Hartal Doktor Kontrak as a Critical Election Issue

The contract system for healthcare workers, namely Doctors, Dentists and Pharmacists was started in December 2016, which allowed for the employment of doctors without the pension scheme and lowered waiting time for medical graduates to be posted to hospitals for their housemanship. They signed a 5-years contract with the government, consisting of 3+2 structure (first contract of 2+1 years for housemanship, 2nd contract of 2 years for compulsory service under the MoH after completing housemanship) with the first batch having their contract ending in December 2021.

Many questioned the short-sighted policy which focuses on resolving short term issues of delayed placements ignoring the long-term career progress of junior doctors who will have to fill up the vacancies of specialist doctors in the future who eventually leave the government sectors for private service after some years of working. In previous years, MMA and MMA SCHOMOS were the main drivers of change for better treatment to contract doctors, with other organizations like the Malaysian Medics International (MMI) being the most vocal medical student-led organization on this issue.

As the clock trickled towards December 2021, many other contributing physical (long working hours, lack of workforce) and mental (having to handle life and death moments every day and worries about future) factors — along with the disappointment over the lack of clear direction and lackadaisical attitude of the government in handling the issue triggered widespread unease among junior doctors, leading to the formation of the Hartal Doktor Kontrak Movement an unofficial “union” of junior doctors to demand fair treatment which eventually led to the nationwide strike of junior doctors to demand fairer treatment. At almost the same time, the Malaysian Medical Association Section Concerning House Officers, Medical Officers and Specialists (MMA SCHOMOS) organized a solidarity campaign for junior doctors, named #CodeBlackMY with a similar intention but different approach.

Speaking in terms of the upcoming election, let us take a look at what has happened since the protest — shall we? Firstly, about 1,118 medical officers, 1,019 dental officers, and 1,288 pharmacy officers have received permanent positions. Also, a 2-years contract extension after their compulsory service, fully paid study leave, scholarship and federal grants were offered for all those with the contract. A special-duty leave, tuberculosis leave and fares to visit home-towns (for those working in Sabah and Sarawak, and originate from Peninsular Malaysia, and vice versa, once per year only) were offered alongside the 300 permanent positions for medical officers that have been offered at Sabah and Sarawak, with 1/3 of the offers rejected (85 rejected directly, 15 resigned after accepting it due to employment elsewhere). An extension of 2-years contract for contract doctors and RM100 million allocation to sponsor specialist studies for 3,000 contract doctors and dentists under Budget 2022 was announced. However, only about 16% of 1,347 government scholarship awards under PLK & HLP (for permanent officers only) were offered to contract officers.

The issues yet to be addressed in this standing include — establishing a more transparent criteria on selection of contract officers for permanent positions, increasing scholarship awards for PLK / convertible loans for PLK. The duration for special sick leaves without any complications — eg. Officers with cancers should be elongated and essentially above all the labeling between contract vs permanent positions have to be blurred. Additionally, to ensure quality healthcare, adequate staffing for all departments in all hospitals should be monitored and skill training for contract officers should be improved. Investments in digitalisation and synchronization of medical records at an era like this is absolutely necessary to ease management and transfer of patient records nationwide and to enable tracking of their records within their own devices.

With the elections tomorrow, we hope that regardless of the party that is chosen — healthcare is made a priority for all walks of life nationwide and the welfare of our healthcare workers who work tremendously every waking second is brought to attention for the betterment of our healthcare system.

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