Monday, February 08, 2010

Compulsory Public Service for Doctors - I say maintain & lengthen, and...

Malaysia spends a lot of money in training Malaysians to become doctors - but alas, a large number of the doctors just cannot wait for the end of their 'compulsory service' period to run away into the private sector .... or even overseas. The available spaces for persons to be trained as doctors is also limited - so if we give it to people who will leave 'public service' very fast, does it benefit Malaysians, especially the poor and those not rich who still depend on government hospitals for healthcare.

Just a short while back, there was a suggestion that the length of this compulsory public service be extended to 10 years from its current 3 years. That came from the Minister in the Prime Minister's Department - but alas,  today the suggestion is to reduce the 'compulsory service' , and this suggestion is coming from the Minister of Health.

I believe that that the following is the best solution
(1)    For all doctors, the current 'two years of housemanship and three years of compulsory public service' is maintained. Note that also these 'fresh doctors' benefit a lot from the experience that they obtain in public service - the number and range of patients they get to see in these few years maybe even more than the number they may see in the next 10 years. Further, it certainly puts them in touch with Malaysians, especially the poor and the low-incomed, which they will never see in private practice - good for 1Malaysia... a 'national service'

(2)    Full scholarships medical graduates be required to provide at least 10-20 years of public service.

(3)    Medical Graduates from the local universities be required to do the current 'two years of housemanship and five(5) years of compulsory public service'
(4)    Salaries of doctors and specialist (and other medical workers) be increased.
(5)    There be no age-limit for the joining of public service. This means that doctors at even 40 or 45 be allowed to join the public service with full benefits, including pension. The requirement should be a minimum of 10 years of service. Retirement age for doctors/specialists/medical staff should also be increased to 65.

(6)    Maybe, we should be also looking at Thailand - where people can go to private hospitals/clinics and get healthcare at the same rate as in government hospitals/clinics. This may be a solution of extending the coverage of public health/medical care, without being just concerned about the numbers of doctors in public service.

(7)     Am very concerned with the present Prime Minister of Malaysia, the Minister of  Health and the DG of health, as they seem little concerned about ensuring free 'universal healthcare' for all. There is too much emphasis on 'medical tourism' - attracting foreigners to come to Malaysia to get healthcare not just in 'private' facilities but also government establishment. We still cannot cater to the health/medical needs of the people of Malaysia - and we are already interested in 'profits'. Remember, it was this PM who tried to privatize IJN - sell it to a private entity - our one and only national heart institute, which is already beyond the reach of the most Malaysians - save for 'public servants' and rich private individuals.

I will be concerned about proposals coming from the Minister of Health (or its DG) - they certainly seem not so concerned about the medical/healthcare of Malaysians. Najib's 1Malaysia Clinics, a good move, but I wonder whether it is just a 'public gimmick' that will 'blind' us from what maybe his true 'corporate nature' , i.e. interested only in making profits for a few... 
PETALING JAYA: The Government is mulling over whether to reduce the compulsory public service period for doctors to two years.

Currently, medical graduates are required to do two years of housemanship and three years of compulsory public service.

Health director-general Tan Sri Dr Ismail Merican said yesterday that the ministry was looking into it and would announce a decision as soon as possible.

Health Minister Datuk Seri Liow Tiong Lai had earlier yesterday refuted suggestions that the Government would extend the compulsory public service to 10 years.

“It is not true. We are not going to extend it to 10 years.

“We are looking to cut it short,” he said in a press conference after launching B-Nes Sdn Bhd.
Earlier this month, Minister in Prime Minister’s department Senator Datuk T. Murugiah suggested that doctors’ compulsory public service be extended to up to 10 years to ease the shortage of doctors in the country.

Liow said that the reduced service time would make it more attractive for doctors to continue working for the Government.

He said that there were about 300 to 400 doctors leaving the country every year while the number of trainee doctors had increased to 3,000 from 700 in 2001.

“If you force them to work, they will tend to leave.

“You must create attractiveness and better incentives,” Liow said, adding that if the ruling was implemented, it would take effect for the new batch of medical graduates as the current batch have a fixed learning schedule.

When asked if this would apply to doctors working abroad, he replied that specialists and doctors above the age of 40, do not need to serve the compulsory service.

Meanwhile, Liow said that Malaysian doctors would not be effected by the implementation of the Asian Free Trade Area (Afta) agreement this year as they are able to compete with foreign doctors.

He also said that there would not be an oversupply of doctors because of the liberalisation.- Star, 8/2/2010, Shorter compulsory public service period for docs mulled

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