KUALA LUMPUR, Sept 3 — The Ministry of Health (MOH), Public Service Department (JPA), and Public Service Commission (SPA) have passed the buck to each other for shortages of medical officers, specialists, nurses, and medical assistants.

An inquiry by the Health parliament special select committee (PSSC) into a proposal to establish a Health Service Commission lent rare insight into the thinking of bureaucrats about an issue that was frequently raised by MPs in the main chamber of the House during the last Dewan Rakyat meeting.

The Hansard of a February 27 hearing by the Health PSSC, which was attended by senior officials from both MOH and JPA, reflected disagreements between the two agencies in the same room.

Health deputy director-general (medical) Dr Nor Azimi Yunus explained that the public health care workforce did not expand in line with services, as new positions were mainly added only for new hospitals or facilities, despite growing manpower needs of existing hospitals with rapid service expansion.

“The capacity for old hospitals remains the same. For example, we have 1,000 positions at Hospital A, but we expand rapidly and so we expect there to be 1,200 positions. But we don’t reach 1,200 positions. Those are old [facilities]. But at the same time, we saw an additional eight new public hospitals coming into operation over the past five years,” Dr Nor Azimi told the Health PSSC at the February 27 meeting.

“There are no positions, like what I said earlier. It’s not to say there was a reduction since 2015, but there was no increase in positions. Maybe JPA had some policies. There was no expansion, but I admit there were additional positions for new facilities.

“For example, if a new hospital is built and a new block is constructed later, there will definitely be positions, but the [manpower] of old facilities can’t match rapid expansion. This is like simultaneous pressure on a bubble.”

The Health deputy DG’s assertion about the lack of new positions created for existing health care facilities was confirmed by JPA data presented at the same meeting that showed new facilities comprising 83 per cent (42,428 positions) of 51,354 new positions in MOH approved from 2019 to 2024.

Health deputy director-general (medical) Dr Nor Azimi Yunus from the Ministry of Health speaks at a Health parliament special select committee meeting on February 27, 2025. Photo by Parlimen Malaysia.

At another March 17 hearing attended by Health Ministry officials without JPA or SPA, MOH medical development division director Dr Mohd Azman Yacob similarly told parliamentarians that health care services in the public sector have expanded rapidly compared to a decade ago, citing the existence of subspecialists today.

“Our services are constantly expanding, so the number of positions can be said to not be truly aligned with the expansion of the service,” said Dr Azman. “We’re building many hospitals, but the HR aspect isn’t really in line.”

Syamsul Nizam Mohd Razali, division deputy secretary of MOH’s human resource division (BSM), told the March 17 meeting that although staffing positions have been rising in the ministry, the rate of increase is outpaced by the growth in services.

“Like what Dato’ Dr Azman said just now, our services are expanding way too quickly. This means that if we offer specialist services and the like, our manpower doesn’t match up at the same time.”

The Health PSSC tabled its inquiry in a 455-page report titled “Proposal to Form a Health Service Commission” in the Dewan Rakyat last Wednesday.

JPA Official: MOH Has Never Not Received New Positions Every Year

Norazlin Alias, senior deputy director of the staffing and organisation division (BPO) at the Public Service Department (JPA), speaks at a Health parliament special select committee meeting on February 27, 2025. Photo by Parlimen Malaysia.

According to JPA’s presentation at the February 27 Health PSSC hearing, Malaysia’s civil service comprising the federal public service, federal statutory bodies, state public administration, state statutory bodies, and local councils had 1,763,743 staffing positions as of November 30, 2024.

About 18 per cent (318,885) of those positions were in the MOH, the second largest workforce after the Education Ministry with 543,608 positions (31 per cent).

Norazlin Alias, senior deputy director of JPA’s staffing and organisation division (BPO), told the Health PSSC that especially since 2020, JPA has always considered the needs of new staffing positions for new or upgraded health care facilities.

“So far, the MOH has never not received positions every year, even though some agencies had to trade off 200, 300 positions for the creation of other more critical positions,” she said.

In other words, Norazlin was saying that MOH regularly receives new positions requested, unlike other ministries or agencies that had to do “trade offs” (eliminate certain positions to create others) before getting approval for new positions.

The JPA official maintained that the MOH has always received consideration because health and defence are classified by the Ministry of Finance (MOF) as critical sectors.

The number of positions, vacancy filling rate, and vacancies in the Ministry of Health (MOH) from 2016 to 2024. Graphic by the Public Service Department (JPA), presented at a Health parliament special select committee (PSSC) hearing on February 27, 2025, and reported in the Health PSSC’s report titled “Proposal to Form a Health Service Commission” that was tabled in the Dewan Rakyat on August 27, 2025.

JPA further presented data that showed a declining rate of filled vacancies in the MOH from 95 per cent in 2016 to 83 per cent in 2024. Last year, as of December 31, 2024, the Health Ministry had 54,362 vacancies, including five in the Malaysian Medical Council and the Medical Device Authority.

When Health PSSC member Dr Alias Razak (PN-Kuala Nerus) questioned the drop in the rate of filled vacancies, Norazlin suggested that MOH, as a head of service, might have needed time to fill staffing positions approved by JPA at a faster pace.

“In December actually, there were 3,000 plus offers for UD positions, if I’m not mistaken,” she said, referring to medical officers. “But maybe some had accepted, while others rejected, so there are still vacancies.”

When both Dr Alias and Health PSSC member Onn Abu Bakar (PH-Batu Pahat) asked if the problem was with MOH or JPA, Norazlin explained that JPA is the agency that provides positions; SPA has the power of appointment; and MOH applies to SPA to fill the positions approved by JPA.

BSM division secretary Noor Azman Abdul Rahman then clarified that the JPA data on the rate of filled vacancies in MOH applied to 83 service schemes in the ministry.

“If we focus on certain schemes or positions, this depends on supply or graduates. For certain schemes, we have issues with supply, such as nurses or even doctors,” he told MPs.

MOH Is Our Number One Priority: SPA Official

Public Service Commission (SPA) secretary Ikhbal Hanam Mukras (left) speaks at a Health parliament special select committee meeting on February 27, 2025. Photo by Parlimen Malaysia.

SPA secretary Ikhbal Hanam Mukras told the Health PSSC at a March 17 hearing – in the absence of JPA and MOH officials – that medical, dental, and pharmacy officers could still be appointed on a permanent basis. These schemes were exempt from the government’s decision for all appointments in the public service to be made on an interim contract basis from February 1, 2024.

Health PSSC chairman Suhaizan Kaiat (PH-Pulai) asked how JPA, SPA, and MOH collaborated to resolve manpower shortages of doctors, nurses, and medical assistants.

“This is subject to JPA because approval is at their level. When it gets to our level, we expedite it because MOH is our priority,” replied Ikhbal Hanam. “If a particular business involves interviews, we will give way to MOH first before we give way to other positions.”

Suhaizan noted that MOH faced complex challenges with doctors leaving for the private sector or overseas. “Who is responsible for this complexity? Is it the service or JPA?”

“Complexity – challenges are actually created by the head of service, by the ministry itself,” replied Ikhbal Hanam.

“The ministry conducts a study on a particular complexity and then raises it to JPA. From that complexity, JPA decides whether to upgrade that position or if there’s a need to increase the number of positions for critical sectors. Then, if it involves appointments, send it to SPA. We will do the recruitment.”

When Suhaizan and Health PSSC member Young Syefura Othman (PH-Bentong) asked whether MOH or SPA was responsible for filling vacancies, Ikhbal Hanam replied: “MOH lah.”

“When there’s a vacancy, MOH must ensure there’s approval and bring it up to SPA. Then we will recruit and fill it.”

The number of filled positions and vacancies in five main service schemes in the Ministry of Health (MOH) as of December 31, 2024. Graphic by the Public Service Department (JPA), presented at a Health parliament special select committee (PSSC) hearing on February 27, 2025, and reported in the Health PSSC’s report titled “Proposal to Form a Health Service Commission” that was tabled in the Dewan Rakyat on August 27, 2025.

Suhaizan told Ikhbal Hanam that the Health PSSC has met JPA, MOH, and now SPA. “MOH is indeed facing [staff] shortages. So we want to know who should take responsibility when a shortage occurs?”

The Pulai MP cited, as an example, a 12 per cent vacancy in nursing positions. “Does this mean that it’s MOH who should take responsibility to fill these positions?”

“Yes,” said Ikhbal Hanam, affirming that SPA was merely in charge of appointments.

The SPA official cited a 1/2024 circular that says staffing and a service scheme are the responsibility of the head of service. In this case, the Health director-general or MOH as a whole is “responsible for ensuring that the position can be filled.”

“But of course there are obstacles when it’s raised to JPA because maybe they [JPA] can’t approve everything, but only a portion.”

The number of new positions approved in the Ministry of Health (MOH), together with estimated financial implications, from 2019 to 2024. Graphic by the Public Service Department (JPA), presented at a Health parliament special select committee (PSSC) hearing on February 27, 2025, and reported in the Health PSSC’s report titled “Proposal to Form a Health Service Commission” that was tabled in the Dewan Rakyat on August 27, 2025.

Suhaizan asked Ikhbal Hanam if the MOH, JPA, and SPA held regular meetings together, remarking: “At that time when we met both MOH and JPA, they were passing the buck to each other – ‘it’s you, it’s yours, this is mine, that is yours.’ So it’s not very clear.”

“We don’t have specific periodic coordination, but if there are issues, then they’ll involve us,” replied the SPA official.

Ikhbal Hanam confirmed that JPA was responsible for approving the filling of vacancies in the MOH, saying: “We don’t have the power to ensure that positions are filled.”

He stressed that SPA “immediately” processes appointments for the MOH after JPA approval, as “MOH is the one priority sector for SPA, regardless of the time.”

“For example, for promotions to KPK (Health DG), we’ll do it within 24 hours. That’s the commitment by the Commission – MOH papers are raised even on weekends for urgency. We know that this service sector is extremely important and crucial for our country.”

Despite an imbroglio over which agency ultimately held responsibility for health care worker shortages, the Health PSSC suggested deferring the establishment of a Health Service Commission, recommending “periodic engagement sessions” between MOH, JPA, and SPA instead.