Lately, there has been a lot of discussion on the plight of medical housemen in our country who are compelled to work long hours uninterruptedly. It is really shocking to know that having gone through the system some 30 years ago, is still has not changed for the better.

It was acceptable then for us to work long hours non-stop as there were at times when only a single houseman was available for each department. At that time, we had just one university producing less than 100 doctors a year.

Today, more than 1,000 doctors are churned out by our 19 local medical colleges every year and they are all absorbed into government hospitals for housemanship and subsequent medical officer and specialist training. Despite this mass production, it is puzzling why we are still short of housemen and that they are still forced to work 36 hours at a stretch.

We are also told that we are not only short of housemen, but also of medical officers, specialists, nurses, and all categories of paramedical personnel. In fact, you name the discipline and we will be told we are short in that area. What is happening to all the doctors being produced by our own universities? When will these shortages ever be overcome? It may not be the actual number that is in short supply but rather the manner in which they are deployed and administered.

I sympathise with the housemen for being blamed for all the complications and death that may arise in the management of their patients despite their long hours of dedicated hard work. It is important to understand that a houseman is the lowest in the hierarchy of the doctors in the medical team.

Although they have very important roles to play, they are the least experienced, needing a great deal of guidance and supervision in carrying out the various treatments. They are practically attached to the specialists who are responsible for not only for their clinical training but also ethical training as well.

Unfortunately, these days some housemen go through their entire clinical posting of several months without ever seeing their heads of department who are too busy with everything else but training their juniors. The training of junior doctors has become the least of their priorities and left to the less experienced. In such a case, it can only be described as the blind leading the blind.

It would be unfair to blame the junior doctors for all the flaws in our health delivery system when they are not properly guided. Unless the senior specialists and consultants lead by example; we will never improve the quality of care for our patients.

Most of us who have been with the system would agree that the quality of medical care on the whole has deteriorated despite the government's efforts to build the latest sophisticated hospitals. The reason for this is obvious - a lack of dedication. Our present system is breeding dedication to the almighty ringgit and not to the profession and patients.

There is a need to re-look the reasons for the deteriorating standards of our health care. Unless we bring back the magic called dedication into our work ethics, no amount of money spent will restore the excellence our health care once had.