The recent announcement by PM regarding the promotional prospect of government doctors is something commendable. When I was in SCHOMOS(Governement wing of MMA) from 2002-2006, we had many suggestions and discussion with Ministry of Health(MOH) regarding the promotional prospect of doctors. Many of our suggestions were shot down.
We did suggest that all MOs should be in U44 upon finishing Housemanship. I personally wrote this proposal to the Minister, Dato Dr Chua Soi Lek in 2006 and it became a reality last year. We also proposed that all MOs of more than 8 years of service should be given U48 after which the promotion should depend on availability of post and the type of job they are doing.
As for specialist we proposed that all specialist should be given U48 from the date of gazettment and U54 upon completing their subspecialty. U52 will be somewhere in between.
Well, the recent announcement says that all specialist will be promoted to U54 within 9 years of service and all MOs will be in U54 after 12 years of service.
Although it is an interesting development and the afford taken by the PM himself on this, is commendable, several problems will arise from this “time-based” promotional scheme. One of the main problems in the civil service is the fact that promotion is never based on merit! this is the phenomenon that is screwing up the system. Furthermore, no action can be taken against these civil servants even though they are hardly doing any job. The commonest action usually taken are “transfers”. They will be transferred from one place to another, making his/her job easier from place to place but receiving the same salary and annual increments. Finally the very same person will be promoted with the rest of the people!
Now, this sickness may be coming into the MOH soon. With the time based promotion introduced into the system, will an MO be interested in doing speciality? wouldn’t it be easy if he just stays as a MO and at the end of 12 years, he will be given U54. The only difference with the specialist will be the “Specialist Allowance” which is about RM 2800 for U54. The MO can easily earn this from doing locums either in MOH or outside. Thus there are no special incentives in encouraging these MOs in doing speciality. They can just park themselves in some rural/semi-rural clinics and continue to enjoy the same salary as with a specialist with less commitments etc. Of course, the good ones will strive to become a specialist but what do they get?
The specialist in the other hand will be at U54 after 9 years of service whether they have subspeciality or not! This is another form of discouragement for specialist. Why must they bother doing subspeciality when there are not going to be any added advantage in civil service. You would have reached U54 by then. In fact, currently there are alot of dissatisfaction among the senior specialist as they are going to be sitting at the same salary scale with their junior specialist who are 3-5 years junior! We have senior consultants who will be at the same salary with their junior trainees. So why bother doing subspeciality!! Those who are really interested will still do it but would they remain in civil service since there is no added appreciation?
These are issues that will be cropping up soon. These steps will definitely retain more doctors in the civil service temporarily. Soon after, frustration will grow again for the senior specialist as they will continue to sit on U54 forever and nothing to hope for anymore. JUSA C post are limited and not everyone will be promoted to JUSA C and thus a bottle neck will appear at U54. Remember your annual increment in U54 is only about RM 180. It will take about 20 years for the basic starting salary of RM 5000+ to reach RM 7 000+.
This new “time based” promotion definitely benefits the MOs more than anyone else. Thus, the government may be retaining more MOs than specialist in long run, unless they come up with a separate salary scheme for specialists.
Furthermore, with 4000 new doctors coming into the market now, would there be enough post to promote everyone. At the moment this type of promotion may look good as there are many vacant post to play around with but within the next 3-5 years all these posts will be filled and another new problem will arise. No Post No Promotion! Remember, doctors will also lose their critical allowance when all the post have been filled. Medicine will not be considered a critical post anymore. That means a RM 750 pay cut! The critical allowance for pharmacist is going to be removed soon if not already.
Lastly, are we giving these promotion based on merit! We already know that the quality of current doctors are going down the drain. We know that there are many “dead wood” specialist sand consultants in MOH. The good ones get frustrated and leave as they are the one seems to be doing all the work and the HODs seem to be flying around the world attending all sort of conferences. I know some HODs who stays at home most of the time taking care of their children but gets paid a JUSA C salary! We’re going to see a lot of this in near future with this type of “time-based” promotion. Why work when you know that you will get the promotion anyway!