It’s back to a shortage of doctors

Extra duties: The manpower shortage has translated to an increased burden for healthcare workers.

Youth diverting from careers in science, pursuing other fields, says expert

PETALING JAYA: A few years ago, there was a glut in medical graduates. But today, the public healthcare system is grappling with a shortage of doctors, especially housemen.

Healthcare stakeholders have warned that if the manpower problem is not resolved, the public healthcare system will eventually suffer and the people would bear the brunt.

Hartal Doktor Kontrak spokesperson Dr Muhammad Yassin said the rights group had predicted the shortage in 2021.

“Actually, this is a global trend where the newer generations are more inclined to non-science streams and prefer to pursue careers based on that. Hence, we have fewer undergraduates at medical school and fewer new medical graduates.

In Malaysia, this is further exacerbated by the contract system issues which had been plaguing the country since 2016,” he said when contacted.

“Hartal has predicted this issue since 2021 but those in power wouldn’t want to listen and didn’t want to take any affirmative actions. Medical graduates prefer to work overseas instead of joining the Health Ministry (MOH).”

He said manpower shortage had translated to more burden and increased mental stress for healthcare workers.

Shortage of manpower, he said, would also lead to reduced quality of services provided and higher risk of medical errors.

He said there had been several reports on longer waiting time at medical facilities and this would only get worse if the matter was not addressed.

Dr Muhammad Yassin said the issue could be resolved with better pay and allowances – issues related to the contract scheme for all healthcare workers, not just doctors – and more perks and benefits, especially for professional development.

Malaysian Medical Association (MMA) president Dr Azizan Abdul Aziz said medical schools were mushrooming in the late 1990s and early 2000s, leading to more medical graduates.

“The rising numbers were alarming and necessitated a moratorium imposed for medical schools in 2011 to control the number of medical students.

“It is important to note that medical school takes five years to produce graduates.

“This means students joining the programme in 2010 would have graduated in 2015. This corresponded with the peak of medical graduate numbers (2017-2020).

“Around the same time, we also had the contract system introduced in 2016, which put medical graduates off from registering in the system (overseas graduates chose to remain overseas, UM and UKM graduates registered in Singapore, Newcastle graduates registered in UK, Monash graduates registered in Australia).

“So, the situation now is a combination of fewer people studying medicine from 2018-2019, plus people not returning to Malaysia,” she said.

She added that the healthcare system would be stretched further, with issues of overcrowded facilities, burnout among healthcare workers, brain drain and, as a result, poor quality healthcare.

Dr Azizan said effective short- and long-term healthcare human resource planning, which is tailored to meet the specific needs of the population, is essential for optimal healthcare delivery.

“We urge for transparency from the MOH on sharing its data on the numbers of healthcare workers by category towards more effective planning of the healthcare workforce,” she said.

The MMA had proposed on many occasions that the government introduce a dashboard where data on the numbers of healthcare workers by category are listed.

“This information should be shared with the public on a dashboard. Currently, no one, except the government, knows what the numbers are,” she added.

Independent healthcare advocate and former contract doctor Dr Sean Thum said there must be a complete overhaul in the current system of how human resources, staff development and talent is managed in the public healthcare system.

“There is a need to separate the public healthcare system from the civil service framework to increase agility, competitiveness and attractiveness as an employer.

“Salaries and benefits need to be revamped to be competitive with the private sector and other regional employers, with flexibility to adapt to market trends.

“Continuing with the current Public Service Department and civil service framework has led to a further decline in the attractiveness of the public healthcare system as an employer,” he said.

Employers worldwide are competing for talent and the Malaysian public healthcare system must become more sophisticated in attracting, managing, retaining and developing talent.

“A healthcare system is only as good as its people, so it must prioritise the well-being of its healthcare professionals.

“Decentralisation of power and increased flexibility and autonomy are necessary in keeping up with the rapidly changing world,” Dr Thum added.

Public health expert and retired Health Ministry official Datuk Dr Zainal Ariffin Omar said there have yet to be definitive solutions for the workforce in the MOH.

“Unless the government implements the right strategy, our health system and rakyat will suffer. The government should be more serious, fast and firm (in finding solutions).

“The Health Service Commission should be established as soon as possible. No more talk or studies.”