PETALING JAYA: Giving Sabah and Sarawak the right to hire their own healthcare personnel could be the answer to the acute shortage of doctors in hospitals and clinics there.
The current federal system is seen as too slow and rigid, contributing to poor placements and high rejection or no-show rates, said former Health Ministry director Datuk Dr Zainal Ariffin Omar.
Giving the states power to hire would provide better decisions on deployment of manpower, he said.
On whether locals should be prioritised for vacancies in the two states, he said the policy already exists to a certain extent.
Under the “Borneonisation” initiative, Sarawak has exceeded its 80% target for locals in key federal posts, and Sabah is nearing 70%. The policy aims to fill key roles with local-born officers, subject to qualification and merit.
On the 30% quota for medical officers in the states to pursue specialist training, Dr Zainal Ariffin said it is a positive step but not the complete solution.
“The quota addresses the major complaint of limited career progression in East Malaysia. However, retention also hinges on better pay, restored regional incentives, housing and clear paths back to home states – factors that permanency alone hasn’t fixed,” he said.
The real challenge lies not just in filling vacancies but ensuring that doctors are willing to serve and remain where they are needed most, said Malaysian Medical Association (MMA) president Dr Sivanaesan Letchumanan.
“MMA believes doctors should be distributed according to the healthcare needs of the population. However, it makes practical sense to give suitable consideration to Sabahans and Sarawakians who wish to serve in their home states, as they may be more inclined to remain there long-term.
“At the same time, appointments must remain merit-based, and efforts to attract and retain doctors from other states must continue,” he said.
He too said the quota for specialist training may help, but this alone cannot solve the manpower retention problem.
“Attracting and retaining doctors, particularly in rural and remote areas, needs better remuneration, appropriate incentives, improved working conditions, adequate accommodation and support facilities, as well as clear career development opportunities,” Dr Sivanaesan added.
MMA Sabah branch chairman Dr Brandon Patrick Senagang said autonomy would enable the state to control its own resources and manpower.
“In the short term, an independent Health Service Commission is needed to oversee appointments, promotions and manpower distribution of healthcare workers independently of the Public Service Department,” he said.
“Sabahans should definitely be prioritised. Therefore, the government should look into giving more slots for Sabahans in medical schools. In addition, the state government should also look into offering more scholarships for Sabahans to pursue medicine.
“We must produce more Sabahan doctors to fill up these positions.”
Welcoming the 30% quota for specialist training, he said it will definitely encourage more doctors to take up medical officer posts in Sabah and Sarawak.
“However, it should not stop there – doctors working in Sabah and Sarawak deserve a better package to ensure better retention.”
Sarawak deputy premier Dr Sim Kui Hian had said on Sept 28 that the state was aiming for health autonomy.
“(The) federal government provides the budget while Sarawak will hold the administrative power to make decisions, planning, recruitment, incentives, placement and allocation, among others,” said Dr Sim, who is also the state minister for Public Health, Housing and Local Government.
