Mdm, today I would like to address the issue of the workload of junior doctors.
MOH has mentioned on the 10th of January 2024 in parliament, that their guideline for junior doctors stipulates that when averaged out over a month, the total work hours per week of junior doctors should not exceed 80 hours. Thus, over an average month of 4 weeks, the total work hours should not exceed 320 hours. Anecdotally, I hear that many junior doctors, particularly in our acute hospitals, regularly hit or come close to this limit. A nationwide survey published in the Journal of the Academy of Medicine, Singapore, in 2023, reports that Junior doctors work an average of 71 hours a week, which adds up to 284 hours an average month.
In contrast, MOMs employment guidelines stipulate that the contractual hours of work for common work arrangements under part IV of the employment act is 44 hours a week, and a typical employee is only allowed to work up to 72 overtime hours a month. For an average month, MOMs guidelines suggest that a typical work month would see one work 176 hours, and even if one works overtime, one should not exceed 248 hours. Any more would presumably not be healthy for the employee. This suggests that MOH allows Junior Doctors to work 72 hours more than what is usually deemed healthy for a typical employee.
Why have we institutionalized the practice of overworking our Junior Doctors? The employment act does mention that managers, executives, solicitors, and such are also excluded from this guideline, and doctors being highly qualified and with specialised knowledge, belong in this category.
To this I say: Doctors hold the lives of the vulnerable and ill in their hands. Some indeed may be capable of operating at such an intense level for prolonged periods of time, but I believe many are not. Do we want doctors that have been consistently overworked to attend to our sick parents and children in their hours of need? Do we want doctors that are stressed to make decisions that can literally involve life and death? The same survey mentioned earlier found a significant correlation between the number of medical errors made with the amount of additional clinical hours worked per week.
I note that in many parent guides that MOH publishes, they emphasize the importance of parents being heavily involved in their children’s life for children’s health development. Many Junior Doctors in the public healthcare system are bonded and do not have the option of quitting if they are unable to deal with the stress and workload. They have no recourse and are forced to make choices that compromise their family time. Is it not ironic that even as MOH puts out these guidelines, their own doctors are unable to follow them due to the amount of hours they need to put into work?
Mdm, the current system to me does not seem sustainable. As the workload of junior doctors increases, many choose to leave the public healthcare system, for better pay and lesser working hours. This only serves to aggravate the workload of the remaining doctors, leading to a self-reinforcing cycle. To me, MOH must intervene fast and decisively to change the system.
Mdm, Minister Ong mentioned in May 2024 that the National Wellness Committee on Junior Doctors has finalised its recommendations and are now progressively implementing them. Are the details of these recommendations and findings going to be made public?
Is MOH looking into more aggressively hiring junior doctors, especially those that have left the public healthcare system? How do they intend to do so, will it include increasing doctor salaries to better compete with the private sector, and if so, how much?
Mdm, I would close by saying, just because generations of doctors have survived such conditions, is no excuse for MOH to continue to perpetuate such attitudes and working conditions. Should we not strive to be a society that is kinder and more compassionate, especially to those that care for us? Thank you, Sir.
