Empty posts, crumbling clinics: Sarawak wants the power to fix its own healthcare

Sarawak is advocating for the decentralization of regulatory powers under the Private Healthcare Facilities and Services Act 1998 to the state Health Department, as discussed by Deputy Premier Datuk Amar Dr. Sim Kui Hian during the MA63 Implementation Action Council meeting.

Dr. Sim highlighted the urgent need to address the region's healthcare workforce shortage, with 5,654 vacancies, and proposed creating 11,000 new positions to meet staffing norms.

Additionally, he called for a significant investment to upgrade and redevelop dilapidated Klinik Kesihatan facilities, pointing to health as an intricate issue within the Malaysia Agreement 1963 negotiations, which may require constitutional amendments.

KUCHING, Sept 12 — Sarawak is pushing for regulatory powers under the Private Healthcare Facilities and Services Act 1998 (Act 586) to be decentralised to the state Health Department (JKNS), said Deputy Premier Datuk Amar Dr Sim Kui Hian.

He said the matter was among three key areas of Sarawak’s health autonomy that he raised on Friday’s Malaysia Agreement 1963 (MA63) Implementation Action Council meeting in Kota Kinabalu.

“The one that impacts most is the Private Healthcare Facilities and Services Act 1998 (Act 586),” he shared in his Facebook post.

He said the regulatory function should be decentralised to JKNS from the Ministry of Health (MOH), in line with the MOH White Paper and provisions under the Federal Constitution allowing such delegation of power.

Dr Sim also called for urgent action to address Sarawak’s shortage of health personnel, with 5,654 vacant posts currently under JKNS.

He said the vacancies accounted for 18 per cent of the state health workforce and staff were not only overworked but also facing burnout.

For the medium term, he proposed the creation of 11,000 posts across various categories to meet MOH staffing norms following an audit of seven Sarawak hospitals last year.

“There is no reason for Sarawak to be sub-standard in manpower,” he said.

On infrastructure, Dr Sim said Sarawak needed RM310 million to upgrade dilapidated Klinik Kesihatan (KK) facilities and RM8.45 billion for their redevelopment.

He said 160 of the state’s 271 KKs, or 66 per cent, were classified as dilapidated.

“There is no reason why Sarawak having more KK daif compared to the rest of Malaysia,” he said.

Dr Sim said health was among the more complex MA63 matters, involving 41 laws.

He said while some MA63 issues had been resolved, the remaining negotiations would be tougher as some involved constitutional amendments requiring approval at Cabinet and Parliament level and, in certain cases, the Conference of Rulers.

He said the negotiations must take into account the spirit of MA63, as well as the Cobbold Commission and Inter-Governmental Committee reports.

“MA63 is a journey. We shall move forward with courage, wisdom and the spirit of our founding fathers,” he said. — The Borneo Post

* Editor’s note: Daif in Malay, used in the quote above by Sarawak Deputy Premier Datuk Dr Sim Kui Hian, means dilapidated.

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砂拉越正在倡导将 1998 年《私人医疗设施和服务法》下的监管权力下放至州卫生部门，正如副首相拿督阿玛沈桂贤医生在 MA63 实施行动理事会会议上所讨论的那样。

沈医生强调，该地区医疗卫生人员短缺问题亟待解决，目前有 5,654 个职位空缺，他建议新增 11,000 个职位以满足人员配备标准。

此外，他还呼吁投入大量资金升级和重建破旧的卫生诊所设施，并指出卫生是 1963 年马来西亚协议谈判中的一个复杂问题，可能需要修改宪法。

古晋，9月12日讯——砂拉越副首相拿督阿玛沈桂贤表示，砂拉越正在推动将1998年《私人医疗设施和服务法》（第586号法令）下的监管权力下放至州卫生局（JKNS）。

他表示，此事是他在周五于哥打基纳巴卢举行的 1963 年马来西亚协议 (MA63) 执行行动委员会会议上提出的砂拉越卫生自主权的三个关键领域之一。

他在 Facebook 帖子中写道：“影响最大的法案是 1998 年《私人医疗保健设施和服务法》（第 586 号法案）。”

他表示，监管职能应从卫生部下放给JKNS，这符合卫生部白皮书和联邦宪法中允许此类权力下放的规定。

沈医生还呼吁采取紧急行动解决砂拉越卫生人员短缺问题，目前砂拉越卫生局 (JKNS) 下有 5,654 个空缺职位。

他表示，这些空缺职位占该州卫生部门工作人员的 18%，工作人员不仅工作过度，而且还面临职业倦怠。

中期来看，他提议在各个类别中设立 11,000 个职位，以满足卫生部去年对砂拉越七家医院进行审计后制定的人员配备标准。

他说：“砂拉越的人力资源没有理由低于标准。”

关于基础设施，沈医生表示，砂拉越需要 3.1 亿令吉来升级破旧的 Klinik Kesihatan (KK) 设施，以及 84.5 亿令吉用于其重建。

他说，该州 271 个 KK 中有 160 个（占 66%）被列为破旧建筑。

他说：“砂拉越的KK daif数量比马来西亚其他地区多，这没有任何道理。”

沈医生表示，医疗卫生是1963年马来西亚协议中较为复杂的事项之一，涉及41项法律。

他表示，虽然《1963年马来西亚协议》的一些问题已经得到解决，但剩余的谈判将更加艰难，因为其中一些涉及宪法修正案，需要内阁和议会层面的批准，在某些情况下还需要统治者会议的批准。

他表示，谈判必须考虑到《1963年马来西亚协议》的精神，以及科博尔德委员会和政府间委员会的报告。

“《马来西亚独立宣言63》是一段征程。我们将秉持勇气、智慧和建国先贤的精神，继续前行。”他说道。——《婆罗洲邮报》

* 编者注：砂拉越副总理拿督沈桂贤博士在上面的引言中使用的马来语“Daif”的意思是破败的。

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