21 January 2025
A Relook at the Waktu Bekerja Berlainan (WBB) Proposal
Dr Musa Mohd Nordin, Paediatrician, DSH
Anonymous, MOH
We agree with the writer that the Ministry of Health (MOH) poorly handled the Waktu Bekerja Berlainan (WBB) or staggered working hours system. [1]
As the quote goes; “Marketing Is Not a Battle of Products, It’s a Battle of Perceptions.” As far as the WBB system is concerned, the MOH has lost the battle of perceptions.
The health minister, vehemently denied he had approved the WBB proposal, which was still in its early stages as part of ongoing efforts to improve the working conditions of health care professionals (HCP). It had neither been approved by the MOH nor submitted to the Public Services Department (PSD). [2]
In a way, the ensuing events were part of crisis management, consequent upon the leakage of the WBB document by a senior member of the MOH, which should be immediately investigated and the offender dealt with seriously.
Thus, we suspect, the rushed townhall, was to explain and rationalise the WBB system, and obtain feedback from the doctors.
We think Dr Azizul Salehudin (Dr AS), has scripted one of the better and fairer summary of the WBB Townhall in his facebook posting on the 17 January 2025. [3]
We have picked the most critical part of his posting related to “points yang tak best” (parts of the WBB which is not beneficial to the HCP) to explain some of the related issues and hopefully offer clarity.
Dr AS: Ada shift yang kerja 18 jam straight, tapi kalau weekdays tak boleh claim apa-apa
Us: They are not eligible to receive on-call claims for the 18 hours of on call duties on weekdays, because they get 2 days off as replacement. In the real world, you can’t have it all – have your cake and eat it – if you get 2 days off, you can’t expect to be paid too. We think it’s a reasonable trade off.
Dr AS: Kalau kerja pre-weekend/public holiday, boleh claim separuh saja.
Us: At least you can still claim ½ of the on-call rate on weekends and public holidays and you still get to enjoy your 2 days off work. We think it is the MOH here who is being generous and it’s the MMA-SCHOMOS et al who are being unreasonable and thankless.
Dr AS: Unit yang takde privilege untuk buat WBB, rate elaun oncall masih sama, tak naik. Dah lah tak cukup orang, kerja lagi lama, oncall rate lebih rendah. Ini susah nak brain. Meaning, 80% akan dapat rate sama macam sekarang.
Us: Yes! The MOH must increase the on call claims for those not able to do WBB. This is what should be the practice until we have enough to do the WBB system.
Dr AS: Walaupun WBB ini shift system, working hours kurang, tapi workload akan bertambah sebab less people working in 1 shift.
Us: We don’t think this is an issue because only those units with enough numbers of doctors will be able to do the WBB system. If you have a good working culture in your department, you will cover each other in good and in bad times. But if you have lousy Heads of Departments (HODs) and specialists (who don’t cover the shortfall) and MOs who are either just lazy or have a bad attitude, then your department is a failure from the outset.
With the supposedly alleged surge into private practice, as a show of protest, they will very soon learn first hand the realities of work burden and remunerations. Either one’s lousy work ethics attracts negligible patients (you can have all your free time now, but with not much to show in your daily or monthly salary slip) or too many patients, and we doubt you’d be complaining then, with the monies pouring into your kitty. Such is the human behaviour and it’s idiosyncrasies!
Dr AS: Elaun kritikal dikatakan sebagai insentif kepada doktor yang kerja luar office hour (shift/oncall), tapi yang kerja office hour dapat juga. Nampak tak konsisten.
Us: We agree on this point. Non-clinical doctors should not be given critical allowances because they do not do any form of shift, on call or out of office hours clinical duties.
Dr AS: Ada plan untuk serap semula non-clinical MO untuk cover kerja-kerja klinikal.
Us: This is surely a good move, getting non-clinical MOs back to doing clinical work and making up the paucity of doctors in clinical practice.
Dr AS: Kalau dapat post-call off tak boleh claim elaun oncall atau ganti kerja weekend/cuti umum.
Us: This is sheer common sense and fairness as you get 2 days off which equals 2 days of salary. At the end of the day, it’s all about money. MMA-SCHOMOS et al complain incessantly about long working hours and the need for time off and work life balance. WBB does exactly that. Restrict on-call hours to not more than 18 hours and allows rest or quality time for the ensuing 48 hours. It’s a fair trade-off, to enjoy 2 days off and not enjoy on-call claims on weekdays, but still enjoy ½ call claims on pre-weekend calls and the revised on call claims on weekends or public holidays.
For those joining private practice, will soon learn that if you take days off, you will get zero salary. OK! You may employ a locum to continue your business but your clients come to your clinic to see you, not your locum. So you may have a little business which would probably be offset to pay your locum.
Dr AS: Terlalu tertakluk kepada pekeliling JPA. Tak wajar pukul rata sektor kesihatan dengan skim lain. Norma & intensiti kerja tak sama. JPA kena bagi kelonggaran, sebab waktu bekerja 45-72 jam itu untuk mereka yang kerja office hour ikut circadian rhythm. Contoh kelonggaran, macam guru. Mereka tidak tertakluk kepada tempoh bekerja 45 jam seminggu.
Us: We are afraid, this can’t be avoided, not until the MOH is separated from the PSD. Let’s be real. All the issues facing MOH vis-à-vis human resource/salaries/holidays etc is because you are all tied to the PSD and the MOF. Maybe it is pertinent to ask your previous health ministers or DGs, who among them has had the gall to challenge the power of the PSD-MOF.
Until and unless this umbilical cord is stripped, you are not special, you are just like any other civil servants.
The health minister has submitted JUSA C requests for all the chronic UD56 (most likely to leave service) multiple times to the MOF, which were flatly rejected.
It’s not fair to train your guns solely on the health minister and the MOH. The MMA-SCHOMOS et al should instead target your attention at the Minister of Finance
The increment of on call claims is also under the purview of the MOF. The MMA-SCHOMOS et al should go question the MOF, as to why your on-call increments were repeatedly refused.
My co-author is a senior consultant who has dedicated his adult life to the betterment of the MOH. His MO stint in rural areas did not deter his spirits. Instead, he learnt his best medicine there. And in his earlier stewardship of MMA-SCHOMOS, has fought diligently for the rights, welfare and wellbeing of the junior doctors, in arms against the DG, DDG, State Directors, yet not a murmur on social media, until this present article, as an anonymous.
With the WBB model, for example an MO does 4 weekdays and 2 weekend calls and get 8 days off. He gets another 6 days off weekends, since he is not on call. In essence, he only works for 30-8-6 = 16 days per month. Isn’t that a solid so-called work-life balance if everyone gets to do WBB?
So, the MMA-SCHOMOS et al needs to be more reasonable and principle centric and not hype and harp on the Ringgit sign. MMA-SCHOMOS et al must not be “penny wise pound foolish!”
Nevertheless, MMA-SCHOMOS must continue to advocate better things for doctors in the MOH. However, this must never be at the expense of compromising patient care. We have the responsibility to “give back” to the thousands of our prevous patients who generously taught us the art of medicine during our times in medical school, who made us better house officers (HOs), medical officers (MOs) , specialists and then subspecialists. We owe the “Dr” in front of our names to these generous souls. Please don’t lose focus in service while fighting for improvement for the HCPs. If you must make a choice to resign and join the competitive and long hours of working in private sector, that if fine. That is your right and hopefully a good and informed choice.
Private doctors work virtually 30 days a month, including Saturdays and Sundays.
My patient actually wonder and have repeatedly asked me; “Eh! Dr kerja hari Ahad ke?”
Whilst you enjoy your precious Saturday rest, it’s our busiest day of the week. And mind you, try function as HO-MO-Registrar-Specialist-Subspecialist-Consultant all in one, in your daily duties as a consultant in private medical practice.
At the end of the day it’s all about the Ringgit. It’s really tough with the PSD-MOF calling the final shots. And it’s going to take a long time and tough duel to be independent as the Suruhanjaya Perkhidmatan Kesihatan.
Our final counsel is that, if you cannot handle the money issue, then go make your money elsewhere and be a master of your own destiny.
It is after all the prophetic call for self-employment, self-financing and self-sustainability.
But please don’t carry on in the MOH service with the bad attitude and lousy work culture. It shows!
References:
