MMA Sabah Warns BIW Cuts Could Worsen Healthcare Inequity in State

21 December 2025

KOTA KINABALU: The Malaysian Medical Association (MMA) Sabah Branch has raised concerns over the revised Bayaran Insentif Wilayah (BIW) framework under the Public Service Remuneration System (SSPA), warning that reductions—particularly those affecting newly appointed medical officers—could deepen healthcare inequity and undermine workforce sustainability in Sabah.

In a press statement dated Dec 21, MMA Sabah Chairman Dr Brandon Patrick Senagang said the association aligns with concerns previously expressed by the MMA President, noting that while remuneration reforms may aim to modernise the public service, the BIW revision warrants urgent reconsideration due to its foreseeable impact on Sabah’s healthcare system.

Dr Brandon stressed that BIW should not be viewed as a routine allowance, but as a policy tool designed to offset predictable disparities faced by healthcare workers in regions with geographical, logistical, and resource constraints.

In Sabah, he said, these challenges extend beyond remote interiors and are embedded across much of the state’s healthcare ecosystem, including staffing gaps, heavy service loads, travel demands, higher living costs, and limited professional development opportunities compared to major centres.

“A fixed, reduced BIW risks sending an unintended but harmful message,” he said, adding that diminished recognition of the burdens of service in East Malaysia could reduce doctors’ willingness to accept postings, weaken retention, and increase reliance on short-term staffing solutions that are costly and disruptive to patient care.

According to MMA Sabah, doctors serving in the state often do so at significant personal cost, including relocation expenses, separation from family support networks, adaptation to limited infrastructure, and sustaining high workloads where demand frequently outpaces capacity. Any weakening of incentives, the association warned, could exacerbate existing shortages that the BIW was originally intended to address.

MMA Sabah has called on the Public Service Department (JPA) and the 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, particularly Sabah.

“This is not a call for special treatment,” Dr Brandon said. “It is a call for equitable policy design, one that recognises that achieving equal healthcare outcomes requires acknowledging and responsibly addressing unequal burdens. Protecting incentives that support staffing in Sabah ultimately protects the health of Sabahans.”