Sabah needs autonomy to solve doctor shortage, says health think tank

The Galen Centre for Health and Social Policy says the current system is too slow and rigid to respond to the state’s realities.

The Galen Centre for Health and Social Policy said the current system is too slow and rigid to respond to Sabah’s realities, and that offering permanent positions alone is no longer sufficient because of what it described as a “structural failure”.

Its CEO, Azrul Khalib, said key issues in Sabah include poor placement decisions and last-minute compulsory transfers.

Azrul said excessive workloads, inadequate welfare support, including incentives that do not match the cost of living, and the challenges of working in remote areas have worsened the situation.

“If the government is serious about resolving the healthcare workforce crisis in the state, Sabah must be given the autonomy to make faster, more flexible decisions tailored to local needs,” he told FMT.

On April 11, Sabah health minister Julita Majungki said the Bornean state was facing a shortfall of about 6,000 doctors, with only 2,884 currently in service compared with an estimated need of 9,000.

Sarawak deputy premier Dr Sim Kui Hian said in January that healthcare autonomy under the Malaysia Agreement 1963 must be expedited without being bogged down by federal bureaucracy, allowing the state government to gradually take over healthcare management.

The Malaysian Medical Association said Sabah’s situation clearly reflects longstanding policy failures in workforce planning and incentives.

MMA president Dr R Thirunavukarasu said addressing the issue requires comprehensive structural reform rather than short-term fixes.

“This crisis stems from inconsistent policies and a failure to retain doctors in the public system. We need to build a system that encourages them to serve, and to stay,” he said.

Thirunavukarasu also stressed the need for a “whole-of-government” approach, with the health ministry working closely with the public service department and the finance ministry to align issues related to remuneration and training.

Sabah MMA chairman Dr Brandon Patrick Senagang said the morale of doctors has been badly affected following a sharp reduction in regional incentives.

He said the lack of cost-of-living allowance increases for staff in remote areas has left many medical officers disillusioned.

“This is compounded by poor infrastructure. Many areas still lack proper road access, as well as consistent electricity and water supply,” he said.

Senagang also warned that critical manpower shortages in facilities such as Hospital Kinabatangan have led to severe burnout, with doctors unable to take adequate leave.

He urged the government to create clearer career pathways, including special quotas for specialist training programmes for doctors working in underserved areas in Sabah and Sarawak.