“Code Black: Saving Our Malaysian Contract Healthcare Workers”
This publication is in conjunction with MMI's National Contract Doctors Day Campaign, particularly for doctors' welfare, alongside Code Black Campaign initiated by MMA SCHOMOS. Information regarding the campaign can be found on their Instagram and Facebook page.
While our frontliners relentlessly work themselves to the bone in face of the COVID-19 pandemic, hopeful that their sacrifices would warrant a change in the flawed contract system, they are struck instead by government inaction. With the current contract term edging closer to an end, the fate of our health care workers evolves into an urgent question the government is yet to answer.
The implementation of the contract doctor system back in December 2016 marked the loss of multiple privileges which permanent doctors were endowed with. In comparison, contract doctors are subjected to fewer maternal and sick leaves. But to make matters worse, the opportunity for specialization has been made virtually non-existent, promising an utterly bleak future in the field of medicine.
Our Minister of Health, Dr Adham Baba revealed recently that among the 23 077 contract doctors hired from December 2016 to May 2021, only 789 (approximately 3%) of them were offered permanent positions, leaving the other 20 000 more doctors doomed to a future of uncertainty. Anxiety is quick to set in as the first contract term expires in December this year, yet without any notices from the government.
How does this affect our rakyat? First, we have to understand our Malaysian healthcare system. Our healthcare system is globally renowned for its accessibility. RM 1 is all we need to obtain healthcare from any public hospital or clinic, services ranging from investigations, diagnosis, and later treatment and medications. However, it is notable that in recent years, regardless of which public hospital or clinic you visited, you would notice longer waiting times accompanied by shorter consultation times. This is purely due to the chronic lack of public health funding, resulting in the lack of human resources.
As we are speaking, the life span of the contracts of these contract doctors is merely 5 years. However, these contract doctors are also the ones fighting this raging pandemic relentlessly by serving in the COVID-19 Integrated Quarantine and Treatment Centres (PKRC) and COVID-19 Assessment Centres (CAC). If their contracts are discontinued, these unsung heroes will be forced to leave the public healthcare system. This will definitely further exacerbate the issue that we have at hand now - lack of specialists in Malaysia to provide specialty care to our rakyat.
In the past 5 years, Malaysian Medical Association (MMA) and the Ministry of Health (MoH) alongside all relevant stakeholders have undergone multiple discussions to establish solutions to this issue. One of these successes after multiple discussions is the increase in salary of contract doctors to a salary similar to their permanent counterparts. However, the main issue - the lack of specialisation opportunities and pathways - remains unsolved.
Thence, MMA has decided to initiate a Code Black movement, calling upon all of us, the rakyat, to come forth and support our contract doctors, allowing them an opportunity to specialisation as well as to improve their general welfare.
It is very important to also note that the Code Black movement is not a physical strike. If a strike occurs during an uncontrolled pandemic, this will severely affect the entire public healthcare system, potentially endangering the lives of many patients. In simple terms, Dr Sean is not agreeable to a physical strike.
The purpose of the Code Black movement is to unite the rakyat and all contract doctors to call upon the government for immediate actions.
In hospitals, Code Black indicates bomb threats. The situation that we are in right now with the contract system can be alluded to a ticking time bomb. Once it explodes, the lives and health of all rakyat will be affected. The contract doctors are not the only ones losing their future, but also our healthcare system. Hence, the time is NOW for us to act to stop this!
How do we get involved? It's simple - from 1st of July to the 12th of July, you can simply change your profile picture of the logo of your institution to black and white. On 12th of July, Black Monday, we humbly request everyone to wear black to work. You may also upload black and white photos onto your personal or institutions' social media pages. Don't forget to include #saveMYcontractHCW, #CodeBlackMY, and #BlackMondayMY on these uploads!
We need your support NOW to support our contract doctors!
This post was published on Sin Chew Daily in Mandarin and was translated by MMI to English on 10/7/2021.
About the author
Dr Sean Thum is a Psychiatry trainee who enjoys a hike and a good book on a Saturday. He serves as a member of the Board of Advisors of the Malaysian Medics International with the intention of providing a bridge linking medical students and graduates to life as doctors in Malaysia.
