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The Studies of Legal Framework between Malaysia and the United
Kingdom in Combating Bullying among Junior Doctor
Nicholase Nimrod Kadap Anak Francis Teron Kadap., Batrisya Khairulazhar., Ajlali Rasyidah Anuar.,
Siti Norzulaifa Zili., Ahmad Afif Qawein Ahmad Mustaqim., *Zuhaira Nadiah Zulkipli., Nurul Jannah
Mustafa Khan., Amelia Masran
Faculty of Law, University Technology MARA, Shah Alam Malaysia
*Corresponding Author
DOI: https://dx.doi.org/10.47772/IJRISS.2025.910000275
Received: 14 October 2025; Accepted: 21 October 2025; Published: 10 November 2025
ABSTRACT
This research critically examines the adequacy of the legal framework in Malaysia in addressing workplace
bullying among junior doctors and draws comparative insights from the United Kingdom's legal and
institutional measures. Bullying in medical settings, particularly during early career stages, has emerged as a
serious concern with detrimental effects on mental health, job satisfaction, professional development, and
patient care. Despite growing awareness, underreporting, fear of retaliation, and hierarchical power dynamics
continue to hinder effective prevention and resolution in Malaysia. Through an in-depth literature review,
analysis of statutory and subsidiary legislation, and a comparative study of healthcare governance structures,
the research finds that Malaysia's existing legal instruments, such as the Occupational Safety and Health Act
1994, Employment Act 1955, Code of Professional Conduct 2019 and Good Medical Practice 2019 offer only
indirect protections and lack specificity, enforcement, and healthcare-centric orientation. In contrast, the
United Kingdom adopts a multi-tiered strategy integrating the Equality Act 2010, Protection from Harassment
Act 1997, Worker Protection (Amendment of Equality Act 2010) Act 2023, Freedom to Speak Up Policy,
Institutional Safeguards, and Professional Codes of Conduct enforced by the General Medical Council. These
mechanisms promote a culture of transparency, protect whistle-blowers, and hold leadership accountable. The
research concludes that Malaysia requires a comprehensive policy overhaul, including the enactment of
specific anti-bullying legislation, the establishment of independent reporting mechanisms, mandatory training
for senior doctors, and cultural reform within healthcare institutions. By drawing on the UK's best practices
while adapting to local contexts, Malaysia can create a safer, more supportive working environment for junior
doctors, ultimately improving healthcare delivery and patient outcomes.
Keywords: workplace bullying, junior doctors, legal framework, comparative study, healthcare governance
INTRODUCTION
Workplace bullying among junior doctors represents a critical challenge that undermines both individual well-
being and healthcare system effectiveness. The hierarchical nature of medical training environments, combined
with high-stress conditions and power imbalances, creates fertile ground for bullying behaviours that can have
devastating consequences on young medical professionals [1]. The phenomenon of bullying in healthcare
settings is not unique to Malaysia but represents a global concern that affects healthcare systems worldwide.
Junior doctors, being at the bottom of the medical hierarchy, are particularly vulnerable to various forms of
bullying, including verbal abuse, professional undermining, excessive workload assignment, and exclusion
from learning opportunities [2]. These experiences not only affect the mental health and professional
development of individual doctors but also compromise patient safety and healthcare quality. The Malaysian
healthcare system has witnessed several high-profile cases that have exposed the severity of bullying among
medical professionals. The tragic death of a houseman in 2022 brought national attention to the toxic work
culture prevalent in many healthcare institutions [3]. This incident, along with subsequent revelations of
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widespread bullying practices, has prompted calls for urgent reform of the legal and regulatory framework
governing workplace conduct in healthcare settings
In contrast, the United Kingdom has developed a more comprehensive approach to addressing workplace
bullying in healthcare through a combination of legislative measures, institutional policies, and cultural
initiatives. The UK's multi-tiered strategy includes specific anti-bullying legislation, whistle-blower protection
mechanisms, and professional accountability measures that create a more supportive environment for junior
doctors [4]. This comparative study aims to examine the adequacy of Malaysia's current legal framework in
addressing workplace bullying among junior doctors and to identify lessons that can be learned from the
United Kingdom's approach. The research seeks to understand the gaps in Malaysia's existing legal protections
and to propose recommendations for strengthening the regulatory framework to better protect junior doctors
from workplace bullying
The significance of this study extends beyond academic inquiry to practical implications for policy
development and healthcare governance. By comparing the legal frameworks of Malaysia and the United
Kingdom, this research provides insights into effective strategies for combating workplace bullying and
creating safer working environments for healthcare professionals. The findings of this study are intended to
inform policy makers, healthcare administrators, and legal practitioners about the need for comprehensive
reform in addressing workplace bullying among junior doctors.
LITERATURE REVIEW
The literature on workplace bullying in healthcare settings reveals a complex phenomenon that intersects with
issues of professional hierarchy, organizational culture, and regulatory oversight. Bullying in healthcare
environments has been extensively studied internationally, with researchers identifying common patterns and
consequences that transcend national boundaries [5].
Definition and Characteristics of Workplace Bullying
Workplace bullying is generally defined as repeated, unreasonable behaviour directed toward an employee or
group of employees that creates a risk to health and safety [6]. In the context of healthcare, bullying often
manifests through various forms including verbal aggression, professional undermining, excessive criticism,
exclusion from professional activities, and assignment of unreasonable workloads [7]. The power dynamics
inherent in medical training environments, where junior doctors are dependent on senior colleagues for
learning opportunities and career advancement, create particular vulnerabilities to bullying behaviours
Research has identified several characteristics that distinguish workplace bullying from isolated incidents of
conflict or disagreement. These include the systematic nature of the behaviour, the power imbalance between
perpetrator and victim, and the negative impact on the target's professional and personal well-being [8]. In
healthcare settings, bullying often occurs within the context of medical training and supervision, making it
particularly challenging to identify and address.
Prevalence and Impact of Bullying Among Junior Doctor
Studies from various countries have documented high rates of bullying among junior doctors, with prevalence
rates ranging from 30% to 70% depending on the definition used and the healthcare system studied [9]. In
Malaysia, a survey conducted by the Malaysian Medical Association in 2024 found that two out of five doctors
had experienced bullying during their careers, with junior doctors being disproportionately affected [10]
The impact of workplace bullying on junior doctors extends beyond immediate psychological distress to
include long-term consequences for professional development and patient care. Research has shown that
bullied junior doctors experience higher rates of depression, anxiety, and burnout, leading to increased
turnover rates and reduced job satisfaction [11]. These individual impacts translate into broader systemic
effects, including compromised patient safety, reduced healthcare quality, and increased healthcare costs.
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Legal and Regulatory Responses to Workplace Bullying
The legal response to workplace bullying varies significantly across jurisdictions, reflecting different
approaches to employment law, occupational health and safety regulation, and professional governance. Some
countries have enacted specific anti-bullying legislation, while others rely on existing employment and
discrimination laws to address bullying behaviors [12]
In the context of healthcare, professional regulatory bodies play a crucial role in setting standards for
professional conduct and addressing misconduct. However, the effectiveness of professional regulation in
addressing workplace bullying depends on the comprehensiveness of professional codes, the robustness of
enforcement mechanisms, and the willingness of victims to report incidents [13].
Comparative Studies of Legal Framework
Comparative studies of legal frameworks for addressing workplace bullying have identified several key factors
that contribute to effective prevention and response mechanisms. These include clear legal definitions of
bullying, comprehensive reporting procedures, protection for whistle-blowers, and accountability mechanisms
for organizations and individuals [14]
The United Kingdom's approach to addressing workplace bullying in healthcare has been characterized as
comprehensive and multi-faceted, incorporating legislative measures, institutional policies, and cultural
initiatives. The Freedom to Speak Up policy, introduced following the Francis Report on the Mid Staffordshire
NHS Foundation Trust, represents a significant shift toward creating a culture of transparency and
accountability in healthcare organizations [15].
Challenges in Addressing Workplace Bullying among young doctor
Despite increasing awareness and policy attention, addressing workplace bullying in healthcare remains
challenging. Research has identified several barriers to effective prevention and response, including
underreporting due to fear of retaliation, hierarchical organizational cultures that discourage complaints, and
inadequate investigation and resolution procedures [16]
The medical profession's emphasis on hierarchy and authority can create particular challenges in addressing
bullying behaviours. Junior doctors may be reluctant to report bullying by senior colleagues due to concerns
about career advancement and professional relationships. This culture of silence perpetuates bullying
behaviours and undermines efforts to create safer working environments [17].
The Research Finding
Legal Framework in Malaysia
The analysis of Malaysia's legal framework reveals a fragmented approach to addressing workplace bullying
among junior doctors, with existing legislation providing only indirect and limited protections. The primary
legal instruments relevant to workplace bullying include the Occupational Safety and Health Act 1994, the
Employment Act 1955, and Professional Codes of Conduct established by the Malaysian Medical Council.
Occupational Safety and Health Act 199
The Occupational Safety and Health Act 1994 (OSHA) represents Malaysia's primary legislation governing
workplace safety and health. However, the Act's focus on physical safety hazards means that psychological
harassment and bullying fall into a regulatory gray area [18]. While the Act requires employers to ensure the
safety and health of employees, the interpretation of what constitutes a safe working environment in terms of
psychological well-being remains unclear.
The 2022 amendment to OSHA introduced some provisions related to workplace harassment, but these remain
limited in scope and lack specific application to healthcare settings. The enforcement mechanisms under
INTERNATIONAL JOURNAL OF RESEARCH AND INNOVATION IN SOCIAL SCIENCE (IJRISS)
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OSHA are primarily designed for industrial safety violations and may not be well-suited to addressing the
complex interpersonal dynamics involved in workplace bullying [19].
Employment Act 1955
The Employment Act 1955 (EA) provides basic employment protections but lacks specific provisions
addressing workplace bullying or harassment. The Act's general provisions regarding unfair dismissal and
workplace conduct offer limited protection for junior doctors who experience bullying, particularly given the
unique employment relationships in healthcare training programs [20].
The Act's complaint mechanisms are designed for traditional employer-employee relationships and may not
adequately address the complex hierarchical relationships in medical training environments. Junior doctors,
who often hold temporary positions with limited job security, may find little practical protection under the
existing employment law framework [21]
Professional Codes of Conduct
The Malaysian Medical Council's Code of Professional Conduct 2019 and Good Medical Practice 2019
establish professional standards for medical practitioners, including provisions related to professional
behaviour and collegiality. However, these codes focus primarily on patient care and professional competence
rather than workplace relationships and bullying prevention [22].
The enforcement of professional codes relies on the Malaysian Medical Council's disciplinary procedures,
which are primarily designed to address serious professional misconduct rather than workplace bullying. The
complaint process is formal and may be intimidating for junior doctors seeking to report bullying by senior
colleagues [23].
Legal Framework in United Kingdom
The United Kingdom's approach to addressing workplace bullying among junior doctors is characterized by a
comprehensive, multi-layered framework that combines legislative protections, institutional policies, and
cultural initiatives. This integrated approach provides multiple avenues for prevention, reporting, and
resolution of bullying incidents
Legislative Framework
The UK's legislative framework includes several key pieces of legislation that provide comprehensive
protection against workplace bullying and harassment. The Equality Act 2010 prohibits harassment related to
protected characteristics and establishes employer liability for harassment by employees [24]. The Protection
from Harassment Act 1997 provides both civil and criminal remedies for harassment, including workplace
harassment [25].
The recent Worker Protection (Amendment of Equality Act 2010) Act 2023 strengthens employer obligations
to prevent harassment and introduces proactive duties for employers to take reasonable steps to prevent
harassment of their workers [26]. This legislation represents a significant shift toward preventive rather than
merely reactive approaches to workplace harassment.
Institutional Policies and Frameworks
The National Health Service (NHS) has developed comprehensive policies and frameworks for addressing
workplace bullying and harassment. The Freedom to Speak Up policy, implemented across all NHS
organizations, provides protected channels for raising concerns about patient safety, quality of care, or staff
treatment [27]. This policy includes specific protections for whistle-blowers and requires organizations to
demonstrate how they encourage and support staff to speak up.
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The NHS also implements mandatory training programs on dignity at work, bullying and harassment
prevention, and bystander intervention. These programs are designed to create a culture of respect and
accountability throughout healthcare organizations [28].
Professional Regulation
The General Medical Council (GMC) in the UK has developed comprehensive guidance on professional
behaviour and workplace conduct. The GMC's guidance on "Good Medical Practice" includes specific
provisions on treating colleagues fairly and with respect, and the organization has established clear procedures
for investigating and addressing complaints about professional behaviour [29].
The GMC works closely with healthcare organizations to promote professional standards and provides support
for doctors who experience workplace difficulties. This collaborative approach helps ensure that professional
regulation reinforces rather than conflicts with organizational policies [30].
Comparative Analysis of The Effectiveness of Legal Framework
The comparative analysis reveals significant differences in the comprehensiveness and effectiveness of the
legal frameworks in Malaysia and the United Kingdom. The UK's multi-tiered approach provides more
comprehensive protection and multiple avenues for addressing workplace bullying, while Malaysia's
fragmented approach leaves significant gaps in protection for junior doctors.
Prevention and Early Intervention
The UK's emphasis on prevention through mandatory training, cultural initiatives, and proactive employer
duties contrasts sharply with Malaysia's reactive approach. The Freedom to Speak Up policy and similar
initiatives create a culture that encourages early reporting and intervention, potentially preventing escalation of
bullying behaviours [31].
Malaysia's current framework lacks comprehensive prevention strategies and relies primarily on reactive
measures after incidents have occurred. The absence of mandatory training on workplace behaviour and
bullying prevention means that many healthcare workers lack awareness of appropriate professional conduct
and reporting mechanisms [32].
Reporting and Investigation Mechanisms
The UK's multiple reporting channels, including Freedom to Speak Up guardians, professional regulatory
bodies, and civil/criminal legal remedies, provide options for victims with different needs and circumstances.
The protection of whistle-blowers and emphasis on organizational accountability encourage reporting and
ensure appropriate investigation of complaints [33]
Malaysia's reporting mechanisms are more limited and may be less accessible to junior doctors. The formal
nature of existing complaint procedures and the lack of specific protections for complainants may discourage
reporting and allow bullying behaviours to continue unchecked [34].
Accountability and Enforcement
The UK's framework includes clear accountability mechanisms for both individual perpetrators and healthcare
organizations. The combination of professional regulation, employment law remedies, and organizational
policies creates multiple layers of accountability that reinforce appropriate behaviour [35].
Malaysia's enforcement mechanisms are less comprehensive and may not effectively hold perpetrators or
organizations accountable for bullying behaviours. The limited integration between different regulatory bodies
and the lack of specific anti-bullying legislation reduce the effectiveness of enforcement efforts [36].
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Causes of Bullying Among Young Doctor in Malaysia
This study also includes findings from qualitative structured interviews conducted with junior doctors in
Malaysia to assess their understanding of the existing legal framework and to gather information on the causes
of bullying, as follows:
Respondent
1
A junior doctor in Malaysia and knows firsthand the realities of practicing in the local
healthcare system. Although he has not personally been bullied, this respondent gives insight
into the deep-seated culture of hierarchy, long working hours, and the absence of specific legal
protections for junior doctors. They refer to the issues that are faced by house officers,
including overwork, sleep deprivation, and pressure to adhere to unwritten rules demanded by
seniors. The respondent also mentions the insufficiency of existing platforms for providing
feedback and the need for improved, clearer policies to safeguard the well-being of junior
doctors.
Respondent
2
A junior doctor who gives a view informed by experience spanning more than two years in the
Malaysian health system. This respondent emphasizes hierarchical structure casualness,
outdated beliefs, and work stress as foundations of physician bullying. They acknowledge that
there are reporting mechanisms like Sistem Pengurusan Aduan Awam KKM (SISPAA) which is
an online platform for managing feedback such as complaints, appreciation, inquiries, and
suggestions from the public regarding the services of the Ministry of Health Malaysia (KKM)
and Occupational Safety and Health Administration (OSHA) but doubt whether they are
effective in reshaping the foundation issues. The respondent advocates for such changes as
confidential reporting mechanisms, professionalism and conflict resolution training, and stricter
legislation to ensure safety and mental health of young doctors.
Respondent
3
A criminal and civil litigation lawyer who is also experienced in conveyancing. He has been
practicing law since 2012 and undergone various types of roles such as partnership and sole
proprietorship. Drawing on his experience in the law, he analyzes the etiology of bullying in
medicine as a mirror of hierarchical structure, bad administration, and non-enforcement in law.
He describes the relevant legislation, OSHA 1994, the Employment Act 1955 and the
Whistleblower Protection Act 2010, and decries their failures. He proposes legal reforms, clear-
cut definitions of bullying, and the establishment of independent monitoring bodies so as to
protect junior doctors in the best possible way.
Respondent
4
A doctor who provides brief but sharp remarks. This respondent mentions understaffing and
overwork at the workplace as key contributors to medical profession bullying. He states the lack
of current legal protection and how common such issues are among medical practitioners. The
respondent suggests that legislation like OSHA 1994 and the Employment Act 1955 would have
to be rewritten and more strictly enforced. They also stress the necessity of cultural change and
continuous education to overcome the underlying reasons for bullying and improve the
working environment for junior doctors.
Table 1: The causes, legal framework, enforcement tools, and social culture of workplace bullying amongst
young doctors
RECOMMENDATIONS AND CONCLUSIONS
Recommendations for Malaysia
Based on the comparative analysis of legal frameworks and the identified gaps in Malaysia's current approach,
several key recommendations emerge for strengthening protection against workplace bullying among junior
doctors.
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Legislative Reforms
Malaysia should consider enacting comprehensive anti-bullying legislation specifically designed to address
workplace harassment in healthcare settings. This legislation should include clear definitions of bullying
behaviour, establish proactive duties for healthcare organizations, and provide multiple remedies for victims
[37]. The legislation should be modelled on successful international examples while being adapted to
Malaysia's legal system and cultural context.
The existing Occupational Safety and Health Act should be amended to explicitly include psychological safety
and workplace bullying within its scope. This would provide a stronger legal foundation for addressing
bullying behaviours and would enable more effective enforcement by occupational safety authorities [38].
Institutional Reforms
Healthcare organizations in Malaysia should be required to implement comprehensive anti-bullying policies
that include clear reporting mechanisms, investigation procedures, and support services for victims. These
policies should be modelled on the UK's Freedom to Speak Up framework and should include protection for
whistle-blowers and accountability measures for leadership [39].
The establishment of independent ombudsman services or similar mechanisms could provide additional
avenues for reporting and resolving workplace bullying incidents. These services should be independent of
healthcare organizations and should have the authority to investigate complaints and recommend remedial
action [40].
Professional Regulation Reforms
The Malaysian Medical Council should strengthen its professional codes of conduct to include specific
provisions addressing workplace bullying and harassment. The enforcement mechanisms should be enhanced
to ensure timely and effective investigation of complaints, and the disciplinary procedures should include
appropriate sanctions for bullying behaviours [41].
Professional training and continuing education programs should include mandatory components on workplace
behaviour, bullying prevention, and professional collegiality. These programs should be required for all
medical practitioners and should be regularly updated to reflect best practices and emerging issues [42].
Cultural and Organizational Changes
Healthcare organizations should implement comprehensive cultural change initiatives designed to promote
respect, collegiality, and professional behavior. These initiatives should include leadership training, bystander
intervention programs, and regular assessment of workplace culture [43].
The medical profession in Malaysia should engage in broader discussions about professional values and
workplace culture, with senior leaders taking responsibility for modeling appropriate behavior and holding
colleagues accountable for their conduct [44].
Implementation Strategy
The implementation of these recommendations requires a coordinated approach involving government
agencies, healthcare organizations, professional bodies, and individual practitioners. A phased implementation
strategy should be developed that prioritizes the most critical reforms while building capacity for longer-term
changes [45].
The government should establish a multi-stakeholder task force to oversee the development and
implementation of anti-bullying reforms. This task force should include representatives from the Ministry of
Health, legal experts, healthcare organizations, professional bodies, and junior doctor representatives [46].
Adequate resources should be allocated for training, system development, and enforcement activities. The cost
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of implementing comprehensive anti-bullying measures should be viewed as an investment in healthcare
quality and professional development rather than as an additional burden on the healthcare system [47].
Monitoring and Evaluation
A comprehensive monitoring and evaluation framework should be established to assess the effectiveness of
anti-bullying measures and to identify areas for continuous improvement. This framework should include
regular surveys of healthcare workers, analysis of complaint data, and assessment of organizational culture
[48].
The monitoring system should include mechanisms for tracking the implementation of recommendations and
measuring progress toward creating safer working environments for junior doctors. Regular reporting on
progress should be provided to stakeholders and the public to ensure accountability and transparency [49].
Conclusions
This comparative study has revealed significant gaps in Malaysia's legal framework for addressing workplace
bullying among junior doctors when compared to the United Kingdom's comprehensive approach. The UK's
multi-tiered strategy, which combines legislative protections, institutional policies, professional regulation, and
cultural initiatives, provides a more effective foundation for preventing and addressing workplace bullying.
Malaysia's current framework, while containing some relevant provisions, lacks the comprehensiveness and
integration necessary to effectively address the complex challenge of workplace bullying in healthcare settings.
The fragmented nature of existing protections, combined with cultural and organizational barriers to reporting,
creates an environment where bullying behaviours can persist and cause significant harm to individual doctors
and the healthcare system as a whole.
The recommendations presented in this study provide a roadmap for strengthening Malaysia's approach to
combating workplace bullying among junior doctors. The implementation of these recommendations would
require significant commitment from government, healthcare organizations, and the medical profession, but
the benefits in terms of improved professional well-being, healthcare quality, and patient outcomes would
justify the investment required.
The experience of the United Kingdom demonstrates that comprehensive reform is possible and can be
effective in creating safer working environments for healthcare professionals. By learning from international
best practices while adapting to local contexts, Malaysia can develop a more effective approach to addressing
workplace bullying and creating a more supportive environment for junior doctors.
The ultimate goal of these reforms should be to create a healthcare system where all professionals can work
with dignity and respect, free from bullying and harassment. This would not only benefit individual doctors but
would also contribute to improved healthcare delivery and better outcomes for patients. The time for action is
now, and the recommendations presented in this study provide a foundation for moving forward with
necessary reforms.
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