kkm pharmacist: crumbling msia healthcare system

valens — Fri, 17 Feb 2023 22:21:14 +0800

KUALA LUMPUR, Feb 14 — A pharmacist working in the Ministry of Health (MOH) central administration has highlighted the lack of mental health protection for government health care professionals and workers.

The pharmacy officer claimed that when complaints are lodged about abusive superiors and staff welfare, top management brushes off these complaints by highlighting that salaries and the ability to resign whenever they wish are the only rights that civil servants have.

Superiors also allegedly push policies to meet key performance indicators (KPIs) to highlight their own departments, rather than tailor them to meet the needs of the department.

In addition to the above, the government pharmacist touched on poor management leading to unequal resource distribution, system inefficiencies leading to a lack of patient care, and a lack of action when it comes to reforms.

The MOH pharmacist was among the 1,652 respondents of CodeBlue’s poll among government health care workers last month that revealed 95 per cent believe Malaysia’s public health care system is currently in crisis, 98 per cent are angry at the situation, 73 per cent are thinking of quitting their job, and 52 per cent are willing to go on strike if one is organised.

On workplace issues, 83 per cent perceive that the government isn’t serious in addressing issues in the public health care system, 80 per cent say they’re underpaid, 78 per cent complain of overwork, 74 per cent suffer from burnout, and 61 per cent feel insecure about their career progression. A quarter allege workplace bullying, while 2 per cent claim workplace sexual harassment.

Below is the pharmacist’s story in their own words. As civil servants are prohibited from speaking publicly, CodeBlue is providing them anonymity. The transcript of CodeBlue’s interview with the pharmacy officer has been lightly edited for clarity.

We Are Health Care Workers, But We Don’t Acknowledge Mental Health

There is inequity in service delivery. Doctors want to deliver service, but the mental health of health care workers is not being prioritised. This was my experience when I was working in the hospital – I developed depression. The working environment was so toxic, but I had to just learn to manage this environment.

Your colleagues tend to judge you the moment you step into the psychiatric clinic.

In my case, I’m a pharmacist. I went to see my superior and I said, “This workplace is a gateway to hell. I’m not able to tolerate it and I have started to have insomnia; it really affects my quality of sleep. I have panic attacks and all those issues.”

There are a few factors leading to the health care crisis. Based on the current issues, it’s the lack of human resources. On statistics, for example, the main professionals, like the ratio of doctors, we have already achieved the World Health Organization (WHO) standard, but the ratio is not relevant because the ratio preset by the WHO is basically across different economic status of countries and health care systems — so you can’t apply it directly to us.

We also have to analyse the distribution of these doctors across the country; this applies to all other health care professionals as well.

Another reason for the health care crisis is the inefficiency of managing the resource, which includes finance.

Let’s say in headquarters, there’s a lot of money and there’s a lot of resources. They tend to spend the money on acquiring one printer for one officer, so each officer will have their own printer, but at the hospital level, staff have to recycle A4 papers.

Do you see the extreme point of this? So this is what actually happens.

I have worked at the facility level where we have to keep track of our A4 paper usage, but on the other hand, there are headquarters full of printers and papers and each officer has one printer. That is at the Putrajaya level. That is the inefficiency of resources.

So when that happens, even if you have ideas and things that you can bring to the table that actually can help things to deliver better service, but because the bosses aren’t keen on it, or they don’t have an opinion on it and they only have their opinion, you have to follow what they say.

There is no opportunity given by superiors to their subordinates to perform. And not only that, they also provide negative criticism. So once you get negative criticism, this demotivates subordinates and then they will say, “Okay, fine. I just follow orders.”

For years, it has been like that. How do you want to change that? It requires a lot of unlearning of the process.

That is why I don’t believe that we can actually solve this problem because it is deeply rooted in the system.

Every year, there will be a kajian kepuasan, which means that all staff can give their feedback on the organisation. Recently, there were a lot of negative comments against superiors: they tend to scream and bully.

Following that, as a plan of action, there was a discussion with subordinates, in which one of the officers said, ‘Hak sebagai penjawat awam adalah gaji dan anda boleh letak jawatan.’ (The only privilege a government servant has is your salary and you can choose to quit.) So, basically trying to say, ‘Deal with it.’

The context was that she was talking about annual leaves and every aspect of serving as a government officer. Of course, there is a need for certain give-and-take. There is a need for extra flexibility in all organisations, but the flexibility here depends on hierarchy.

The bosses don’t see the bigger picture; decisions are driven by ego.

What I’m saying is what I perceive through my experiences serving here.

On another level, the infrastructure.

For example, I have worked in a hospital in an outpatient setting with congested infrastructure. That hospital is one of the state hospitals that caters to almost a thousand patients in the outpatient pharmacy, but we only have four to four and a half counters to cater to this amount of patients.

Apart from that, there is no integrated system between facilities. Each facility has its own system. For example, at the pharmacy level, we have this system called the pharmacy information system. This pharmacy information system is not integrated with the hospital system. It actually exists by itself. So every time a patient comes in, I need to key in or transcribe the prescription into the system.

This is what I mean when I say there is no integrated system between facilities. Therefore, if the patient goes from hospital A to hospital B and he doesn’t carry his history, the hospital B doctors have to go back to review the history and everything is delayed because of that.

Can you imagine the delay that causes? That is actually one of the reasons why patients have to wait.

The main reason our health care system is going to collapse sooner or later is because our primary care is failing. You can simply argue based on the data given that we are actually spending more on tertiary care, but we are not spending much on primary care.

It’s very simple. Management is designing policies based on this one thought: “This is my KPI; I must make sure my KPI is achieved.”

So, bosses don’t deliver policy that actually takes into consideration other sectors that could be affected by the policy.

That is how the policy is being designed.

There is no proper engagement with stakeholders. This is very classic. I think if you interview a pharmacist, they would actually say, “Pharmacists are shiok sendiri.”

Shiok sendiri means they like policies that make the light shine on the pharmacy department.

But you (the pharmacy department) are actually an integrated part of the health, so whenever you want to come up and deliver service, you’re supposed to bring in all other people into the policy, but it does not happen that way.

Apart from that, we also have to see in terms of adding infrastructure, but adding infrastructure should not be like Hospital Cyberjaya that is pulling existing human resources from other facilities. They’re not actually creating new posts for the new hospital.

We do more and more research. We already know that whatever research we are going to do, we are going to come up with the same findings. It’s not going to make any difference because there are no policy changes.

THE ISSUES ARE EXPLAINED IN MORE DETAILS HERE:
https://codeblue.galencentre.org/2023/02/14...ok-good-on-you/

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kkm pharmacist: crumbling msia healthcare system