Commissioning a solution: Healthcare experts say the Health Service Commission would grant the Health Ministry greater flexibility in hiring, setting salary schemes and managing promotions, independent of the JPA.
PETALING JAYA: While the long-awaited Health Service Commission has not yet been established, healthcare practitioners believe it could provide the crucial solution the Health Ministry needs to tackle its ongoing manpower issues.
Currently, the hiring of healthcare workers for government hospitals and clinics is managed by the Public Service Department (JPA), a practice typical of most civil services.
Former deputy health minister Datuk Dr Lee Boon Chye said the commission would grant the ministry greater flexibility in hiring, setting salary schemes and managing promotions, independent of the JPA.
“A health service commission outside the JPA requires an amendment to the Federal Constitution and a new Act in Parliament,” he said.
Dr Lee stressed that the commission must be independent of the JPA, or it might struggle to meet its goals, much like the Education Ministry’s special commission, which doesn’t have full autonomy.
“Even with this special commission (for the Education Ministry), the overarching influence of JPA via Cabinet in terms of salary scheme and the number of staff to be hired is still obvious. Hence, the shortage of teachers persisted,” he said.
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“The setting up of the Health Service Commission depends very much on the future plan for the Health Ministry.
“If national health financing is in the pipeline, the public healthcare sector and the private healthcare sector will be integrated. Under such circumstances, the Health Service Commission will become irrelevant.”
Dr Timothy Cheng, an orthopaedic surgeon, said there is a possibility that JPA may not understand the nature of the healthcare sector.
“For example, working hours in the office are very different from the hospital. One cannot just add and subtract an hour or two on paper and assume it works for a nurse or doctor in a busy ward,” he said.
“Most doctors, especially house officers, do not punch in at 8am sharp and leave at 5pm sharp. They stay back for additional clinical work.
“The nature of doctors’ job means they cannot be simply shoved together with other job schemes and treated equally.
“We invite JPA to shadow a doctor for an on-call day to understand better what we mean. A separate mechanism is needed for doctors,” he added.
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Dr Cheng said the Health Service Commission must be “fully independent”, allowing it to hire and terminate staff, decide on salaries, and set contract terms, among other things.
He said he is not convinced that the persisting problem in public healthcare, particularly in terms of shortage and distribution of manpower, will be resolved this year without a specialised commission in place.
Independent health advocate Dr Sean Thum agreed, saying that the commission will offer the Health Ministry more autonomy to manage its manpower and the flexibility in offering remuneration packages.
He said the JPA’s system seemed rather inflexible, which made it tough to compete against a flourishing private healthcare system and lucrative opportunities overseas.
“Certainly, JPA wouldn’t like it, as that would mean we are taking away some of their responsibilities. But by doing so, we can have a body that can provide sole focus on the governance of health matters,” he added.
Former Health Ministry official Datuk Dr Zainal Ariffin Omar said the commission should be set up as soon as possible and should comprise members who are well versed with health services in Malaysia and other countries.
The proposed commission, he said, must also work with the JPA.
In April, Health Minister Datuk Seri Dr Dzulkefly Ahmad said the proposal to establish a Health Service Commission would be referred to the Cabinet.
The commission was part of Pakatan Harapan’s election manifesto.
The ministry has faced numerous challenges, including brain drain and retention issues with healthcare workers, which have sometimes resulted in shortages and uneven distribution of human resources across healthcare facilities.
Between 2019 and 2023, a total of 6,417 medical officers, both permanent and contract, resigned from the service.
Dzulkefly, however, clarified that 3,200 of these resignations were procedural, as these individuals transitioned into permanent roles.
As of June last year, the civil service had nearly 52,000 doctors, consisting of both medical officers and specialists in permanent roles.
In the past five years, about 3,500 of these professionals have left their positions at the Health Ministry.
