Reported doctor no-shows in Sabah and Sarawak prompt MMA call for incentive overhaul

The Malaysian Medical Association (MMA) has urged the government to reinstate the previous percentage-based Regional Incentive Payment and enhance incentives to attract and retain doctors in Sabah and Sarawak, following significant no-show rates among medical officers assigned to permanent positions there.

MMA President Dr. Sivanaesan Letchumanan highlighted the underlying issues, including relocations, understaffed facilities, and inadequate support, which discourage doctors from accepting postings in these regions.

He called for improved living conditions, clearer service terms, and stronger retention incentives, underscoring the need for increased healthcare investment and a strategic approach to address workforce shortages in East Malaysia.

KUCHING, Oct 1 — The Malaysian Medical Association (MMA) has called on the government to urgently revert to the previous percentage-based Regional Incentive Payment (BIW) and introduce stronger incentives to attract and retain doctors in Sabah and Sarawak, following reports of widespread no-shows among medical officers (MOs) posted to permanent positions in the two states.

MMA president Dr Sivanaesan Letchumanan said the association was deeply concerned by reports that large numbers of MOs did not report for their permanent postings on September 28.

“Some facilities reportedly received no new medical officers, while others recorded no-show rates of between 70 per cent and 76 per cent. The official figures should be urgently verified and made public,” he said in a statement.

On September 28, government hospitals and clinics across Sabah and Sarawak reportedly saw widespread no-shows among medical officers (MOs) offered permanent positions, with some facilities reporting zero arrivals and others recording no-show rates of up to 76 per cent.

According to CodeBlue, social media posts from doctors highlighted the strain on understaffed departments, with Sri Aman Hospital receiving only six of 20 expected officers, while hospitals such as Kanowit, Keningau, Beluran, Sipitang and Kudat reported either none or far fewer than the assigned postings.

Dr Sivanaesan stressed that If contract medical officers are refusing permanent positions, it points to deeper problems that cannot be ignored.

“For years doctors have sought the security of permanent appointments. The fact that some are now reportedly declining these positions should be a clear warning that the current situation and conditions in East Malaysia are discouraging doctors from serving there,” he said.

He explained that doctors posted to Sabah and Sarawak may be required to relocate far from their families, bear substantial moving costs and serve in severely understaffed facilities with demanding workloads. In some areas, they also face inadequate accommodation and support.

Healthcare workforce shortages and retention were also among the issues MMA recently discussed with Deputy Premier Datuk Amar Dr Sim Kui Hian, reflecting the urgent need to address the manpower challenges facing healthcare services in the state.

“We must stop blaming doctors and start asking why the system is failing to attract and retain them,” Dr Sivanaesan stressed.

He emphasised that reverting to the previous percentage-based BIW was crucial, as the current fixed payment had significantly weakened the value of the incentive for doctors serving in Sabah and Sarawak.

He also called for a dedicated East Malaysia service allowance, alongside supplementary incentives such as housing assistance, transport support and retention bonuses.

Relocation assistance, he said, must reflect the real cost of moving to Sabah and Sarawak and should be provided before doctors relocate, rather than months later through a claims process.

Dr Sivanaesan further urged the government to provide certainty on the duration of East Malaysia postings, noting that doctors whose long-term preference was to serve in Peninsular Malaysia should be given a clearly defined period of service with a transparent pathway for transfer back upon completion.

“Knowing from the outset how long they are expected to serve may encourage more doctors to accept these postings,” he said.

He also highlighted the need to improve living and working conditions, stating that rural quarters must be safe, properly maintained and adequately furnished, wih reliable water and electricity, internet access and transport connectivity.

“Reward service in underserved areas with meaningful career progression. Rural service should count towards postgraduate training, specialist pathways, promotions and preferred future placements,” he said.

Doctors should also receive clear information about the challenges, opportunities and career benefits of serving in East Malaysia before selecting their placements, he added.

“Compulsory postings and administrative directives alone will not solve this problem. Doctors need compelling reasons to go — and compelling reasons to stay,” Dr Sivanaesan said.

With Budget 2027 approaching, MMA urged the government to provide the resources needed to strengthen incentives, improve working and living conditions, support relocation and retain healthcare workers in areas where they are urgently needed.

The association also reiterated its call for Malaysia’s public healthcare allocation to be progressively increased towards five per cent of gross domestic product (GDP), saying adequate investment was essential to address chronic manpower shortages and strengthen healthcare delivery in Sabah and Sarawak.

“Sabahans and Sarawakians deserve the same timely and safe access to healthcare as every other Malaysian. An empty post does not treat a patient. A permanent appointment without a credible retention strategy is merely a number on paper,” Dr Sivanaesan said, warning that every further delay would add to the burden on doctors already serving in Sabah and Sarawak and place greater strain on patient care. — The Borneo Post

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马来西亚医学协会（MMA）敦促政府恢复以前按百分比计算的区域奖励金，并加大力度吸引和留住沙巴和砂拉越的医生，因为分配到这两个州的常驻医生的缺勤率很高。

马来西亚医学协会主席西瓦纳桑·莱楚马南博士强调了根本问题，包括搬迁、人员配备不足的设施和支持不足，这些问题阻碍了医生接受在这些地区的任职。

他呼吁改善生活条件、明确服务条款、加强留任激励措施，并强调需要增加医疗保健投资，采取战略性方法解决东马劳动力短缺问题。

古晋，10 月 1 日讯——马来西亚医学协会 (MMA) 呼吁政府紧急恢复之前的按百分比计算的区域激励支付 (BIW) 制度，并推出更有力的激励措施来吸引和留住沙巴和砂拉越的医生。此前有报道称，被派往这两个州担任永久职位的医务人员普遍缺勤。

马来西亚医学协会主席西瓦纳桑·莱楚马南博士表示，该协会对大量军医未在9月28日到岗报到的报道深感担忧。

“据报道，一些医疗机构没有收到新的医务人员，而另一些医疗机构的缺勤率则高达70%至76%。官方数据应该尽快核实并公布，”他在一份声明中说。

据报道，9 月 28 日，沙巴和砂拉越各地的政府医院和诊所普遍出现医务人员（MO）缺勤的情况，一些机构报告称无人到岗，而另一些机构的缺勤率高达 76%。

据 CodeBlue 报道，医生们在社交媒体上发帖强调了人手不足的部门面临的压力，斯里阿曼医院只收到了 20 名预期人员中的 6 名，而卡诺维特医院、根地咬医院、贝鲁兰医院、西必丹医院和古达医院则表示，要么没有人员到岗，要么人员远少于分配的岗位。

西瓦纳桑医生强调，如果合同制医务人员拒绝永久职位，这表明存在不容忽视的更深层次的问题。

“多年来，医生们一直寻求永久职位带来的保障。现在有报道称一些医生拒绝这些职位，这应该是一个明确的警告，表明东马目前的局势和条件正在阻碍医生在那里服务，”他说。

他解释说，被派往沙巴和砂拉越的医生可能需要远离家人，承担高昂的搬迁费用，并在人手严重不足、工作量繁重的医疗机构工作。在一些地区，他们还面临住宿和后勤保障不足的问题。

医疗保健人员短缺和留任问题也是马来西亚医学协会（MMA）最近与副州长拿督阿玛沈桂贤医生讨论的问题之一，这反映出该州迫切需要解决医疗保健服务面临的人力资源挑战。

“我们必须停止指责医生，开始追问为什么医疗体系无法吸引和留住他们，”西瓦纳桑医生强调说。

他强调，恢复以前按百分比计算的福利金至关重要，因为目前的固定支付方式大大削弱了在沙巴和砂拉越服务的医生的激励价值。

他还呼吁设立专门的东马服务津贴，以及住房援助、交通补贴和留任奖金等补充激励措施。

他表示，搬迁援助必须反映搬迁到沙巴和砂拉越的实际成本，并且应该在医生搬迁之前提供，而不是在几个月后通过索赔程序提供。

西瓦纳桑医生进一步敦促政府明确东马地区的任职期限，并指出，长期倾向于在西马地区服务的医生应该获得明确的服务期限，并在服务期满后获得透明的调回途径。

他说：“如果能从一开始就知道他们需要服务多久，可能会鼓励更多医生接受这些任命。”

他还强调了改善生活和工作条件的必要性，指出农村地区的居住条件必须安全、维护良好、家具齐全，并有可靠的水电、互联网接入和交通连接。

“应奖励在服务欠缺地区工作的人员，并给予他们有意义的职业发展机会。农村服务经历应计入研究生培训、专业发展路径、晋升和未来优先工作安排，”他说道。

他还补充说，医生在选择工作地点之前，也应该清楚地了解在东马服务所面临的挑战、机遇和职业发展优势。

“仅靠强制调动和行政指令无法解决这个问题。医生需要有充分的理由离开——也需要有充分的理由留下，”西瓦纳桑医生说。

随着 2027 年财政预算案的临近，马来西亚医学协会敦促政府提供必要的资源，以加强激励措施，改善工作和生活条件，支持搬迁，并将医护人员留在急需的地区。

该协会还重申了其呼吁，要求逐步提高马来西亚公共医疗保健拨款占国内生产总值 (GDP) 的 5%，并表示充足的投资对于解决长期存在的人力短缺问题以及加强沙巴和砂拉越的医疗保健服务至关重要。

“沙巴和砂拉越人民理应像其他马来西亚人一样，及时、安全地获得医疗保健服务。空缺的职位无法为病人提供治疗。没有切实可行的留任策略的永久任命，不过是纸面上的数字而已。”西瓦纳桑医生警告说，任何进一步的拖延都会加重沙巴和砂拉越现有医生的负担，并给患者护理带来更大的压力。——《婆罗洲邮报》

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