MMA rejects new shift system for public clinics, says health workers already overworked and stressed

KUALA LUMPUR, June 16 — The Malaysian Medical Association (MMA) has come out strongly against the Health Ministry's new shift system for government clinics, arguing that public healthcare workers already overworked due to manpower shortages would not be able to cope.

MMA president Dr N. Ganabaskaran said a survey his group conducted among 9,320 Health Ministry staff in various categories revealed that 92 per cent of the respondents disagreed with the shift system, which was implemented in phases starting yesterday.

“They believe the ministry should first address the staff shortage and infrastructure issues, as currently all government clinics are understaffed and overworked,” he said in a statement.

Dr Ganabaskaran added that 84 per cent of the respondents said this will increase their current workload, with 89 per cent saying it will increase their work-related stress and that they will eventually suffer burnout.

“In another poll conducted online by Public Health Malaysia, 63 per cent of its respondents voted against the current move. There is an acute shortage of doctors, nurses and other support staff at healthcare facilities in the country including our government clinics.

“The shift system will only work provided the government addresses the staffing issues and necessary infrastructural support. Under the new two shift system, there will be less healthcare workers working per shift due to the shortages,” he said.

Dr Ganabaskaran said that due to the overcrowding of government clinics, there are peak times at the clinics where the shortage in staff will stress the system, which can greatly affect the quality of care.

“All ministry health clinics in the country are currently open from 8am to 5pm on Mondays to Fridays. The shift system, to address the problem of overcrowding, will see the clinics extend opening hours to 9.30pm.

“The two shifts for staff are from 8am to 5.00pm and 12.30pm to 9.30pm. Ministry staff were notified of the shift system only recently. Government clinics operate as a one-stop-centre providing outpatient care services and treatment for various chronic diseases,” he said.

These include maternal and child health care, rehabilitation services, dietician consultation services, nutritional counseling, physiotherapy services, occupational therapy services, emergency cases, pre-pregnancy services, health screening services, methadone services, tuberculosis screening and treatment, community psychiatric services, running promotion and prevention campaigns, as well as smoking cessation programmes, among others.

To add to the burden, Dr Ganabaskaran said healthcare workers in these clinics are also involved in Covid-19 screening and contact tracing for cases, carrying out domiciliary care and conducting community outreach programmes.

“The staff are well trained in these aspects to ensure proper care is being given to the rakyat. By implementing the shift system, it will be impossible to continue the current care being provided.

“A proper study should have been conducted with proper stakeholder engagement before implementing the move. Besides doctors and nurses, adequate pharmacists, lab technologists and even ambulance drivers need to be looked into, as some cases will need to be referred to hospitals” he said.

The president also noted that the shortage of doctors in government clinics will also affect the Family Doctor Concept in care where doctors provide care for patients and their families from “womb to tomb”, as doctors who see a particular patient and their family members regularly may not be assigned on the usual shift under the new shift system.

“The family doctor concept is something even the Ministry of Health has supported. They understand its effectiveness in the prevention, early detection and treatment of chronic illnesses as family doctors will be very familiar with their patient's medical history from the regular follow-ups and good relationship they have developed with their patients.

“We welcome any enhancement to our healthcare system but all these dynamics need to be taken into consideration. On the other hand, we should educate and  empower the public to adhere to staggered appointments to reduce congestion in clinics which we have failed to do from not resorting to a shift system,” Dr Ganabaskaran said.

He urged the ministry to conduct a more detailed study on the new shift system before implementing the move.