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