Are we facing a public healthcare crisis?
by Edgar Ong · Borneo Post OnlineTHE public healthcare system in Sarawak is facing several significant challenges, with the most critical being a persistent shortage of manpower, particularly doctors and specialists.
Studies have shown that more than 11,000 new positions are needed to support operations at the state’s major hospitals.
The exact statistics are publicly available and have been publicised by the Health Ministry (MoH) repeatedly over the mass media.
State officials have been campaigning and urging the federal authorities to allow more local recruitment autonomy in order to hire their own healthcare workers to better address local needs, as well as to improve loyalty and retention.
There have been many shortcomings in the federal recruitment process overall.
Besides this most pressing concern of personnel shortages, there are other issues as well.
Equally critical areas include infrastructure issues of current facilities facing urgent upgrading, in view of many urban hospitals and rural clinics being old, and some in dilapidated condition.
Most of them need immediate attention of expansion or re-building to meet modern standards and also to cater for a growing population.
A large segment of the state’s population reside in the remote areas and are dispersed by road access issues – many places are only reachable via river or by air.
Proper and emergency healthcare deliveries offer great challenges for the patients in these areas.
Time and again, issues of funding and resource disparity have been highlighted by state authorities, who continue to be challenged as our state medical services have been operating on significantly lower allocations from the federal government.
This does not compare favourably with similarly-sized hospitals and health facilities elsewhere in Peninsular Malaysia.
Such inadequacies have led to overcrowding and strained services.
It is not uncommon for emergency patients to be wait-listed for up to 24 hours after being triaged; and another 24 hours before any free bed is available in the ward.
The systems are all in place and are operating at optimal levels, from my personal observations during various admissions over recent years, but it is also obvious that all departments are short-staffed and almost every single medical personnel is overworked.
It’s certainly a miracle that the Sarawak General Hospital (SGH) in Kuching has been coping so well with all the workload, and has been providing the best of healthcare to the constant flow of both outpatients and warded patients over the years.
Kudos to all the specialists, doctors, nurses and staff for this achievement!
Sarawak also faces a high prevalence of non-communicable diseases (NCDs) like diabetes, heart and kidney failures, as well as specific tropical and zoonotic diseases.
In Kuching, two specialist medical centres have been specially set up to cater for heart patients: the Sarawak Heart Centre in Kota Samarahan, and the specialist centre adjacent to the SGH.
Both are now operating at beyond the maximum capacity and have definitely outgrown their original expectations in terms of the optimal number of patients seen.
A third major specialist clinic meant for cancer patients is in the works.
The state government has also invested in new facilities, namely the Petra Jaya Hospital; the Universiti Malaysia Sarawak (Unimas) Teaching Hospital, and Sarawak Infectious Disease Centre.
Earlier this year, the federal Health Minister Datuk Seri Dr Dzulkefly Ahmad said that a total of 6,919 healthcare personnel under the MoH had resigned and moved to the private sector between 2020 and 2024.
This had included 2,141 nurses – aggravating the shortage of nurses in Malaysia to reach almost 60 per cent by year 2030.
In a media statement published on Dec 11 this year, Parti Sosialis Malaysia (PSM) had issued a demand calling for a ‘moratorium on private hospitals for the next five years to save the public healthcare system.’
It had said: “This is because, in the process of rapid expansion, the private healthcare sector is poaching the workforce from our public healthcare system.
“The ‘poaching’ refers to the practice by high-income countries or private healthcare systems of aggressively recruiting healthcare professionals from areas that already face critical shortages.
“This practice raises significant ethical concerns due to the negative impact on our public healthcare system.
“Poaching of medical specialists is not new. It is more politely referred to as ‘medical brain drain’.
“This has resulted in a global health workforce crisis, according to the World Health Organisation (WHO), causing poorer countries to lose their healthcare workforce to richer countries.
“Similarly, in Malaysia, we face a workforce crisis within our public healthcare system.
“Not unlike the global health workforce crisis, our ‘poorer’ public healthcare system is losing people to the wealthy private sector.”
The PSM statement continued by taking medical tourism to task: “We already face an acute shortage now of specialists in public hospitals.
“What will happen when even more private hospitals rapidly expand, especially to cater to medical tourism?
“It has been reported that private health services are the eighth fastest-growing service industry.
“The number of healthcare staff in the public sector for Malaysia grew 12 per cent, from 98,973 in 2015 to 110,708 in 2022.
“Meanwhile, over the same period, the private sector saw staff numbers grow 27 per cent, from 132,082 to 167,690.
“In 2022, Malaysia had 207 private hospitals, up from 183 in 2015, compared to 160 government hospitals (148 under MoH, 12 non-MoH).”
In conclusion, the statement from PSM had emphasised that the WHO General Assembly in May 2025, which Dr Dzulkefly attended, reaffirmed that the enjoyment of the highest attainable standard of health ‘is a fundamental human right, without distinction of race, religion, political belief, economic or social condition’.
“It recognised that access to health and care services is a critical component of this right, and a cornerstone of human dignity and well-being.
“Therefore, it is urgent that policymakers uphold the fundamental rights of our ‘rakyat’ (people) to enjoy the highest standard of healthcare by taking immediate action to impose a moratorium on private hospitals for the next five years, in order to save our public healthcare service.”
This may appear to be a rather drastic proposition at first reading, but it will go a long way to addressing what is ailing the current healthcare crisis in our public sector.
It is my personal opinion that for us in Sarawak, the more urgent and pressing issue is to take back full autonomy of our public medical services without any more delays.
That will be the vital first step forward for us in determining our own future insofar as how we want to advance and proceed with revamping our healthcare systems.
Let’s get Sarawak to progress even faster and gain a greater autonomy in its public healthcare service towards an even brighter and fairer future for all its citizens.
‘Hidup Sarawak’!