LETTER | It may be a new year, but the issues plaguing government doctors are old and may remain the same till 2026 unless some action is taken this year.

Official statements about these issues are either inaccurate or vague and have no specific date or target for resolution.

Junior doctors (and support staff) are quitting government service at an alarming rate; coupled with severe maldistribution of manpower, this has caused patient care to suffer especially in rural/district hospitals.

Official numbers may or may not be accurate but we know for sure that the total number of doctors is reducing and will continue to reduce. I receive messages regularly on “how to quit” and “what is my alternative if I quit” and it is quite heartbreaking.

Permanent position criteria

Since the implementation of the contract system in 2016, - the criteria remained a mystery, and no one knows what it is.

The situation was further worsened when the last intake into permanent positions disregarded working duration and seniority, causing even more doctors to give up and quit.

On-call claims and remuneration

After more than a decade without revision, an increment is announced, only to find out that it will not be implemented in all hospitals but for a pilot project to first take place.

Selection of these “privileged doctors” to undergo the project is again, another mystery and has given rise to even more confusion and doubt

Manpower distribution

The current placement system is messy and full of glitches. There are doctors who wanted to remain in Borneo but were forced to choose to transfer out, and then after that were told to appeal to remain (which was approved). Again, this leads to confusion, doubt, and a waste of time and resources.

Manpower norms and current numbers are not published, and there is no system to match doctors in departments in which they have a keen interest (and have a lack of manpower)

More responsibility, same grade/salary

House officers who become medical officers (MO) assume more responsibility and become fully registered medical practitioners but in their first year as an MO, remain at the same salary scheme and pay grade as house officers.

A bit of work to synchronise the completion of housemanship and promotion to a higher pay grade can be done, but is not being done. The new SSPA has also not rectified this.

Subspecialist allowance and Jusa/Special Grade criteria

Subspecialists come back from three years of training and are often strained financially as the allowances are insufficient for their expenses; only to find out that there is no extra remuneration despite them having a higher qualification.

The promotion to Jusa/Special Grade positions is again, another mystery; the frequency of such promotions is also seemingly random.

This is the tip of the iceberg but I shall stop for now. What will 2025 hold? I hope it will be different from 2024.

I hope that the ministry will not only listen but also act upon suggestions that have been given by the Malaysian Medical Association and by other groups.

I hope that the government will stop warning doctors and healthcare staff with “larangan kenyataan awam”.

Doctors have written in officially, the association has engaged with the minister, the secretary-general, the deputy minister, and parliamentarians - what else is there left to do? Understand and realise that the voices and grumblings from social media and articles are just as representative (or better) than the endless observations and surveys.

This 2025, I hope that the government will not only talk about but form an independent Healthcare Services Commission, one that is autonomous and responsible for human resources, infrastructure and all other aspects of the public healthcare system.

Blessed New Year Malaysia. May God bless us all.

TIMOTHY CHENG is an orthopaedic surgeon who is outspoken, passionate about government healthcare, and extremely saddened and frustrated at the current state of affairs of the public healthcare system.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.