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Malaysia ’ s healthcare system is in a crisis due to a shortage of healthcare professionals

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18 The HEALTH | May-June . 2024

In dire straits

Malaysia ’ s healthcare system is in a crisis due to a shortage of healthcare professionals

BY KHIRTINI K KUMARAN

THE HEALTHCARE system in Malaysia is at a critical point due to a significant decline in the number of healthcare professionals , particularly housemen .

Data from the Ministry of Health ( MoH ) paints a grim picture : a 50 per cent plunge in the number of housemen from 6,134 in 2019 to a 3,271 in 2023 . This alarming trend has sent shockwaves through the healthcare community , prompting stakeholders across the board to call for decisive action by the MoH .
Hartal Doktor Kontrak spokesperson Dr Muhammad Yassin attributed this decline to global trends and systemic issues within Malaysia ’ s healthcare infrastructure . The waning interest in science-based disciplines among newer generations , coupled with the contractual system plaguing the nation since 2016 , has sapped the vitality of the medical profession .
Under the contractual system , thousands of Malaysian doctors are relegated to contractual positions with diminished pay and benefits compared to their civil service counterparts .
Malaysian Medical Association ( MMA ) President Dr Azizan Abdul Aziz wants the MoH to have an immediate road map with timelines on how the manpower issue will be resolved . “ That would reassure all stakeholders that our rakyat will continue getting high quality healthcare at public health facilities ,” she said .
She emphasised that transparent data sharing from the MoH was essential for effective healthcare human resource planning .
Datuk �eri Dr D�u�ke�� Ahmad
Dr �i�hae� �e�aku�ar
Dr Azizan Abdul Aziz
“ Accurate data on workforce distribution was crucial in identifying manpower shortages and planning ahead .
“ This data should be shared on a dashboard for public viewing on MoH ’ s website . We are pleased that the MoH is currently working towards a master plan for its human resources , as announced recently by the media .
“ While transparency in data is important , the MMA still awaits the long overdue announcement on the increase of the oncall allowance . Competitive wages are also crucial in stemming the brain drain .
“ We hope to be able to engage with the MoH more extensively on addressing the manpower shortages in the system . The nation ’ s healthcare is at stake . The best time for the implementation of proactive policies was yesterday . The second-best time is now .”
The brain drain in government hospitals is not surprising given the more lucrative remuneration in rapidly growing private hospitals . Ironically , around 70 per cent of large private healthcare groups are controlled by government-linked companies .
Parti Sosialis Malaysia Chairman and health activist Dr Michael Jeyakumar offered an analysis of the declining housemen numbers : “ That is a good thing . There have been too many house doctors flooding the system the past seven years .”
He attributed this trend to an oversaturation of house doctors caused by the proliferation of private medical colleges and the extension of house officer ( HO ) training to two years .
“ This led to a situation where there were too many house doctors in the system , and the existing training staff were insufficient to meet the demand in supervision and training . This definitely affected the quality of doctors being released into the system .”
The government was at one time worried that there were too many new housemen flooding the market and was unable to accommodate them in government healthcare facilities . It then stopped issuing permits to new medical schools .
REPERCUSSIONS ON SERVICE QUALITY
However , the repercussions of the current doctor shortage is reverberating throughout the healthcare ecosystem . Overburdened healthcare facilities struggle to cope with increased workloads , leading to longer wait times , heightened stress among frontline workers , and decreased service quality .
In district hospitals , the absence of house officers compounds existing challenges , forcing medical officers to shoulder dual roles and leaving critical gaps in patient care . Most recently , a viral image circulated on social media showed medical staff writing a message on a whiteboard at a hospital in Kedah apologising to patients for the prolonged waiting time to see a doctor .
According to the message on the whiteboard , patients can expect a five-hour wait to see a doctor . There was a shortage due to many doctors moving to the private sector .
In response to mounting pressure , Health Minister Datuk Seri Dr Dzulkefly Ahmad issued directives to redeploy house officers to district hospitals in need , acknowledging the situation ’ s urgency .
“ I am acutely aware of and deeply sympathise with the grievances of healthcare workers every day and every week ,” he wrote via a post on X .
“ With 147 hospitals and more than 3,000 health clinics nationwide , I am bound to receive numerous complaints . Continue sending feedback and criticisms ( while avoiding sinful language ). I will continue

Worrying shortage of nurses

A SIGNIFICANT shortage of nurses is becoming increasingly evident . Health Minister Datuk Seri Dr Dzulkefly Ahmad issued a warning recently , predicting an estimated deficit of 60 per cent of nursing staff by 2030 .
Speaking at a recent event marking the launch of a new hospital in �uala �umpur� �r �zul�e�� underscored nurses ’ critical role in the healthcare ecosystem , emphasisin� the si�nificance of nurses alongside doctors and specialists .
He emphasised the urgent need for collaborative efforts between the public and private sectors to mitigate the impending crisis and fortify the nation ’ s healthcare infrastructure .
“ I fully support any initiative from the private sector so that we can together not only develop health facilities but human resources as well .
“ We can build hospitals using bricks and mortar , but what is important is the staff . This is not just the doctors and specialists . It is also as important to have enough nurses .”
His comments align with a detailed report titled ‘ Supply and Needs-Based Requirement Projections of Malaysian Human Resources for Health Using System Dynamics Approach 2016 - 2030 ’. The report ’ s projections revealed a si�nificant shorta�e of nurses in relation to the population ’ s growing demands .
Alarmingly , the report indicates that by 2025 and 2030 , the chasm between supply and demand for nursing professionals is projected to widen further , with shortfalls of 57.9 per cent and 61.9 per cent respectively . This poses a grave threat to the nation ’ s ability to provide adequate healthcare services to its populace .
However , the report highlights the efficac� of a proactive approach in alleviating the nursing crisis . The projected shortfall can be si�nificantl� miti�ated b� adoptin� a strategy of maximising student intake in nursing programmes .
Under this scenario , with a maximum intake of students in Diploma , Degree , and PSL ( Post- Specialty Learning ) programmes , the gap between projected supply and demand will narrow considerably by 2025 and 2030 .
Addressing the nursing shortage demands a concerted effort from all stakeholders , including policymakers , healthcare institutions and educational bodies . To avert the looming crisis , urgent measures such as expanding nursing education programmes , enhancing retention strategies , and incentivising career pathways must be prioritised .