I wrote 3 parts on ” The Storm is coming……..” but realised that the storm has already hit us. It is now the hurricane that is coming. I just received the info below from a friend of mine in Facebook. In 2008, just before the last general election, the government introduced the night clinics in some of the government polyclinics and klinik kesihatans. The night clinics are supposed to run from 5pm till 10pm daily and 8am till 12.30pm on Saturdays. They idea is to serve the people with a RM 1 clinic and to reduce the load at emergency department. Many was not interested initially but with the RM80/hour rate that the government was paying, soon there were long queues waiting to get a slot . In fact, the hospital doctors on the other hand were complaining as they were receiving RM 150/call when the KK doctors were getting RM80/hour. My wife works in a KK and I use to tell her that it is likely a temporary measure as I could see that the storm was coming then.
With the increasing number of graduates being produced over the last 2 years, it is almost likely that most KKs will have full number of MOs. KKs which had only 2 MOs before are now having close to 10 MOs. I was informed that most KK’s MO post in Selangor, N.Sembilan and Malacca is deemed full and by the end of this year, the entire Peninsular Malaysia MO post will be full. I know some of these states have already sent their MOs to Klinik 1Malaysia which was supposed to be manned by Medical Assistants (MA). Most of these KKs previously use to get their MAs to run the clinics, to help the doctors. However, I was informed that MAs are not running clinics anymore in most KKs. In fact, some MAs are being sent to Klinik Desa to do admin and clinical work. I know 1 MA who was complaining about this to me quite some time ago. The MOs are now being asked to do more and more admin work, audits and even becoming bidans to visit antenatal mothers and visiting old folk homes!! Who knows that soon MOs will also be doing the nurses jobs! Too many mah………..
With the overflow of MOs in KKs, it is time for MOH to introduce the shift system for the night clinics. This will remove the RM80/hour allowance that these doctors were enjoying before. Can anyone complain? The answer is NO. With the flooding of the market with doctors, the administrators will just say ” you tak suka , you boleh keluar……….. “ I wrote about this in 2006 . It is just a matter of time when these system is introduced to ALL Klinik Kesihatans throughout the country to serve the rakyat………
Now, didn’t I say the storm has hit us ……………… and it will only get worst……….. I am very sure they will remove the critical allowance (RM750) by 2016. Our new medical students in public universities this year are now given an option between PTPTN loan and JPA scholarship, it use to be only JPA scholarship. Some hidden message ?
Oh, and don’t think the private sector is greener either. The 1Care system is just around the corner…………
ATTENTION GOVERNMENT DOCTORS ……. i’ve got DISTURBING NEWS
now KKM is unable to cope up with the payment of extended hours in the klinik kesihatan…….. so they have proposed a plan which KK Port Dickson is going to be the PILOT health clinic to carry out the SHIFT SYSTEM……..
there will be ONE doctor allocated for that week starting from monday upto friday starting work from 12.30pm UPTO 9.30pm…. then on SATURDAY that doctor has to work from 8am-4.15pm…. WITHOUT GETTING PAID FOR EXTRA HOURS DUTY…….
i call this HARASSMENT…… we’re forced to worked extra hours without getting paid extra….. the total hours for that week will be 53 hours … which is far more than the total number of hours a person can work for a whole week which is 40 hours…….
as a result of that , we cannot attend any courses , or go for any events which normally happens on weekends…….. surely the doctors are going to REBELIOUS about this……….
Pagalavan's Avatar 
A little bit confuse on the message. Since there are more than enough of MOs in the system as claimed, why is it the MOs are forced to work extra hours (ie 53 hours vs 40 hours, and without extra pay)? Isn’t it should be shorter working hours for all MOs?
It is not actually extra working hours. You are taking turns and time offs will be given as a replacement.
=.=”‘
another knee-jerk..
after merdeka for almost 55 years…
happy merdeka, dr paga! 🙂
What happens when a typhoon comes in a developed nation like UK or states or sometimes even in Malaysia, people evacuate and move away from areas of typhoon..
We are reaching a stage of hurricane but we are still sitting on the hurricane..there is no hurry as the hurricane will pass by and the ones that stay will stay…
Happy Merdeka !!
Lets wait patiently for hurricane
We don’t believe in prevention
We only believe in natural course of destruction……………
yang
The best part is : for Malaysian graduates, there is no where else to go.
Government knows this. Why should they want to improve situations? As they say : “Kalau nak pergi, pergi-lah!”.
It must be destroyed first before picking up!
Any source for this information?
from a reliable source.
Hi Doctor, i’m a 3rd year medical student in Royal College Of Surgeons in Ireland at Dublin. I’m getting scared of this situation happen in our beloved country Malaysia. So i figure soon i will have a medical degree that recognise by some country and i thought maybe i can go oversea to practice medicine such as Singapore etc. But then i realize RCSI has many oversea branch such as in Bahrain, Malaysia , and some more in Dubai also. Then i scared the oversea medical council will doubt that my medical degree from RCSI was not the original from Dublin. So i scare at the graduation time i will get a medical degree which is same as the Malaysia or Bahrain branch. So i need Doctor or anyone who had graduated from RCSI Dublin answer me about the confusion of the medical degree awarded by RCSI Dublin compare with the oversea RCSI branch. Thank you.
generally, each medical council will look at a degree based on where you underwent the clinical training. RCSI is setting up all this branches to make money, period!
Wow, i hard to believe that one of the world prestigious medical school need to become like this. So sad. By the way, Doctor. So you mean that my medical degree will be original from RCSI Dublin and not same as the other branches. Right???
Hi TRUTH, I graduated from RCSI too. Don’t worry your degree will be from National University of Ireland/ RCSI. Cheers!
yes
Prestigious? You must be kidding. Irish Medical Schools are well known Internationally to be degree mills. They have 4 medical schools for a country of 3 million. That is not counting the numerous ‘twinning’ arrangements they have with so many other countries.
hi doctor
i think u have to listen to both parties before u jump to any conclusions..
so many misleading statements that could confuse the future doctors..
FYI, the idea to introduce shift system was because the ministry received so many feedback on the previous on call system..
the doctors claimed to have less quality time (to be with family and friends), even their quality of work were proven to decrease(there were studies done on this)..
so to overcome this situations, the ministry had conducted studies, meeting with MOs and HOs to get some feedback and came up with the idea of introducing the shift system..
as for the allowance RM150 and RM80..both are different allowances given for different tasks..and with the introduction of shift system, govt still gave the doctors a special consideration on the allowance(RM450/month)..whereby any other profession that also work on shift basis did not get anything..
regarding the critical allowance, there are several criteria that will be reviewed every few years..and for the record, any allowances is only previllege (not a must) given to govt servant for services/ specialty/ any other reasons and govt have all the right whether to add some more or to stop the allowances..but i have no comment on that matter..
i respect your view on these matter and all my answers is my personal view..it have got nothing to do with the MOH as i am not MOH employee..but u know what?there’s no harm if u give both side a fair chance to be heard =)
I think you are getting confused with 2 different issues. The article above has nothing to do with the HO shift system. This is about the “extended hour” clinic session that are conducted by KKs and Government polyclinics. You must understand the history behind this “extended hour clinic”. It was first introduced few years before 2008 at Emergency department. The doctors were paid RM40 per hour. Unfortunately there was lukewarm response. Most of the slots were taken by contract expats. Thus, the government decided to extend it to KKs and polyclinics. The response was poor till they increased the rate to RM 80/hour. Now, with the surplus of MOs in KKs and polyclinics, the shift system in being introduced in these clinics so that they do not need to pay the RM80/hour. It has nothing to do with ” having better family time” etc.
Now, coming to HO shift system. Let me tell you again that it has nothing to do with “having better family time” etc as you have mentioned above. The whole shift system was introduced due to oversupply of HOs. If you read the speech given by our Ex DG, he has clearly stated that. In some hospitals, there were close to 50 HOs running around in the department. They were only doing 1 call per week. There were enough family time !! The previous DG had to send out circulars in 2010 to make sure that each HO does atleast 10 calls per month. Unfortunately, to make this happen, some departments had to increase the number of HOs on-call to about 5-6/day from the usual 1-2. These resulted in huge amount of money being spend by the hospitals. Thus the new DG was asked to reduce the MOH expenditures. The new DG decided to implement the shift system without looking at the implications. The RM 600 shift allowance is just a temporary measure to prevent the doctors from complaining that their income has reduced, since the election is just around the corner. Anyway, I am sure most HOs would have realised that their income from call-allowance has actually been cut by atleast 50%.
The latest survey done by SCHOMOS of about 900 HOs(in latest MMA magazine) clearly showed that 75% of the HOs felt that they are not getting enough clinical exposure compared to the on-call system. 52% said that the on-call system is better then the current shift system.
The whole idea of producing surplus of doctors is to prevent doctors from demanding. I was in SCHOMOS before and have attended meetings with JPA and MOH administrative staffs. I know what I am talking about when I say that it is just a matter of time when they will say ” you tak suka, you boleh keluar”.
Alright, I just want to ask you guys this. If you think that this is a system that is unsustainable and unjust, what are you guys going to do? Just going to sit back in your chair and accept it wholeheartedly? All I see is just plain talk but zero action. As far as I am concerned I am already taking preliminary steps to boycott this. How about you? Secondly, will anyone out there or in this blog entry or even the administrator himself lend a hand and champion this cause? If yes, then all is well. If no, then why write about just to enlighten people but not to empower them?
You are welcome. Pls enlighten us on what you are doing? I have done enough for the doctors when I was in government service. FYI, the time based promotion that the doctors are enjoying in civil service was single handedly written by me in 2006!
Oh BTW, as a civil “servant” you can’t boycott anything that the government orders! Unless ALL your superiors supports you, which will not happen as everyone “makan” gaji. You are welcome to explain your actions in this blog and I will publish it. My blog receives 2000 views per day.
Hello Dr Paga, this is completely irrelevant but do you think I have a chance of getting into IMU PMS or Monash Sunway with ABBB in Cambridge A Levels? I really want to study medicine.
you can try.
The storm has cum n gone waiting for the hurricane ,can dat come n go?
This is propesterous! Indeed, being a doctor is considered by some as a noble profession. But the doctors need to earn a living too. Not every doctor came from rich family. Some of them still have to support their extended family as well. If the govt is really running out of money, I think cancelling the pay for extended hours is way too much. I can still accept if they reduce the amount of payment to a certain extent, but to cancel and then replacing it with shift system if totally unacceptable. If other means come to no avail, I think we should make a nationwide petition against such implementation before it\’s too late… Just my 2 cents… Thank you Dr. Paga for raising this issue.
Why should the government pay an allowance when the doctor is working shift hours? There is no logic to this. Do other employees ( whether private or government) who works shift hours get any extra allowance? NO. Unless you work overtime beyond your shift hours. As long as the total working hours is the same as anyone else, no one is going to pay you extra allowance.
I’m sorry but i think i have been misunderstood. Allow me to rephrase. I disagree with the decision to change to shift system at all (and not that i wanted the govt to pay extra allowance for the work shift hours) and I just prefer the current extended hours system. But if the govt is really running out of money, then i would prefer for them to stick with the extended hours system but with less payment rather than changing to shift system in KK. Sorry for the inconvenience caused.
When there are enough doctors in each KK to run shift system, it is only logical to introduce it. You can’t run away from it. Any administrators will do the same.
You will soon find out what can and will be done, I don’t intend to publicize my efforts. It is nothing extraordinary but it requires tenacity and the eagerness to pursue what is right. I dislike the cowardly act of just being subservient and accept an injustice just because you have to because we can’t ‘boycott’. The ‘makan gaji’ habit has to go, and you need a good leadership skills to rally that cause. Being subservient is the very reason why we are in this mess to begin. Secondly, it is great to know that promotion of salary was your idea, However that was in the past though we appreciate it. What matters the most now is what can be done now for the current predicament. And that is where we come in. You could lend your own expertise by letting us know acquaintances that can benefit our cause. We need to build a good networking amongst all people so that we know whom to contact to get things done. You can publish that here so that we know what to do and who to communicate with.
I wish you Good Luck in your efforts. I have gone throu all this before and did exactly what you are trying to do now. It is not easy when doctors themselves are NOT united. Worth giving a try.
I will be delighted to help if you need it. You can email me.
http://pagalavan.com
Sent from my BlackBerry® wireless device via Vodafone-Celcom Mobile.
I believe that doctors need a real crisis to unite. This recent debacle might be one of them. I am optimistic if I seize the opportunity, things might turn around. There is no harm trying and trying again even if it did NOT work before. Persistence is key. Will keep you informed if I require further assistance and thanks for offering a helping hand.
BTW, just to tell you a story. When I was an MO, i was rebellious. I went against my HOD for asking the MOs to do extra calls when we were very short of MOs and preparing for MRCP at the same time (imagine 1 MO covering more then 1 ward(40 pts) at that time). I collected signatures from all MOs to go against the idea. My HOD was upset with me but you know what happened after that? The very same MOs that I was trying to protect turned against me! Finally the HOD still went ahead with the plan but excluded me. The rest just followed the plan. That’s how disunited we are.
Being rebellious and doing the right thing are two very different things. Doing the right thing does not mean being rebellious. Being impulsively rebellious is being does not mean you are doing the right thing. Hope this helps.
What I meant by being rebellious is doing the right thing. Just like when you said “boikot”. Isn’t that rebellious?
What you mean by doing right thing can be rebellious to the eyes of the others. A person who fights for his rights can also be considered rebellious! Right?
You are absolutely correct. But rebellion is not retribution. There is a thin red line separating both terminologies. Most ‘people’ don’t see it. Rebellion does not mean proving your critics wrong – it is a chance for the critics to hear 2 sided discourse on the issue.
As I said, I wish you good luck. I have done all those that you are planning. You will know what I mean when the time comes. However, I still feel it is worth giving a try.
Is it better to study something like Biomedicine/Biotechnology in a renowed University overseas or to study medicine in a University that is only recognised in Malaysia- ie, IMU local/UCSI/etc?
Depends on what you are interested in!! Doing a course in a renowned uni will give you a better job prospect in many countries.
I like health sciences, hence I am considering these field. But I am scared that by studying a Biomedical/Biotechnology course, I will only end up as a lab assistant with meagre salary. If I study medicine in IMU local/UCSI, do I still have a chance of working overseas? From reading your blog I know that the chance for a doctor to specialize in this country is also very low…but maybe I don’t want to work as a doctor but what about lecturing and management?
LOcal IMU and UCSI is not recognised elsewhere. I think local IMU is recognised in Sri Lanka! So, you can’t work overseas. To be a medical lecturer, you need a post graduate degree. You can’t become a lecturer with just MBBS degree. As for management, are you talking about government service? Whether you get a admin post or not depends on availability of post. For higher management post, you will need Master’s in Public health.
[…] 10pm every night. This has started as a pilot project in some Klinik Kesihatan as I have mentioned here. It was also mentioned in the newspaper article as “Shorter queues and extended hours at rural […]
Just as an update here. I managed to stop this shift system scheme from being implemented at my clinic. All I had to do, contrary to the predicted belief that it would fail by certain quarters, was to summon all involved and collectively voice our opinion. We did it through a formal petition by letter and we also discussed this issue diplomatically with all relevant parties. The JKN and PKD was receptive as they were intimidated by the sheer number of supporters who signed the petition. So, to those who thought it would fail, you people won’t even know unless you tried. And to those who have the nihilistic opinion that ‘Ahhh, I have tried, it won’t work’, I would advise they to stay away from the the main game and guard the sidelines or be a reserve if you are lucky. Enough said…………..
Good to hear this but it will not end here. The final decision is made by MOH and DG, not JKN or PKD. It might as well be a temporary measure. Anyway, good that you guys are united for once.
We are all well aware that the ultimate decision resides with the DG or MOH. That is a no brainer. What is more important is solidarity. Even if they try that stunt again, we need to just remind them it is not what we want, I am not concerned if it is the MOH or DG. They are as human as we are and they can’t unilaterally call the shots anymore.
They can, unfortunately, just like the HO issue.
Under the GO and government circular, everyone have to ikut perintah. That is the agreement that you have signed when you join civil service
See, this ikut perintah thing has to go. Pseudo-democracy, it is like swearing allegiance to the devil. Many of us are unaware of the hidden agenda of that document, partly because we were uninformed when we signed it. However, that does not mean that we should be influenced by what might be, as you have mentioned, ‘implicitly’ meant by the akur janji. I and many others no longer believe in that akur janji because it is purely draconian. I have completely gone against that akur janji treaty to stop this shift charade, but I used a loophole – I followed protocol and used it against them. Simple. Rebel but be wise. That’s my advice. Having signed the akur janji doesn’t not mean you have to be subservient to anything. You just need to work around it, not just accept it all in a purely nihilistic manner.
You see, no matter where you work, whether in private or government, you are bound to the contract that you have signed which includes obeying superior’s orders. If you don’t like it, you may leave. The only time you don’t need to follow any superior’s orders in when you are self employed!
Of course, you can protest or object but it is up to the superior to decide
Well, your wish may come true after all, our DG is in the papers for wrong reasons!! See the papers online
Read that and I have no ill wishes towards him. Just like General Petraeus, he should resign gracefully.
How come Pagalavan.com doesn’t have a “Like” button?
😉
Looks like I have completely put a halt to the shift system in my state after all. In fact, we got rid of a few ‘dead woods’ that were causing major problems as well in the process. So good prevails if you keep up the pressure. And of course if you don’t back down out of illogical fear or nihilistic beliefs. Happy New Year.
for time being!
are you sure the shift system has been cancelled? I just heard it has been approved for pilot project at KK PD?
Status update. KKM’s and JKN’s plan was thwarted once again. They tried to implement it but their have to concede to failure due to increasing pressure from doctors and all supporting staff members. It goes to show that solidarity is the single most important thing. People are no longer afraid to be vocal about their welfare. And this is what they fear the most. Kudos to all those who remained united for the sake of all doctors in this country.
Yes, they tried to implement it in PD and Bahau. However, we managed to unite and go against them with very valid reasons. Problem solved. Nothing is impossible. Period.
Postponed, not solved
I am correct by stating it is solved because we prevented it from happening twice. We are consciously aware that it could be postponed or permanently put to a halt. That is purely common sense. The most important issue, however, is the fact that they can no longer act unilaterally. They have already begun to ask our opinion before they act. This crucial attitude has been changed through this struggle. To me, that alone is enough.
After a 4 year hiatus, here we are once again, only to reiterate the fact that there is no shift system. I believe that what I did was right and I guess 4 years is enough to say it is solved. Secondly, thanks to our reform paper, they are aware that it is not prudent to commence such policy without doubling the number of staff at an institution.