Underpaid and overworked, Malaysia's contract doctors revolt amid Covid-19 surge

The contract doctors are refuting claims that there is an oversupply of doctors in the public health system.
The contract doctors are refuting claims that there is an oversupply of doctors in the public health system.PHOTO: AFP

KUALA LUMPUR - Thousands of young contract doctors in Malaysia's public healthcare system, many of whom are at the forefront of the country's Covid-19 battle, are revolting over a years-long issue - the poorer employment terms offered to them than to their predecessors.

An online campaign called Hartal Doktor Kontrak (Contract Doctors' Strike) has gained traction over the past week, and was trending for hours on social networking site Twitter on Monday (June 28).

The association representing government doctors in Malaysia, MMA Schomos, has also launched a social media campaign asking all Malaysians to wear black for a "Black Monday" in mid-July in solidarity with the doctors.

But the biggest concern is the purported plans by an independent group of doctors to stage a walkout on July 26 if their grouses are not addressed by then. According to the doctors, the majority of the contracted staff are the ones working in dozens of Covid-19 response centres in Malaysia, as the country continues to struggle with thousands of cases every day amid a limited supply of hospital beds.

Malaysia said on Tuesday (June 29) that it has recorded 6,437 new coronavirus infections. The last time it reported more than 6,000 daily cases was on June 18, when the country logged 6,440 cases. 

The revolt involves more than 20,000 Malaysian doctors who had been offered only contractual positions by the government under a system introduced in 2016. What was initially supposed to be a stop-gap solution to the government's inability to offer permanent positions continued and the contracts kept getting extended, and for more and more medical graduates. Government service is compulsory for new medical graduates for around five years.

Being on a contract for years, these doctors take home significantly lower pay than their predecessors, and do not enjoy most of the benefits that come with working in the civil service. Postgraduate pathways to progress in their careers are also not open to them.

Only 3.47 per cent, or 789 of 23,077 contract doctors, have been given permanent positions, leaving most of them with little hope of attaining greater job security.

Medical associations are estimating that there are more than 4,000 doctors graduating every year, and this problem will likely continue compounding unless the government finds a solution.

"What kind of public healthcare system will we have in 10 years' time? Most of us do not have pathways to specialisation," a contract doctor told The Straits Times on condition of anonymity.

In order to specialise, the contract doctors need to quit government service, pay their own way, and then apply to rejoin the government service at the final stage of completing their master's.

Should they wish to switch to the private sector without pursuing postgraduate pathways, they need to serve at least 4½ years with the government before making the switch.

Permanent doctors are allowed study leave and can easily rejoin government service to complete all the necessary steps to finish their specialisation.

Contract doctors also start at and later progress through lower pay grades in the Malaysian civil service. Their grade revisions only happen via contract renewals, and are not automatically based on years of service, as in the case of permanent staff.

"The first batch of contract doctors who have now completed five years are taking home less than half compared with the pay those in permanent positions would have got at the same stage.

"I have seniors who started their own postgraduate course, but are stuck because they need (placement in the specialisation) before they can complete their courses," said a doctor, who received a new pay grade earlier in the week, but only after nearly three years of service. He did not want to be named.

The Health Ministry has said that hiring doctors beyond the availability of permanent positions was against the government's rightsizing policy, and that such appointments could lead to reprimands by the audit department. It has also previously said that Malaysia's ratio of one doctor for every 454 people is in line with the World Health Organisation's recommendations.

However, doctors are refuting claims that there is an oversupply of doctors in the public health system.

"If there is an oversupply, why are people still waiting for two hours or more to see their doctors at public health clinics?" the doctor asked.

Finance Minister Tengku Zafrul Tengku Abdul Aziz last Friday agreed to expedite solutions concerning contract doctors.

Former health minister Dzulkefly Ahmad, meanwhile, said there was "no quick-fix".

Dr Muhammad Azrin Omar, former special officer to Dr Dzulkelfy, said the whole public healthcare system in Malaysia needed a revamp.

"They (doctors) are right to be angry when the system does not allow them to progress in their careers. The whole system needs reform," Dr Azrin said on Twitter.