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THE ill-thought-out contract system of 2016 is the harbinger of the present “perceived shortages” of junior medical doctors in the country.

I believe the acute shortage of house officers in university hospitals can be resolved by circumventing the silo operations of the Health and Higher Education ministries, harmonising the distribution of house officers and medical officers, addressing salary implications for junior doctors, rectifying the maldistribution of the healthcare workforce, and reviewing the parallel pathway and Master of Medicine programmes.

I’d like to offer some insights on the issue of maldistribution of the healthcare work force.

The ideal ratio for doctor to the population is 1:400, as recommended by the World Health Organisation. 

In 2021, the ratio in Malaysia stood at 1:420, which seems to suggest that we are not desperately short in terms of numbers.

Put in another way, there are 2.4 doctors for every 1,000 persons in Malaysia.

However, there is a gross mismatch in the number of doctors servicing the population, with over-representation in the Klang Valley versus rural areas, Sabah and Sarawak. The technocrats in Putrajaya and state health departments have obviously failed to distribute the doctors equitably and justly to serve the healthcare interests of the wider Malaysian community.

This has triggered the anger of junior doctors, who feel betrayed by the unfair salary schemes and benefits, and unjust career pathways, thus encouraging them to seek more favourable pastures elsewhere. Many of the woes in the Health Ministry can be mitigated, if not solved, by its technocrats at virtually zero cost by:

(i) Rectifying the maldistribution of the medical workforce in the Health Ministry. 

I am led to understand that the paediatric fraternity has virtually solved its manpower distribution issue with an ingenious data-driven, doctor- to-workload system, which can be further improved and digitalised for other disciplines.

With artificial intelligence and algorithms, the movement and rotation of doctors can be fairly and promptly decided.  

Data driven by a prolific Health Information System (HIS) would empower technocrats at the ministry to better forecast medical manpower needs and allocate personnel more effectively.

They must learn from multinational corporations about effective manpower distribution.

(ii) Having clear selection criteria for promotions, transfers, entry to post-graduate programmes, attaining scholarships, etc. The current Health Minister, a Muslim democrat by word and deeds, must implement a just culture in his ministry.

(iii) Ensuring a fair and competitive salary scheme and promotion schedule for junior doctors. The selection criteria for permanent and super scale posts must be made public. Other non-financial incentives such as posting of choice upon completion of service to an under-served location should be strongly considered.

(iv) Exploring public private partnerships, such as attractive travel fares or priority seats, to facilitate and incentivise the relocation of doctors to under-served rural areas or Sabah and Sarawak.

The monumental task of the Health Minister is to ensure that all the relevant ministries and government agencies act promptly in managing the crisis of depleting medical human resources, and mitigating its adverse effects on the nation’s healthcare services. 

Dr Musa Mohd Nordin

- The views expressed here are the views of the writer and do not necessarily reflect those of the Daily Express.

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