The article by Dr. Musa Mohd Nordin provides a detailed look into the early termination of the Waktu Bekerja Berlainan (WBB) system for healthcare workers in Malaysia. The WBB, conceptualized as an innovative work schedule, aimed to provide a transformative alternative to traditional on-call and shift systems, addressing long-standing issues of professional burnout and work-life balance among medical professionals. The premature cancellation of this pilot program forfeited a significant opportunity to improve the wellbeing of healthcare workers and potentially enhance patient care.
The Vision Behind WBB
Alleviating Professional Burnout
The core of Dr. Musa’s argument revolves around the lost chance to address burnout, a predominant issue among healthcare workers. The WBB project was meticulously designed by medical professionals, reflecting a deep understanding of the profession’s demands and the necessity for a work-life balance. Health Minister Dzulkefly Ahmad echoed this sentiment in an interview with The Edge, stating that not trying the WBB is a failure in itself. This underscores the frustration felt within the medical community, as the project’s potential benefits were dismissed prematurely without a fair assessment. The WBB aimed to offer not just a shift in working hours but a holistic improvement in quality of life for doctors and healthcare personnel.
Pilot Phase and Targeted Departments
Critics of the decision to cancel the WBB system argue that the pilot could have been implemented in a limited number of hospitals to gauge its practicality and effectiveness. The specific hospitals and departments identified for the pilot phase were comprehensive and included crucial specialties such as the Pediatric Department at Tunku Azizah Hospital and the Medical Department at Slim River Hospital. Additionally, departments like Obstetrics and Gynecology at Putrajaya Hospital and the Orthopedic Department at Raja Permaisuri Bainun Hospital were set to participate. Emergency and Trauma Departments at Melaka and Sultanah Bahiyah Hospitals, as well as the Oral and Maxillofacial Surgery Department at Tengku Ampuan Rahimah Hospital, were also part of the pilot. This targeted approach highlighted a strategic effort to test and refine the WBB system before considering wider implementation.
Challenges and Controversies
Leakage and Misrepresentation
Despite the well-thought-out plan, the project met an untimely end due to a premature leak of the WBB document before formal approval. This leak led to widespread dissemination of falsehoods, misleading interpretations, and defamatory comments about the content and intent of the WBB system. According to Dr. Musa, these distorted perceptions were fueled by leaders within the medical profession, netizens, and politicians, further skewing public perception and undermining the project’s credibility. The fallout from this misrepresentation robbed the healthcare community of a potentially game-changing initiative designed to safeguard their wellbeing and improve the quality of care provided to patients.
Real-World Medical Expertise
Dr. Musa emphasized that the WBB system was developed by clinicians with firsthand experience in medical environments, beginning in January 2024. These experts aimed to limit on-call hours from the existing 33 to 18 and reduce weekly working hours from 99 to 72. The goal was to protect healthcare workers’ physical, cognitive, emotional, and mental health, thereby ensuring the continued delivery of safe, high-quality healthcare services. This level of expertise and firsthand knowledge was integral to the WBB’s design, making its termination not only a practical oversight but a dismissal of professional insight and experience. The initiative’s objectives were clear: less burnout, improved job satisfaction, and better patient outcomes.
Recommendations for the WBB Task Force
Increase in On-Call Allowances
In the wake of the WBB system’s premature cancellation, Dr. Abu Bakar Suleiman has taken on the leadership of a new WBB Task Force. This task force is expected to tackle pressing issues such as the potential reduction in income due to changes in on-call allowances distribution. One of Dr. Musa’s key recommendations is to increase on-call allowances across all three working systems immediately. This move aims to prevent further attrition of healthcare workers to the private sector or other countries, which could exacerbate the already existing shortage of medical professionals. For this to happen, the Ministry of Finance needs to make a robust investment in Health Resources for Health (HRH) to ensure the retention of essential medical staff and maintain an effective healthcare system.
Combatting Fraudulent On-Call Claims
An essential issue highlighted by Dr. Musa is the need to address fraudulent on-call claims and restrict unnecessary allocations of on-call duties. Ethical utilization of resources is paramount for maintaining the integrity of the healthcare system. Alongside this, the task force must ensure that post-call doctors are required to leave by 10 AM after handing over their duties, even if it necessitates exceptions within the Public Services Department (PSD) work rules. These measures aim to enhance the overall efficiency of the workforce while safeguarding the health and well-being of medical professionals. By rectifying these practices, the task force can ensure fair compensation and more rested and attentive healthcare workers.
Addressing Workforce Distribution
Doctor-to-Population Ratios
Another critical challenge highlighted by Dr. Musa is the maldistribution of healthcare resources and personnel, despite Malaysia’s relatively favorable doctor-to-population ratio of 1:406 in 2023, close to WHO’s recommended 1:400. This imbalance creates pockets of deficiency that can severely impact the quality of healthcare services. To address this, the Task Force is urged to advise the Ministry of Education on expanding undergraduate admissions into medical schools should shortages of junior doctors persist. This proactive approach can help ensure an adequate supply of future healthcare workers distributed appropriately across the country.
Stability and Loyalty
Dr. Musa Mohd Nordin’s article delves deeply into the early termination of the Waktu Bekerja Berlainan (WBB) system for healthcare workers in Malaysia. The WBB was conceived as a revolutionary work schedule meant to replace traditional on-call and shift systems, addressing the critical issues of professional burnout and work-life balance among medical professionals. This system was designed to offer a better, more sustainable working environment for healthcare workers, with hopes of also improving patient care through its positive effects on staff wellbeing. Unfortunately, the pilot program was cut short prematurely, leading to the loss of a significant opportunity to make lasting improvements in the lives of healthcare workers and potentially enhance the quality of patient care. The early termination of the WBB system is seen as a missed chance to tackle some of the long-standing challenges faced by medical professionals, including exhaustion, stress, and the struggle to balance personal and professional lives effectively.
