GEORGE TOWN, May 12 — Penang state exco Norlela Ariffin has presented 13 recommendations, on how to improve work environment for housemen and doctors at government hospitals, to the Health Ministry for consideration in the setting up of its independent taskforce.
The state health committee chairman said the recommendations comprised suggestions by doctors who contacted her directly.
“I managed to discuss with the state health department about the 13 recommendations after the Covid-19 meeting two days ago,” she said.
She said she was told that she could apply to the state health director and the health minister to invite trainee doctors to attend the health committee meeting.
Among the recommendations was housemen’s working hours, which should not exceed 70 hours a week, according to the Health Ministry’s guidelines.
She said in Australia, doctors are generally required to work 85 hours in two weeks or 42.5 hours a week.
She said junior doctors in Australia work between 50 and 55 hours a week with a requirement for a minimum of eight hours of rest along with a shift system.
“Before we look at burnt out doctors, we need to take a step back and look at the condition and environment of the healthcare system,” she quoted from the proposal.
As for the lack of funding in the government healthcare system, Norlela said this is due to a heavy reliance on public coffers.
“What Malaysia needs is ‘medicare’ or insurance system like in Australia and our neighbour Singapore.”
She said this may carry a risk of political backlash so it must be modified to ensure that the poor are not deprived of quality healthcare while the rich don’t get away with paying the bare minimum.
She said there is currently a shortage of hospitals and pointed at Seremban as an example, with only one hospital catering to the growing city.
She said Nilai is in need of a hospital and at least one can be built in Batang Benar to improve coverage to the outskirts such as Pajam, Mantin and Beranang.
“What we have now is neither an oversupply of doctors or lack of demand, but a lack of hospitals to accommodate both,” she said.
She said it is due to the shortage of hospitals that placement of housemen slowed down, with some having to wait between one and one-and-a-half years before they are successfully placed, affecting their adaptability in the workplace.
She said there was also a lack of human resource management skills, where medical officers were expected to train juniors in high-stress environments while junior doctors are not taught how to manage stress.
Norlela said some senior doctors tend to discriminate against graduates from universities that are not on par with other medical universities.
“The state health department has given feedback that all these universities are recognised by the Health Ministry and not all graduates from these lesser-known universities are less proficient,” she said.
She also suggested a need to increase efficiency, such as the use of new medical diagnostic devices or bring equipment closer to the ward, so that junior doctors do not have to take on roles similar to hospital attendants, where they are required to bring blood samples to laboratories and wait more than two hours there for results.
She said there should also be improved efficiency in pre-hospitalisation diagnostics to reduce waiting time and patient overload.
She said the hospital director and emergency ward director have requested that paramedics in 20 ambulances, along with some wards for Covid-19 patients, be empowered to use new wireless diagnostic devices to send patient data to specialists so that diagnosis can be sped up.
“This is so that the patients can be sent to treatment directly and avoid patient overload at the emergency department and cut down waiting time,” she said.
Four recommendations were related to the treatment of junior doctors, such as a lack of protected meal breaks, a lack of emphasis on the human performance and limitations of these doctors after a certain number hours of working, the labelling of these conditions as a ‘rite of passage’ and outright bullying that include name calling, tie-pulling, body shaming, physical and mental abuse.
Norlela said there is a need for psychiatric evaluation of senior doctors, specialists and administrators who are bullies as they could also be victims who had become abusers.
“There is a need for symbiosis as there is a perpetual shortage in the ministry and this is caused by a lack of cooperation between the public and other sectors,” she said.
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