In early July, Indonesia announced its intention to send trained nurses abroad, with Malaysia listed as one of the priority destinations. On paper, it’s a diplomatic win–Indonesia boosts employment and Malaysia fills chronic vacancies in its hospitals.
But dig a little deeper, and the proposal feels less like a solution and more like a symptom of our own policy fatigue.
It sounds like good news. A neighbour helping another. A regional partnership. Even a bit of Asean solidarity.
A good headline, perhaps…but a shallow fix.
Malaysia’s public health care system isn’t short on talent–we are short on reasons for talent to stay.
According to Ministry of Health (MOH) statistics, Malaysia currently has about 130,000 registered nurses, but only 64,000 are employed in the public healthcare sector. That’s less than 50 per cent.
Each year, qualified local nurses quietly exit the system. Between 2020 and 2024, over 2,100 Malaysian nurses resigned from public health care positions.
These weren’t just contract staff, more than 80 per cent (1,754) were permanent employees, signaling deeper dissatisfaction and burnout among long-serving personnel.
The usual narrative blames salary. But any nurse will tell you, it’s not just about the money. It’s about the workload, burnout, rigid shifts, lack of autonomy, minimal upward mobility, and a culture that too often rewards compliance over critical thinking.
When talented nurses are treated like cogs in a machine, they eventually look for the nearest exit.
This exodus isn’t merely anecdotal. In 2023 alone, 2,445 Malaysian nurses applied to work overseas. While the majority came from the private sector, nearly 900 public sector nurses, including 259 from the MOH and 633 from statutory bodies also joined the international job market.
These numbers highlight not just the lure of better pay abroad, but also growing disillusionment with domestic conditions. For many, working in Singapore or the Middle East isn’t about ambition, it’s about survival.
Even among those with post-basic qualifications (nurse with specialist training in areas like intensive care, nephrology, or emergency services) resignations doubled from 60 in 2019 to 118 in 2023.
These are precisely the kind of experienced professionals the public system can least afford to lose, especially as patient demand and case complexity continue to rise.
Meanwhile, unfilled positions within the public sector are climbing rapidly. From just over 2,000 vacancies in 2020, the figure swelled to 6,896 by 2023.
Pointing to a widening gap between policy promises and operational reality. Taken together, the figures tell a sobering story: the outflow of skilled local nurses is neither temporary nor marginal–it’s a structural haemorrhage.
So, what’s our response? Not reform. Not retention. But recruitment–from outside.
It’s not that Indonesia’s nurses aren’t competent–many are. It’s that plugging them into our overburdened, under-supported system without fixing the foundations is a recipe for deeper dysfunction.
Language barriers, unfamiliar protocols and cross-cultural misunderstandings in high-pressure wards? That’s not staffing, that’s risk. Let’s not mistake urgency for strategy.
Importing Labour, Exporting Talent?
When Malaysia talks about recruiting Indonesian nurses, the signals are mixed. Are we solving problems or just outsourcing it?
Welcoming foreign nurses is not wrong. But doing so without fixing our internal retention ecosystem turns Malaysia into a transit lounge; a place where nurse pass through rather than thrive.
Worse, it may create a false sense of policy success while masking deeper issues in workforce planning.
It is undeniable that cross-border collaboration has value. But the timing and tone matter.
If Malaysia accepts foreign nurses while many of our own are still on contract extensions, awaiting confirmation or burnt out beyond repair, what message are we sending?
It’s one thing to host guests. It’s another way to ignore the people who built the house.
And here’s a bitter irony. While we import, other countries continue to actively recruit our nurses. Malaysia becomes both an importer and exporter–a net loss, with taxpayers footing the training bill.
It’s also worth asking: will Indonesian nurses want to stay long in our system? If their own country is investing in them for international work, wouldn’t they also be drawn to higher-income countries like Japan, Germany, or Saudi Arabia, as Malaysian nurses are?
If we don’t fix the push factors here, we may simply become a stepping stone in someone else’s talent pipeline.
What we really need is a proper diagnostic. That means honest data collection on why nurses leave, where they go and what would make them stay.
It means consulting nurses directly when shaping policies, not just speaking about them from the top down.
MOH’s Budget 2026 wishlist should reflect this urgency. Investing in training is crucial, but retention is where the real returns lie.
Offer flexible scheduling, improve workplace culture, expand leadership pathways, and treat nurses as partners in care, not subordinates in a hierarchy.
And one final dose of realism. Indonesia nurses may act as a much-needed painkiller, but to cure the chronic condition plaguing our system, Malaysia needs more than foreign labour.
It needs political will, policy imagination and the humility to listen to those who’ve been at the bedside all along.
Malaysia doesn’t just need more nurses. We need a system that deserves them.
Afifah Abd Wahid is an economics lecturer at the Faculty of Business, Multimedia University.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
