Health Minister Dzulkefly Ahmad recently sounded the alarm on Malaysia’s critical nursing shortage. In a parliamentary reply earlier this year, it was revealed that between 2020 and 2024, a total of 6,919 health care workers under the Ministry of Health (MOH) had resigned, and among them were 2,141 nurses, comprising both permanent and contract staff.
To put things in perspective, this isn’t just a Malaysian issue. It is a global challenge that many countries are struggling to manage.
The World Health Organization (WHO) has long warned of a global nursing shortage. Even before the pandemic, there was a deficit of nearly six million nurses worldwide.
The Covid-19 crisis pushed already strained health systems to breaking point, and many countries are now aggressively recruiting foreign nurses to replenish their ranks.
Malaysian nurses, in particular, are highly sought after in Singapore, the Middle East, and Australia for their training, work ethics, and multilingual capabilities.
And it isn’t hard to see why working overseas is so attractive. Singapore and New Zealand, for instance, offer highly competitive remuneration packages, better working hours, and even pathways to permanent residency for nurses who serve a few years.
Malaysian nurses working abroad frequently report higher job satisfaction, citing not only the improved pay and benefits, but also healthier work environments and greater respect for the profession.
What happens when our best nurses leave? Those who remain in the public health care system face the impossible task of doing the same (or more) with fewer hands.
Longer shifts, higher patient loads, and increased stress lead to burnout, which in turn drives even more nurses to resign. It is a vicious cycle we can’t afford to ignore.
Workplace stress and burnout are not abstract concepts here; they manifest as longer waiting times at public hospitals, overworked staff, and exhausted frontliners who have little time or energy left for themselves or their families.
The nursing shortage, left unaddressed, compromises both the quality of care for patients and the health of our health care workforce.
To be fair, the Madani government did make an important move by implementing a long-overdue salary revision for civil servants in December 2024, the first adjustment since 2012.
Another increment is scheduled for January 2026. This should rightly be applauded because it benefits the entire public health care workforce, including nurses.
It’s also worth remembering that revenue from taxation in Malaysia directly funds the salaries and benefits of civil servants, including our doctors, nurses, and other health care professionals. Until and unless Malaysia reforms its health financing system, this fact shall remain the case.
Ensuring sufficient, sustainable revenue streams is essential if we’re serious about strengthening our public health care system and retaining its workforce.
However, this salary revision came with a complication: the standardisation of a 45-hour work week across all civil service positions, including nurses, who previously worked 42 hours a week.
This decision, made under the rigid frameworks of the Public Service Department (JPA), failed to appreciate the distinct and demanding nature of clinical work compared to desk jobs.
Nurses across the country voiced their frustration, and rightly so. Adding hours without addressing workload distribution, patient numbers, or staffing levels only worsens morale.
This situation clearly illustrates why Malaysia urgently needs to remove health care practitioners from the general civil service framework and establish a dedicated Health Services Commission. Clinical work is inherently different; our policies should reflect that.
At the same time, the Health Ministry has been mulling over another proposal: allowing Employees Provident Fund (EPF) members to use their retirement savings from Account 2 to pay for health insurance premiums. While this may appear beneficial at first glance, it raises troubling questions.
Who ultimately benefits from this? The answer: private insurance companies and corporate hospital conglomerates. Many Malaysians opt for private health care services because public hospitals often face overcrowding, extended waiting times, and limited staffing, problems rooted in the same talent drain that the private sector contributes to.
Private hospitals, with their deeper pockets, attract public-sector doctors and nurses with better pay and benefits, further hollowing out our public health care system.
Because private hospitals can charge much higher fees, which are typically covered by insurance policies, they can afford state-of-the-art equipment and more generous salaries. The irony is, these financial gains often come at the expense of an under-resourced public system serving the majority of the population.
If we are serious about tackling the nursing shortage and strengthening our health care system, several immediate steps are essential to break the cycle.
In the short term, we must expand workforce capacity by increasing the intake of nursing students and offering retraining or upskilling opportunities for those returning to the profession. As Malaysia ages, our need for quality health care providers, including nurses, surges too.
A 2016 MOH projection estimated that Malaysia needs over 260,000 nurses by 2030, a figure we look unlikely to achieve should brain drain persists.
Simply increasing nurse numbers isn’t enough. We must remember that nurses are people too, and it is essential to invest in initiatives that support their well-being, including flexible scheduling, mental health services, and opportunities for part-time work or career breaks.
At the same time, we need to strengthen retention incentives, such as housing allowances, service-linked bonuses, and clear, attainable pathways for career progression within the public health care system.
50In the long term, we need to establish a Health Services Commission to govern the recruitment, management, and welfare of health care professionals independently from the broader civil service. This would allow for more flexible, sector-appropriate policies on work hours, remuneration, and career pathways.
This includes improving salary structures and benefits for nurses in the public sector, ensuring they reflect the demands and risks of clinical work. Future periodic salary revisions must consider inflation, cost of living, and parity with regional competitors.
The health of a nation is built on the backs of its health care workers. Malaysia must urgently address its nursing shortage before the gap becomes insurmountable. Failing to act decisively will not only compromise patient care but deepen inequality between those who can afford private care and those who rely on overstretched public services.
This is beyond just a policy issue. It is a moral and economic imperative. And if we are to build a fairer, healthier Malaysia, we must start by valuing those who dedicate their lives to caring for others.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
