GEORGE TOWN: Forcing junior doctors to work at least 65 hours a week is a violation of labour laws, a trade unionist and a former human resources minister said.
Former human resources minister M Kula Segaran and trade unionist K Veeriah said Malaysian labour laws limited working hours to 48 hours a week, a standard advocated by the International Labour Organization (ILO).
They said the long hours endured by housemen – and some senior doctors – was a form of modern slavery bordering on forced labour.
Presently, housemen (HOs) work three shifts -7am to 5pm, 7am to 9pm, or an on-call shift from 8pm to 9am.
They are also required to put in extra hours for at least two weeks whenever they are posted to a new department. They are to follow a senior doctor throughout the day. Their stay can be extended by another two weeks if they have not met the standards set. HOs rotate through nine different medical disciplines in their hospital every quarter.
The two weeks, informally called “tagging”, require housemen to be on duty from 7am to 10pm. However, they are forced to be at work as early as 4am to prepare patients’ briefs before their senior doctor arrives at 7am. All HOs get a day off in a week. Checks by FMT showed this was the situation in larger hospitals with bigger wards.
Seniors and medical officers (MOs) also endure long hours – at least 75 hours a week, mostly on call. They have a more typical 8am-5pm work week and are usually on call after work until noon the following day.
However, a health ministry document in 2019 said housemen had a “60-62 hour work-week now, a significant improvement compared with an average of 84 to 106 hours a week before September 2011″.
Time to relook SOPs on working hours
Kula said doctors’ working hours at public hospitals needed an urgent review, as it was against local and international labour laws.
“This is modern slavery. I don’t think this should be condoned. Doctors, both juniors and seniors, should not work beyond their capacities,” he told FMT.
He said the labour department must look into the practices in hospitals and make recommendations on how SOPs could be improved for the well-being of all workers in hospitals.
When the long working hours were regularised, other issues faced by doctors and other workers alike would dissipate.
Why can’t doctors take their own advice?
Veeriah said the horror stories of housemen facing abuse, besides long hours, were clear signs of forced labour as per the ILO’s indicators.
“And it cannot be disputed that working excessive hours results in both physical and mental health deterioration,” he said.
“To be subjected to working between 12 and 16 hours a day is simply inhumane and a gross infringement of the fundamental norms to a decent, safe and healthy working environment.
“The World Health Organization (WHO) and ILO said long work hours led to deaths and an increase in heart disease last year, and significantly so in men in Southeast Asia and the West Pacific.
“WHO has said working more than 55 hours a week is a serious health hazard. Shouldn’t doctors take their own advice?”
Mental health remains taboo among doctors
Psychologist Sitra Panirsheeluam said the long work hours would be punishing for any worker, leading to mental fatigue and cognitive overloading.
“Cognitive overload is when one is given too much information at once, or too many simultaneous tasks, resulting in not being able to perform or process the information.
“Being a doctor and dealing with people and medication needs one to be fully alert as it can cause fatalities in extreme cases.
“Who’s checking on our doctors’ mental health? Sadly, it remains taboo.”