Saturday, May 27, 2006

Politicians can be responsive

I've been wanting to blog about this since the beginning of the week but couldn't find time until now. A few weeks back, I blogged about how Tok Pa should use incentives and not appeals to nationalism to entice Malaysian doctors abroad to come back home. There was a wide consensus in the responses towards what Tok Pa said and I also blogged about it here. The latest appeal was carried out by Health Minister, Dr. Chua Soi Lek. It looks like he's at least heard what some of the 'rakyat' had and have been saying.

The Star reported earlier this week that Dr. Chua, in a meeting with Malaysian students in London said that 'Malaysian specialist doctors will be rewarded with an “instant” pay rise of about RM4,000 if they were to return home and serve the country.' Their salary scale 'would immediately move up from the Grade U41 salary scale of RM3,000 to Grade U48 of RM7,000.' He also said 'the Public Services Department (PSD) had approved the “big jump” in recognition of their specialised skills and training in Britain.'

He didn't appeal to their sense of nationalism or patriotism. Indeed, the report explicitly stated that this was not the intention of the Health Minister. Rather, he appealed to them using a mixture of incentives, a higher salary scale being one of them.

But of course, we have to put this salary 'jump' into context. Does this mean that specialists who were trained overseas and who returned back to Malaysia only earned RM3,000 a month before Dr. Chua's announcement? This seems surprising, somehow. RM3,000 is what a fresh graduate working in Accenture in KL would get, not what a medical specialist should earn in a hospital, even if it is a government hospital. But if this is somehow true (because overseas trained specialists have to do 'time' within the local system first?), then it is no wonder that these specialists didn't want to come back to work in Malaysia in the first place.

The other question we have to ask is whether the RM4,000 'jump' is enough to entice a sufficient number of specialists to return home. We cannot compare how much a specialist in the UK is earning in ringgit terms because that is not an accurate indicator. For example, a specialist in London might be earning, let's say, 150,000 pounds a year which translates into 900,000RM a year (using a 6 to 1 exchange rate) or roughly 75,000RM a month, which is 10 times the 7,000RM he or she will be earning in Malaysia. But this does not take into account a high cost of living in London and a higher marginal tax rate that kicks in earlier than in Malaysia. Minus living expenses and taxes, the nett pay of this specialist in London might only be something like 40,000 pounds or 240,000RM per year or 20,000RM per month. It's still more than 7,000RM (or 5,000RM nett pay in Malaysia) but at least the gap is not as wide as perceived earlier.

I don't know if this salary is sufficient but addressing the issue of salary is a good start.

Dr. Cha also said that Malaysian medial students would 'find it more difficult to work in Britain in the next three to five years' as 'the British government would increasingly give preference to its citizens and EU nationals, while Malaysians would be lumped together with other nationalities'.

I actually doubt whether this is the case on the ground. While not having the proper citizenship, I have the impression that Malaysian doctors are well-respected and valued in the UK. They would have a better command of English than doctors from perhaps, the former community countries (Poland, Czech Republic for example) and they would have been the 'cream of the crop' to be able to go to the UK to study medicine in the first place and later, to take the specialist exams.

Furthermore, most Malaysian specialists in the UK would have been in the country long enough (10 years) to apply for a Permanent Resident status which would put them on more or less equal terms with citizens of other EU countries and even UK citizens. The enticement to come back to Malaysia only works for those who have finished their medical degree (which takes about 5 to 6 years) and have not done their specialisation).

But if they do want to come back to Malaysia, then they would have to ask - is it better for me to do my specialist courses in Malaysia or in the UK? Earlier, I blogged about the dean of the UKM medicine faculty, Prof. Dr. Lokman Sain, appealing for Malaysian doctors to return home to do their specialist degree in Malaysia because there were more places open to them in Malaysia. Dr. Chua seems to have used similar arguments, which received some criticisms in that earlier post.

Interestingly, in the Star on the same day, this report came out, saying that it took 8 years to do a specialist course in Malaysia while it would only take 2/3rds of that time (I'm guessing 5 to 6 years) in the UK.

Again, one can criticize Dr. Chua's approach in this respect but at least, he's appealing to their self-interest rather than asking them to come back based on nationalistic or patriotic appeals. And even if the argument about non-EU citizens is not entirely accurate, at least he's putting the perception out there that things are not always rosy overseas compared to the situation back in Malaysia.

Finally, some of the points which the Star report briefly highlighted are also encouraging. They included:

- ON-CALL allowance in- creased from RM25 to RM170
- ALLOWING locum in government hospitals
- SIMPLIFIED Bahasa Malaysia exam for service confirmation
- FULL-PAYING patients in Putrajaya and Selayang hospitals as a pilot project, where part of the full rates go to doctors
- 298 promotional posts approved for senior positions

I think that these are moves which were enacted to prevent government doctors from moving to the private sector in the Malaysian context. But they also bode well for doctors who are thinking of moving back home to Malaysia.

This episode clearly shows that our politicians (at least some of them) can be responsive towards what the public is saying or has been saying on certain issues. Hopefully, this trend can continue.


Anonymous said...

Woah can't believe doctors used to earn RM 25 during on-calls...that's the pay equivalent to working at McD in the UK PER HOUR.

Anonymous said...

Anon above,

u cannot compare after conversion. compare it dollar-for-dollar using a practical Big Mac index instead. u have to take into account cost of living within respective countries, quality life, public fund benefits, etc.

this is a big misunderstanding many students and potential migrants have in mind. they are blinded by the conversion, then they realise that it's not so green a pasture they once thought. many UK citizens themselves are having a tough time getting jobs and earning a living. in fact, almost every developed nation this day is facing this problem.

Anonymous said...

The UK NHS is all messsed up. I think the M'sian UK-based students are having a problem now, made worse by a weird job allocation system:

Anonymous said...

One more point for Dr Chua to put in place, i.e. to be fair, locally trained specialist should be accorded the same "jump" of RM 4,000. A specialist is a specialist no matter where one is trained so long as it is recognised and accepted by MMA and the relevant Health Authorities.

Anonymous said...

wat ever happened to hypocrettes oath? Drowned by $$$$$$$?

Anonymous said...

Yeah a direct conversion cannot be used, especially for London as the salaries are higher, but proportianlly the cost of living is EVEN higher.

RM7,000 is econmically equivalent to around 36,000 per anum in UK, which is a fairly high salary (Average stands at about 16,000 per year).

Anonymous said...

UK is giving priority to UK citizens and EU citizens now, for jobs and particularly in medicine. So, 'others', including Malaysians will no longer have easy acccess to worthwhile jobs. You might get a job there, but chances are you'll just be an 'extra pair of hands' to do mundane things - certainly it will be harder to find postings that allow for sufficient training to 'become well trained specialists'.

While I am not a medical person myself, I have enough friends who are to totally empathize with our local doctors/specialists - they work their butts off and many of them include those who 'came home' and started working on completion of their studies abroad. The rest (and presumably, majority) were trained locally. If you ask me, the former, those folks who returned from abroad to serve the nation displayed exemplary values. I think it's a pity that the media and many others seem to have had a field day with remarks on 'nationalism and patriotism', but let's face it that's what these folks displayed - they had the presence of mind to know that they went on a scholarship (again, in reference to gov't scholars) - and to return and honor their obligations.

If I'm not mistaken, some Malaysian student wrote a letter to the Star about that meeting in London where Tokpa met with the Malaysians, and it sounded like the usual press spin that turned those remarks on 'patriotism' around. But that's another story.

Back to our local doctors - YES, in relative terms, they do work for peanuts. MMA (at least I think it was them, in a news report a few weeks back) rightfully spoke for the rights and welfare of these doctors. MOH has to be VERY CAREFUL about 'rewarding and enticing' those who are currently abroad to come home.

Do NOT piss off the good doctors at home and at the very least - mete out the same rewards who didn't overstay abroad abd came home to serve the country (oops - that patriotism thing again). For all you know, these wonderful people who have 'had it good' abroad, will come back for a year or two (or less) then decide that life here is not good enough for them. Then they fly off again. And in that time, they would have denied worthy 'loyal and patriotic' doctors similar opportunities.

In all this, people also seem to have forgotten that those sponsored students who went abroad signed a CONTRACT, which I am sure (and have been told) clearly stipulates that they need to return on completion of their studies. All this waffling about 'staying on because there are opportunities abroad'... please la. You sign a binding document, abide by it. You can't have your cake and eat it too.

Anonymous said...

Persuambly another advantage of serving in Malaysia is that you are less likely to get sue..


Anonymous said...

when you mentioned specialist in uk 150 k pound,that guy must not drink, eat, rent, buy house or pay tax, then he can bring RM 1 million home, you must be talking about consultants as there is no such thing as specialist in uk, you must be wrongly informed, below consultant is fellow, registrar and their pay is shit, to be a consultant in uk is much harder than in singapore or malaysia for reasons that only those really into the system of trying to be a consultnat in uk will know...those quoting to make a point are only referring to the lucky few. A Registrar and Fellow in UK is not a specialist, only consultant counts and they are the one earning big.