By Datuk Seri Wilfred Madius Tangau
While the Covid-19 pandemic has cast a long shadow on our country, it has also pushed Malaysia’s contract doctor system front and centre into the spotlight, revealing the harsh reality behind current public healthcare system.
Since 2004, a mushrooming of medical colleges in Malaysia offering medical courses has caused an influx of doctors, making mandatory placements in government hospitals a difficult process due to limited available positions for housemen.
According to The Straits Times, currently, only 3.47%, or 789 of 23,077 contract doctors from this process has found permanent positions within the government sector.
The lack of transparency on the selection of permanent medical officers has brought further negative implications as junior doctors are left wondering helplessly if they have a chance to secure a livelihood upon the end of their 2-year mandatory service.
With recent escalating events, this situation does not only put the futures of young doctors in jeopardy, but also patients who are receiving treatment in government hospitals.
These events demonstrates that speedy reformation is vital to ensure the security and sustainability of Malaysia’s public healthcare system.
There are different factors to take into account, but among the many steps required towards creating a better public healthcare system, WISDOM Foundation strongly believes that decentralisation is one of the key steps necessary for long-term reformation.
For example, our Malaysian Health Minister announced on 4th August 2020 that there is a ratio of one doctor for ever 454 people in Malaysia. However, it was then pointed out that the official ratio of doctors to the population is 1:662 in Sarawak and 1:856 in Sabah.
The highly centralised decision-making in the system has created a gap between the understanding of needs at the federal level and grassroots level, which causes inefficient administration and assessment of on the ground conditions.
By distributing decision-making throughout the different levels of governance, administration can be executed better to meet the needs of local situations.
Hence, we implore the federal government to adopt a hybrid decentralisation in the reformation of the administration of the public healthcare system to improve its effectiveness, equity, and efficiency for the futures of our young doctors as well as the livelihood of our nation.
Wilfred Madius Tangau
Executive Chairperson
WISDOM Foundation
