Although Budget 2017 revealed that the Ministry of Health (MOH) would be allocated with RM25 billion compared to RM23 billion in the previous year, the announcement by Prime Minister Dato’ Seri Najib Razak still roused a weekend heated with discussion amongst the Rakyat.

As a solution to the problems of healthcare graduates waiting too long for placements due to constraint in permanent posts, an initiative has been announced to appoint 2,600 medical, dental and pharmacy graduates for service in government facilities from December 2016 – on contractual basis.

Government hopes this will be good news for HCPs and their families

"All the posts in this category (doctors, dentists and pharmacists) will be selected through contract system and we will suggest that doctors work for the government for at least four years while dentists and pharmacists can work up for three years under the contract," said Health Minister Datuk Seri Dr S. Subramaniam.

“The problem we had initially was the limited number of posts. The Public Service Department (JPA) is restricted from creating new permanent posts. For example, if there are 80 posts available, it can only accommodate 80 doctors on a permanent basis,” he explained, adding that this improves flexibility in recruitment as the number of contracts can be adjusted based on demand.

"So with this move, waiting period for doctors to get the placements will also be reduced.”

Healthcare professionals have voiced their support with this initiative, such as senior physician Dr Ahmad Faizal Perdaus who agreed that such plans are necessary to address the oversupply of medical graduates.

“It would be a waste for the students taking five years to complete their degree and in the end they cannot find jobs,” he added.

But what happens after contracts expire?

While Malaysian Medical Association (MMA) secretary Koh Kar Chai agreed that employment on contract would allow for necessary training for graduates, he queried what would happen following expiration of contract.

“Basically after housemanship, excellent ones will be absorbed straight as permanent MOs (Medical Officers),” said the Director General of Health Datuk Dr Noor Hisham in a Facebook post. “The rest will continue as MO contract for two years from this cohort, the better ones will be absorbed as permanent MOs.”

“After two years of compulsory service, those not eligible to be absorbed as permanent MOs, will have to join the private sector,” he further explained, concluding that the merit-system aims to produce more specialists from excellent housemen.

“But how many of them can be absorbed into the private sector when what most private hospitals require are specialist doctors with sufficient experience and not new medical officers,” queried Opposition MP Teresa Kok. “Can they really find jobs in the private sector?”

“With the introduction of the contract scheme, the Health Minister should tell the public the clear and honest picture about doctors becoming jobless,” she stressed, rather than “giving the impression” that jobs are still plentiful for them in the private sector.

Despite her concerns, healthcare professionals have voiced in agreement that contractual posts may be better for overall standards in the long run, as only the “best” will be selected in the profession, with private facilities also selectively hiring skilled doctors.

MMA's president Dr John Chew has since expressed interest in working with the JPA to ensure clear outline of the fairness of employment.

"While we wait for the details of the contract for housemanship, we would like to be involved with the Government employment agency to have transparency in appointments, employment and disciplinary procedures,” he said.

The changing landscape not just for housemen

“We cannot cut (the recruitment) as we like. If we reduce the number of doctors and paramedics, our services will crumble but we always want to do the best for the people,” said deputy health minister Datuk Seri Dr Hilmi Yahaya, adding that the increasing number of patients required demand for medical servants.

In addition to contractual employment, the government will also introduce a grade 56 between grade 54 and JUSA C in the civil service salary scheme for medical and dental specialists, with aims to address the issue of delays in promotion and retain specialists in the public sector. This initiative is in addition to the recent expansion of the Full Paying Patient scheme in public hospitals as a form of encouragement for specialists to remain in government sector.

“Some feel it might delay the promotion process when they could make the jump straight to JUSA C category,” said Koh.

“This should not be the reason to restrict eligible candidates to move up in the ranks,” added Faizal, who said that the new Grade 56 should not be a glass ceiling for medical professionals to progress to JUSA C. MIMS

Read more:
Budget 2017: An overview of its impact on Malaysian healthcare in the coming year
Malaysia’s MOH proposes expansion of full paying patient services
Malaysia’s Deputy Health Minister: We cannot afford budget cuts for 2017
In conversation: Dato’ Dr Ahmad Faizal Perdaus on the changing dynamics of Malaysia’s medical fraternity – Part 1