Kota Kinabalu: A single doctor at Ranau Hospital’s outpatient department attends to nearly 200 patients daily, while only two doctors handle between 80 and 100 patients at its 24-hour emergency department, according to a healthcare workers’ union.
The Joint Council of Presidents and Secretaries-General of Health Ministry Workers Unions (Mapsu) cited the situation in proposing a RM10,000 special incentive to attract and retain doctors serving in Sabah and Sarawak, particularly in rural and remote areas.
Mapsu President Ajulahin Japin, who is also Sabah Medical Services Union President, said the workload reflected the pressure faced by medical personnel at healthcare facilities struggling with manpower shortages.
“Such workloads are extremely demanding, even with the assistance of assistant medical officers.
“Under Mapsu’s proposal, doctors accepting postings in Sabah or Sarawak would receive RM5,000 upon reporting for duty to help cover relocation and initial settlement expenses.
“Another RM5,000 would be paid after completing three years of service, tying half of the incentive to retention,” he said on Wednesday.
Ajulahin said relocation costs, welfare concerns and challenges associated with postings were among the factors doctors considered when deciding whether to accept placements in Sabah and Sarawak.
“The scheme would primarily target rural and remote areas.
“The proposed incentive should be regarded as an interim measure rather than a permanent solution, and could eventually be reviewed once Sabah and Sarawak produced enough local medical graduates to meet their healthcare manpower needs,” he said.
The proposal comes amid continuing concerns over Sabah’s ability to attract medical officers, despite permanent appointments being offered.
Health Minister Datuk Seri Dr Dzulkefly Ahmad told the Dewan Rakyat on Oct 8 that only 336 of the 528 medical officers offered permanent placements in Sabah had reported for duty, leaving 192 who did not.
In Sarawak, 337 of the 527 medical officers offered placements had reported for duty.
Dzulkefly said factors contributing to rejected placements included separation from family, rural postings, relocation and logistical costs, preferences for urban facilities, and concerns over career development.
The Health Ministry has proposed reserving 30 per cent of Federal Training Award specialist-training places for medical officers serving in Sabah and Sarawak.
It has also introduced full transfer allowances for eligible officers posted to the two states.
Ajulahin said financial incentives alone would not resolve the shortage, calling for adequate accommodation, transport and other basic support for healthcare personnel, particularly those posted to rural and remote districts.
Mapsu also urged the Public Service Department to review pension policies and the Bayaran Insentif Wilayah (BIW), saying remuneration and long-term welfare could influence doctors’ decisions to accept and remain in postings in Sabah and Sarawak.
Ajulahin said increasing the number of locally trained doctors remained the more sustainable long-term solution.
He said the shortage was not solely due to the number of medical graduates available nationally, but also whether doctors were willing to accept postings and remain in the two Borneo states.
Mapsu called on the Sabah and Sarawak governments, the Health Ministry and the Public Service Department to consider the proposal and work towards immediate measures to improve healthcare recruitment and retention.
Ajulahin said prolonged doctor shortages were already affecting patients, particularly through long waiting times at outpatient facilities.
