Improve the remuneration for local doctors instead of turning to foreign doctors

Improve the remuneration for local doctors instead of turning to foreign doctors

EDITORS’ NOTE: The writer is currently a General Practitioner in private practice. He wishes to remain anonymous.

I refer to the report on 30 March 2009 - “1,000 foreign-trained docs still not enough” (read article here). Health Minister Khaw Boon Wan revealed that the public healthcare sector needs to recruit a thousand more foreign doctors to filled the gaps and a third medical school may be needed in the future.

I beg to differ with Mr Khaw’s observation that there are insufficient doctors in Singapore. There are 250 graduates from NUS medical school every year. Less than half the number of doctors retire or close down their practices in the same period of time.

The shortage of doctors lies in the public sector especially in primary healthcare and less popular specialties like Geriatrics, Internal Medicine and Palliative Care.

Over half of our polyclinics are now staffed by foreign doctors who have communication problems with elderly patients. Very few local doctors wish to further their careers in the polyclinics and left for the private sector upon the completion of their bonds. Why is this so?

The monthly salary of a final year medical officer at a polyclinic is only S$5,000 plus compared to S$8,000 to S$9,000 in the private sector with less than half the workload. Even a part-time locum working only three days a week can chalk up the same amount.

An internal medicine trainee needs to spend a few years toiling in the public hospitals, but end up with a salary less than fellow GP colleagues outside. The attrition rate for internal medicine is probably one of the highest amongst all specialities. Many of my friends who were internal medicine trainees give up halfway due to work-related or family reasons and some already passed their MRCP examinations.

Though medicine is a holistic profession and financial renumeration should not be an overriding factor in determining the career paths of doctors, more can be done to ensure that local doctors are adequately rewarded for their contributions to public healthcare.

MOH has always argued against that an increase in salaries of healthcare workers will lead to higher healthcare costs for Singaporeans. We spent only 4% of our GDP on healthcare which is far less than most developed countries.

The government can well afford to spend more of our GDP on healthcare to improve working conditions of local doctors and nurses so as to keep more of them in the workforce. Why do we have so few local nurses in public hospitals? The starting pay for a staff nurse is only S$1,500 compared to about A$4,000 in Australia.

Though it is cheaper to employ foreign doctors, they are merely stop-gap measures which do not address the root cause of the problem.

With an aging population, we need more family physicians, geriatricians and palliative care specialists in the healthcare system to add more years of healthy life to Singaporeans.

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