MEDICAL OFFICERS IN CIVIL SERVICE (Resignations and conditions of work)

[Mr Speaker in the Chair]

Mr P. Govindaswamy: To ask the Minister for Health (a) how many medical officers resigned from the Civil Service in 1977; (b) how many medical officers were attached to the various hospitals as at 30th November, 1977, and whether the number of medical officers in each hospital was sufficient to cope with the workload; and (c) what are the average working hours per week and the number of off days per month for medical officers and housemen, and, if it is not possible for them to work within the required working hours and take their off days weekly, whether he will consider making an alternative arrangement.

Mr Speaker: Mr P. Govindaswamy.

Mr Ahmad Haleem (Telok Blangah): Mr Speaker, Sir, Question No. 1.

The Minister for Health (Dr Toh Chin Chye): Mr Speaker, Sir, I have distributed to Members of the House figures (Cols. 299 - 300) to Question 1(a) and 1(b). I will therefore not repeat them here. figures - APPENDIX TO ORAL ANSWER TO QUESTION NO. 1(Cols. 203-205)

In answer to Question 1(c), I would like to explain that the hours of work of doctors vary according to the posting. Normally doctors who are working in Outpatient Departments, for example, work office hours and they have a normal week of 42 hours. Those in the hospitals, besides their normal week of 42 hours, are required to perform night duties. If they have a night duty once a week, it will add 15 1/2 hours to the normal 42 hours quota, and if they do have two night-duty performances in a week, it will work out to about 72 hours in a normal week. In the Accidents and Emergency Department the doctors work on shifts and, therefore, they have a 42-hour week but they are given time off for night duties.

The problem is a very vexing one because night duties are not necessarily applicable to all doctors working in hospitals. In our system we find that housemen and medical officers are asked to perform night duties. This means that they must be within the hospital precincts. Senior doctors, however, are on call which means that they can go home, attend to their family life or attend to their social life, but they have a bleeper and, if necessary, they can be called to the hospital. Sir, I am in sympathy with those who have to perform as many as two night duties in a week, especially those who are in the Department of Obstetrics and Gynaecology. As Members of the House are aware, babies do not tell doctors what time they are supposed to come out into the world. We therefore find that most doctors posted to the Department of Obstetrics and Gynaecology, including the Registrars and Senior Registrars, have a higher mean rate of weekly hours. They range from 68 hours for Registrars and Senior Registrars, 55 hours for Consultants, 78 and 79 hours for medical officers and housemen respectively. The problem, of course, really depends upon manpower. If there are more doctors available who can be rostered for night duty, then the number of hours per week worked by each doctor can be reduced.

However, I must point out the distinction between hours of work and productivity. During the night, patients do not require much attention as most of them have been treated and attended to during the day. So during the night it is necessary to have only a small number of doctors for emergency calls. That is why they are asked to be within the hospital precincts. In the case of housemen, it has been a tradition that to be on night duty is part of their training. While we can permutate the roster, I am afraid that as of this moment it is not possible to reduce the number of night duties which are already allocated because of the existing staff position. If doctors are unable to perform night duty on a particular day, arrangements can be made for them to have substitutes. I think that is not a problem at all. However, I do hope to make an in-depth study into this problem, and I do admit that it is an unsatisfactory position.

In New Zealand medical doctors of all grades are on call and this means that they must be within the precincts of the hospital. It is only the Consultants who are allowed to stay away from the hospital. That would be an excellent pattern for us to follow. So we will have to take some time to work out a re-arrangement of the night duty roster, and if we can have more manpower pitching in, I think the burden will be less both for the medical officers and housemen.