The Malaysian Medical Association (MMA) Sabah takes note of the revised Bayaran Insentif Wilayah (BIW) framework under the Public Service Remuneration System (SSPA) and aligns with the concerns raised by the president of the MMA.
While remuneration reforms may be intended to modernise the public service, the BIW revision — particularly the reduction affecting newly appointed medical officers — warrants urgent reconsideration due to its foreseeable impact on health care equity and workforce sustainability in Sabah.
BIW is not merely an “allowance” in the ordinary sense. It is a policy instrument designed to partially offset predictable disparities: the financial and social costs of serving in regions where geography, logistics, and resource constraints materially shape daily clinical work.
In Sabah, these realities extend beyond remote interiors; they are embedded across much of the state’s health care ecosystem — from staffing gaps and service load to travel demands, living costs, and limited professional development pathways compared to major centres.
A fixed, reduced BIW risks creating an unintended but harmful message. When young doctors perceive that the system is less willing to recognise the genuine burdens of service in East Malaysia, the consequence is rarely theoretical — it translates into reduced willingness to accept postings, weaker retention, and increased reliance on short-term stopgaps that are costly for the system and disruptive for patients.
Sabah’s health care challenges cannot be solved by goodwill alone. Doctors who serve here often do so at personal cost — leaving family support networks, managing relocation expenses, adapting to limited infrastructure, and sustaining high workloads in settings where demand can outpace capacity. Any policy that weakens incentives, even unintentionally, risks worsening the very shortages the BIW was meant to mitigate.
MMA Sabah therefore calls on the relevant authorities — particularly the Public Service Department (JPA) and Ministry of Finance (MOF) — to review the revised BIW structure and restore a fair, progressive mechanism that reflects the realities of service in East Malaysia, especially Sabah.
This is not a call for special treatment. It is a call for equitable policy design: one that recognises that equal outcomes in health care require unequal burdens to be acknowledged and responsibly addressed. Protecting incentives that support staffing in Sabah is, ultimately, protecting the health of Sabahans.
This statement was issued by MMA Sabah chairman Dr Brandon Patrick Senagang.
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