of doctors in the public health system. After all, human lives are at stake.

Keep them in service

The biggest challenge facing the government at present is retaining military doctors. Salaries are not commensurate with the long working hours and heavy responsibilities they have to shoulder on a daily basis. The low on-call allowance has been a point of contention for several years.

The new scales are expected to be introduced as part of the upcoming civil service pay review, details of which are expected to be revealed when the 2025 budget is tabled in October. The new pay system will not come into effect until next year.

Hopefully the budget will also address the long waiting periods, of six months to a year, faced by those who have completed their internship before being offered a permanent placement.

Many of those leaving the civil service are said to belong to this group. Classified as “vagrants,” they are tired, having had to wait between seven months and a year before being placed as interns.

Hopefully, new effective short- and long-term measures can be put in place to stem the loss of doctors in the public health system.

The opinions expressed are those of the author and do not necessarily reflect those of FMT.