Saving our frontliners

Republished from New Straits Times, April 21, 2020,
with the author’s permission. Read the original here.

By Yong Soo Heong

IN THE BATTLE against the deadly coronavirus, we have continuously hailed our medical frontliners as heroes and heroines. Credit should be given when it’s due in this grim situation.

But should we be content with praise alone? Certainly not. We should put our money where our mouths are to prove our commitment to these hardworking people, who are sacrificing their lives for the wellbeing of others.

In the combat against the unseen enemy, medical personnel, be they doctors or nurses and other ancillary staff, are much sought-after. But our efforts to acknowledge their moil had been at best sputtering.

If one had been following the narratives on our country’s public healthcare system, it would have been rather demoralising.

Letters penned by doctors in the media give a dismal picture of the treatment they get in terms of permanence of positions, salaries and allowances. And yet we hail them as saviours during these precarious times.

For instance, an estimated 9,000 contract doctors are undergoing housemanship.

About 4,000 of them are given contracts at Grade UD41, thus having the same pay as housemen, but considerably less by about RM8,000 annually compared with their permanently-hired colleagues at Grades UD43 or 44, while doing the same kind of work.

The words of a prominent senior official at the Health Ministry on the state of the healthcare system are telling: “We are currently underfunded, understaffed, underpaid, overworked, overstretched and with facilities overcrowded with patients.

“We all need to try harder to improve the public healthcare system to increase the funding, to increase the number of healthcare workers, to improve the salary scale and availability of jobs and posts in our healthcare facilities, all of which are beyond the control of the Health Ministry.” Need we say more?

It’s not hard to see how things are wrong. Despite the glowing optimism among some quarters to make medical tourism a money spinner, little is being done to ensure a sustainable healthcare eco-system.

We go back to basics. In July 2018, the ministry applied for 21,741 positions to the Public Service Department and Public Services Commission.

However, the ministry was directed to downsize its applications, and 10,675 positions were applied for subsequently.

It meant that what the medical experts had recommended was slashed. In the pandemic, have we heard anyone say that we’ve too many medical personnel?

The wellbeing of the rakyat is not measured by big government buildings, imposing bank towers, large houses or flashy cars.

Their access to good or adequate healthcare is a substantial yardstick. The war against Covid-19 is a case in point.

As a layman, I cannot understand the paradox. Although we clamour for medical tourism and seek adequate healthcare for citizens, we’re not getting enough funding for posts or establishing training hospitals.

We also see much finger-pointing on the proliferation of medical schools in the country, numbering 33, and producing about 3,000 doctors annually.

Another 3,000 Malaysian doctors return from overseas yearly after completing their degrees. That should make us the envy of many countries. But somehow, there are not enough hospitals to absorb them.

Another area of concern is the relatively small number of specialists. With a 33 million population, Malaysia has an estimated 7,000 specialists, a rather insufficient number. A case in point is the National Heart Institute, which treats at least 150,000 heart patients per annum, yet we have fewer than 500 cardiologists.

Consequently, the inability of the public medical system to absorb more permanent doctors puts a damper on specialisation.

Without permanent positions, talented doctors can’t apply for specialist courses. Some may have blamed excessive workload or the long duration of courses for the relatively poor interest to specialise. But if excessive workload is cited, surely solutions can be found?

After the pandemic is over, the government must rectify these faults. Let medical experts make recommendations and leave meddling mandarins or administrators out of the equation.

I pray that solutions will not be plagued by a description in a Chinese proverb, that it’s easy to get a thousand prescriptions but hard to get one single remedy.

• Datuk Yong Soo Heong is a former chief executive officer and editor-in-chief of Bernama. Read more about him here.