Review Of Doctors' Salaries

27 Jun 2000

The Ministry of Health and the Restructured Hospitals (RHs) will increase the salaries of doctors with effect from 1 Jul 2000. The average salary increase will be about 25% for Medical Officers (MOs), Registrars and Associate Consultants, and 19% for Consultants and Senior Consultants. The salary review incorporates a new remuneration structure that will guide future reviews. The increase is higher for MOs, as a more competitive salary structure is necessary in order to retain them for a longer time in the public sector. The overall salary increase is around 22%.

The Ministry last reviewed the salaries of Medical Officers (MOs) in Oct 96. A new promotional grade was introduced, and the allowance paid for night duties was raised. These measures helped to lower the attrition rates in the last few years. In 1999, only 15% of Medical Officers who resigned, did so within the first 5 years of service, compared to 54% in 1996, before the new salary scale was implemented. However, salaries are not sufficiently competitive. 75 doctors resigned over the first 4 months of the year, compared to 128 and 75 for the whole of 1999 and 1998 respectively. Specialists' salaries also need to be reviewed. A salary review for specialists was conducted in 1997 but was not subsequently implemented due to the economic downturn. It is therefore timely to review the salaries of our MOs and specialists in the public sector and RHs. A fair and competitive salary structure is needed to encourage good doctors to pursue a long-term career in the public sector and RHs so that they can provide good healthcare as well as train the new generation of doctors.

The basic principle applied in this salary revision is to benchmark salaries to comparable market rates, where these are available. The majority of MOs within the first 5 years after graduation, are in the public sector serving their bond. They can expect to earn salaries comparable to other professionals in the civil service, with an added allowance for undertaking onerous night duties. Their salaries must also not be so misaligned with what they can earn in the private sector that they are "pulled" to break their bond and forgo the all-round training that the five-year bond period offers them.

Beyond the 5 years of initial service, the Ministry will benchmark MOs' salaries to private sector general practitioners in the same age group. The MO salary scale is also applied to doctors still undergoing specialist training, as there are no private sector counterparts for this group. The MO salary structure must therefore be competitive in order that a significant proportion of each cohort is prepared to undertake the rigours of specialist training. The majority of MOs in the public sector can thus expect to earn around the 50th to 60th percentile of private sector earnings. The better performers would similarly be paid the upper end of private sector salaries. Doctors performing more onerous night duties, will receive an additional allowance.

Starting pay for an MO will increase by 22%. This will be achieved through increases in their basic pay and night duty allowances. Registrars and Associate Consultants will also get increases in basic pay, night duty allowances and performance bonuses.

Specialists in the public sector and RHs will be benchmarked to the private sector specialists' earnings. The average increase for the specialists is 19%, but some doctors would receive more, and others, less. The exact quantum will vary, depending on the individual specialist's performance and ability, and how close his salary is to market levels. Whilst specialists will get a smaller increase in their basic pay and their specialist allowance, the greater proportion of the increase will come from higher performance bonuses.

One key concern would be whether the public sector hospitals will be increasing fees to fund the salary increases. Healthcare is a manpower-intensive industry. We cannot expect the pay of our healthcare professionals to remain stagnant whilst that of other Singaporeans continues to rise. Hospital fees are regularly revised, in line with inflation and advances in medical technology. But these regular fee increases are not enough to fund this salary increase. The government will therefore increase the subvention to the public sector hospitals and RHs. Existing schemes, such as Medisave, Medishield and Medifund, will continue to help Singaporeans fund their health care expenses.

MOH and the RHs will further refine the new remuneration structure as the basis for annual salary reviews.