Establish a public health services commission

By:

Chee Heng Leng

Affiliations:

Citizens' Health Initiative/Peoples' Health Forum

Policy Code:

3i Health

Problem Statement:

There is a continual brain drain from the public health care services into the private hospitals and clinics. This causes delays and services to drop in quality, and affects the majority of Malaysians who depend on government health care. One of the reasons for the brain drain is that the private sector can afford to pay higher remuneration. However, public sector health service staff are also unhappy about other aspects of their jobs, such as heavy workloads and difficult working conditions. The public services commission manages the remuneration scales and working terms and conditions for the entire civil service, including those in the medical sector. It is difficult for the PSC to de-link the medical sector from the overall civil service in terms of salaries and working conditions, and therefore, they cannot respond specifically to the particular problems of health and medical staff in the public health sector.

Value(s) and Belief(s):

Good quality health care delivered without delays and without charge at the point of service is important to preserve the health status of the Malaysian population. This can only be achieved by a health and medical workforce that is happy, dedicated, and with a high morale.

Proposal of Solution:

Set up a separate Public Health Services Commission (PHSC) that can (i) offer public health services personnel better remuneration, terms of employment and benefits, transparent criteria and processes for upskilling, promotions, and career prospects, and (ii) attend to the dissatisfaction driving loss of senior experienced staff. For example, for medical doctors and specialists, a current dissatisfaction is with the ad-hoc and non-transparent nature of the promotion system. Therefore, the PHSC may set up a transparent promotional system, with fixed periods for promotional exercises and clear criteria prioritisation for promotion. Another example is that currently, doctors cannot be promoted unless they undertake administrative posts. The PHSC may then set up a career structure to enable doctors to remain in general clinical service even as they are promoted. The PHSC can also incentivise doctors to remain in public service, by allowing official time-off to subspecialise, research and publish, teach, and attend conferences.

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