As a government doctor who is serving in a university hospital as a specialist and lecturer, I read with great dismay the diversion currently being created by our current health minister, who previously, I was told, was a medical doctor himself. (I am sure he still is unless the Malaysian Medical Council [MMC] decides otherwise.)
A diversion since it diverts everybody's attention from the real problem facing the health profession nowadays. I believe that the crux of the matter is an imbalance in the distribution of doctors rather than a state of absolute deficiency.
Let's just face it; everybody wants to stay within an earshot of a school, shopping mall, place of worship, family entertainment centre, etc. Why should doctors be any different?
This state of apparent shortage of doctors becomes real when more doctors leave for private practice and move nearer to the city or join a private hospital as a specialist.
Why this happens is not a zillion-dollar question.
Apart from the push factors of poor wages, punishing working hours for junior doctors and the realisation that possessing an MD or MBBS is not an end in itself unlike maybe a Bsc. Eng, BA or LLB.
There is the pull factor of being financially independent especially regarding children's education. I wouldn't be able forgive myself if my kids in years to come, are good enough to do medicine, got a place in medical school but I, instead, couldn't afford to pay their tuition fees.
So, is the answer in forcing private doctors to do 'public work'? It would violate their human rights (after all, they are still human) to force them to work in some rural areas miles away from their homes (since the cities are already full of doctors right?) and while they are doing it, who is paying for the overheads of their own clinics?
As for private specialists from private hospitals, where are you going to find a place for them to work? Asking surgeons to give away their operating time for others is blasphemy.
I would really ask our minister to stop scapegoat-ing these group of doctors. Instead, look into an alternative remuneration scheme unlike the present outdated NHS, where a surgeon who operates on one patient a month is paid the same as one who does 20.
The Canadian system of not having a fixed salary is appealing since having a fee-based service (the government being the paymaster) can only make one more efficient and besides countering a bit of the pull factor in quitting government service. (Then again if you pay peanuts, you get peanuts.)
To address the urban-rural imbalance, I can only hope they come up with a financial lure not unlike one EU country I know where working as a specialist/consultant in designated rural area can earn one a significant bonus.
I hope I am not discouraging any budding physicians and surgeons out there. If this is your calling, I welcome you with open arms but after almost 15 years, you do get jaded thinking about mortgages, education funds and income taxes in between doing cardiopulmonary resuscitation.