KOTA KINABALU: The Sabah Malaysian Medical Association (MMA) Sabah has voiced concern over revisions to the Bayaran Insentif Wilayah (BIW) framework under the Public Service Remuneration System (SSPA).
Its Sabah chapter chairman Dr Brandon Patrick Senagang said that the changes could further strain healthcare equity and workforce sustainability in the state.
He said Sabah MMA aligns with concerns previously raised by MMA President regarding the revised BIW, particularly the reduction affecting newly appointed medical officers.
While acknowledging that remuneration reforms may be aimed at modernising the public service, the association cautioned that the BIW revision warrants urgent reconsideration due to its foreseeable impact on Sabah’s healthcare system.
“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 shape daily clinical work,”
He noted that in Sabah, such challenges are not confined to remote interior areas but are embedded across much of the state’s healthcare ecosystem.
These include persistent staffing gaps, heavy service loads, travel demands, higher living costs and limited professional development opportunities compared to major urban centres in Peninsular Malaysia.
According to MMA Sabah, a fixed and reduced BIW risks sending an unintended but harmful signal to young doctors.
“When doctors perceive that the system is less willing to recognise the genuine burdens of service in East Malaysia, the impact 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,” he said in a statement.
He added that Sabah’s healthcare challenges cannot be addressed by goodwill alone, as doctors serving in the state often do so at significant personal cost.
These include leaving family support networks, managing relocation expenses, adapting to limited infrastructure and sustaining high workloads in settings where demand frequently outpaces capacity.
MMA Sabah has therefore called on the Public Service Department (JPA) and the Ministry of Finance (MOF) to review the revised BIW structure and restore a fair and progressive mechanism that reflects the realities of service in East Malaysia, particularly Sabah.
“This is not a call for special treatment. It is a call for equitable policy design — one that recognises that equal healthcare outcomes require unequal burdens to be acknowledged and responsibly addressed,” Dr Brandon said, adding that protecting incentives for Sabah postings ultimately means protecting the health of Sabahans.
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