TheHEALTH May/June 2024 | Page 19

May-June . 2024 | The HEALTH

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to pay attention and take action while continuing with my various reforms .”
He also stated that the MoH implemented various short-term and long-term improvement measures to address complaints .
However , such stopgap measures may offer only temporary relief without addressing the underlying issues driving attrition rates among medical professionals .
RETHINKING TRAINING AND FUNDING
Regarding the contract system for healthcare professionals , Dr Jeyakumar proposed extending the contract to eight years to facilitate specialisation and equalise benefits with permanent staff .
“ The doctors on contract should have the same perks and allowances as their colleagues in government service . Otherwise , they will be unhappy that they are being paid less despite doing the same work .”
Additionally , he stressed the need for uniform study and exam leave provisions to ensure fairness among all healthcare professionals .
Regarding legislative changes or reforms , he said : “ The crucial issue is funding . We need to put more money into healthcare .
“ Federal government allocation to MoH is only about 2.5 per cent of GDP . This is much lower than the nine to 10 per cent of their GDP allocated to health care in the UK and Japan .”
He advocates for increasing healthcare allocation to at least four per cent of
GDP to address systemic shortcomings .
BALANCING QUANTITY AND QUALITY IN MEDICAL EDUCATION
Dr Jeyakumar proposed a collaborative approach between the MoH and senior public service doctors to determine annual medical school quotas .
“ We need to appreciate that there has been a degree of ‘ corporate capture ’ of the regulating bodies – MMC , MAQ , MHE , MoH - by some of the larger private medical colleges which have managed to recruit high-ranking health ministry officials to become their CEOs or other senior officers .
“ These senior retired staff often have strong strings to pull within the regulatory bodies ,” he claimed .
Addressing the issue of Malaysian medical graduates studying abroad , Dr Azizan stressed the need for significant improvements within the healthcare system to attract them back .
“ At the moment , I think we should be worrying more about doctors leaving
than trying to get doctors to come back ,” she added .
GOVERNMENT ’ S PROPOSED INCREMENT FOR CIVIL SERVANTS
Regarding the proposed increment of 13 per cent in salaries for civil servants , Dr Azizan acknowledged it as a fair measure in challenging economic times .
“ However , the civil service , especially the healthcare sector , must be informed that this would not be a one-off goodwill gesture but rather the beginning of a system that remains competitive ,” she said , emphasising the need for regular reviews of wages and allowances to maintain competitiveness and safeguard the welfare of healthcare professionals .
Meanwhile , Dr Jeyakumar criticised proposed salary increments for civil servants , suggesting that funds would be better allocated to initiatives such as an old-age pension scheme .
KEY PRIORITIES FOR ACTION
Looking ahead , Dr Azizan outlined key priorities for the MMA , including extensive engagement with the MoH to address manpower shortages .
While the MMA is not a regulatory body , it plays a vital role in advocating for improved public healthcare policies and better working conditions for healthcare professionals . The focus lies on collaborative efforts between the MoH and medical associations to implement effective strategies .
Dr Jeyakumar emphasised the importance
of viewing the public healthcare system as a cornerstone of societal solidarity and urged against heeding contrary advice from international organisations .
“ Government should recognise that our public health care system is a very important component of our society .
“ It is a very visible expression of solidarity of the people . We all contribute to taxes , which are used to help whoever is in need . It creates a sense of belonging to the nation . In a real way , it defines the nation ’ s ethos and soul .
“ The public healthcare system should never be sacrificed at the alter of ‘ fiscal responsibility ’.”
Dr Jeyakumar called for increased government revenue . “ The government must make long-term plans to increase its revenue as a portion of GDP .
“ In the 1980s , government revenue was about 30 per cent of GDP . It has now dwindled to 15 per cent of GDP . The causes of this , eg lowering corporate tax from 40 per cent of profits in the 1980s to its current 24 per cent must be identified and dealt with .”
He also proposed innovative solutions , such as involving general practitioners in long-term disease management and providing research grants for specialists .
There is an urgent need for systemic reforms to mitigate the healthcare manpower shortage in Malaysia . As Malaysia navigates these challenges , collaboration between healthcare stakeholders and sustained government commitment will be essential to build a resilient and sustainable healthcare workforce for the future .

The heart of the problem

AT THE CORE of Malaysia ’ s healthcare system lies a crisis that threatens the lives of thousands of heart patients : the rising strain in cardiac care at government healthcare facilities .
From surgery delays to infrastructure problems and shortage of cardiothoracic surgeons , Malaysia grapples with a triple challenge that jeopardises the well-being of its citizens and undermines the integrity of its healthcare infrastructure .
The Serdang Heart Centre ( SHC ) is at the forefront of this crisis . Inaugurated in December 2022 with much fanfare and high expectations , it was designed to alleviate the burden on the National Heart Institute ( IJN ) in Kuala Lumpur . The SHC was hailed as a beacon of hope , promising expedited treatment and cutting-edge cardiac care to those in need .
However , infrastructure problems plague the SHC , with its four operating theatres rendered inoperable due to maintenance issues ranging from faulty air conditioning to unresolved structural problems .
The consequences are dire : a backlog of approximately 1,000 awaiting crucial heart surgeries , their lives hanging in the balance as urgent cases take precedence , leaving others to languish in uncertainty and despair .
Across the nation , other cardiac centres grapple with similar challenges , exacerbated by a chronic shortage of cardiothoracic surgeons .
EDUCATION POLITICS AND MEDICAL URGENCY
While the nation grapples with a critical shortage of cardiac surgeons , the debate over inclusivity and accessibility in
Shahrin Sahib
higher education has reached boiling point . The UiTM Student Union ’ s campaign against temporarily open up its cardiothoracic surgery master ’ s programme to non-Bumiputera students ignited a fiery debate .
The call to wear black as a protest against inclusivity has drawn condemnation from both Malays and non-Malays alike , who highlight the pressing need for more cardiothoracic surgeons .
The proposed UiTM-IJN-cardiothoracic surgery postgraduate programme is a crucial initiative to address the severe shortage of specialist doctors , particularly in cardiac care . Thus , the student union ’ s stance was severely criticised as narrow minded .
Heart disease remains the leading cause of premature deaths in Malaysia , with a staggering 18.4 per cent of all confirmed deaths attributed to this ailment in 2022 alone . The dire lack of cardiothoracic specialists has exacerbated the situation , resulting in prolonged wait times for critical surgeries and , tragically , preventable deaths while patients languish on waiting lists .
Medical professionals , including Malaysian Medical Association ( MMA ) President Dr Azizan Abdul Aziz , have
UiTM
unequivocally advocated for the temporary admission of non-Bumiputera Malaysians into UiTM ’ s cardiothoracic surgery programme .
She stressed the paramount importance of prioritising public health over political considerations , emphasising that cardiothoracic surgeons are among the most sought-after specialists in the country .
ALLEGATIONS OF DOUBLE STANDARDS
However , UiTM Vice-Chancellor Shahrin Sahib , has cited the institution ’ s commitment to upholding the UiTM Act 1976 and Article 153 of the Federal Constitution as grounds for maintaining the status quo . This stance has been met with disbelief , as critics argue that neither legal framework explicitly prohibits the admission of non-Bumiputera students into UiTM ’ s programme .
The admission of non-Bumiputera Malaysians into UiTM ’ s cardiothoracic surgery programme represents a critical step towards addressing the acute shortage of cardiac surgeons and improving healthcare outcomes for all Malaysians .
Concurrently , the Malaysian Medical Council ( MMC ) finds itself embroiled in
Serdang Heart Centre .
a controversy surrounding specialist recognition , with the Malaysian Association of Thoracic and Cardiovascular Surgeons ( MATCVS ) highlighting glaring disparities in the treatment of parallel pathway trainees compared to their counterparts undergoing traditional master ’ s studies .
MATCVS Secretary John Chan sheds light on the apparent double standards within the MMC , citing the recognition of master ’ s studies graduates at public hospitals compared to the refusal to register parallel pathway graduates . This discrepancy raises questions about the integrity of the medical accreditation process and the equitable treatment of medical professionals striving to serve their communities .
The MMC ’ s refusal to acknowledge specialists trained under the parallel pathway programme not only undermines these individuals ’ contributions but also exacerbates the crisis at hand .
Against this backdrop of uncertainty and bureaucratic impasse , patients continue to suffer . The politicisation of higher education , coupled with an aversion to decisive action , has undermined efforts to bolster Malaysia ’ s healthcare system and meet the needs of its citizens . – The HEALTH