KUALA LUMPUR, Sept 11 — Abdul Rahman Dahlan, a former minister in Prime Minister Najib Razak’s administration, has demanded that Singapore compensate Malaysia for recruiting Malaysian doctors and nurses.
Abdul Rahman, who was previously Minister in the Prime Minister’s Department in charge of the Economic Planning Unit (EPU) from 2016 to 2018, branded Singapore as “the most aggressive” country in poaching health care professionals from Malaysia, citing what he described as unprecedented walk-in interviews in Kuala Lumpur itself.
“Previously, out of deference to Malaysian sensitivities, they only organised quiet, targeted and selective interviews for pre-identified Malaysian candidates. Even then, those interviews were done in Singapore,” Abdul Rahman wrote on Facebook Tuesday.
“Now, it’s open, aggressive and ‘in-your-face’ marketing campaigns, just like what Singaporean developers are doing in search of Malaysian buyers for their spanking new condominium projects in Singapore.”
The former minister from Sabah further accused Singapore – the wealthiest member state of Asean that is able to attract Malaysian health care workers with higher remuneration – of undermining Malaysia’s mission to provide adequate and affordable health care for Malaysians, especially in underserved areas in the east coast of Peninsular Malaysia, Sabah, and Sarawak.
“Malaysia, through G2G (government-to-government) policy implementation, should negotiate that Singapore compensate the Malaysian government [for] the full amount of subsidies Malaysia had spent on educating and training these doctors and nurses,” said Abdul Rahman.
“That money can be utilised to improve health care services to Malaysians, particularly in underserved areas. That is the only fair thing to do.”
Alternatively, the former minister suggested that in lieu of a one-off compensation from Singapore to Malaysia, the Malaysian government could impose an additional monthly or annual levy on Malaysian doctors and nurses working in the island republic, based on their contracts and income drawn in Singapore that could be verified by the Malaysian High Commission.
This compensation should be borne by Singaporean employers, not the Malaysian employees.
“This shouldn’t be seen as a punishment on those who seek employment outside the country (in these focus sectors), but rather as a compensatory mechanism after having been trained locally at the expense of the taxpayer,” said Abdul Rahman.
“After all, Singapore, as I said earlier, loves to weaponise their deep pockets. I believe Singapore would not have any problem paying back the subsidies.”
The former minister pointed out that Malaysia is spending a “huge amount of money” from limited resources to subsidise the cost of training doctors and other medical professionals in public universities.
“[The] Malaysian government is willing to do that even at the expense of spending comparatively less on much needed infrastructure development in rural areas. This is a critical mission for the Malaysian government as it tries to provide decent and affordable health care for its citizens throughout the country,” said Abdul Rahman.
“Unfortunately, this national agenda is being upended because of the exodus of medical professionals in search of better employment benefits and work-life balance in Singapore and elsewhere.
“Most Malaysians feel frustrated and perplexed especially when they feel Singapore, as an important Asean member state, is showing lack of empathy for Malaysia’s medical predicament.”
It costs nearly RM1 million to train one doctor in Malaysia.
Malaysia’s Ministry of Health (MOH) imposes bonds of up to RM700,000 for a period of up to seven years for Hadiah Latihan Persekutuan (HLP) scholarship recipients pursuing specialisation in medicine.
Abdul Rahman described his suggestions of Singapore compensating Malaysia for hiring Malaysian doctors and nurses as a “win-win”.
“Singaporean hospitals get the doctors and nurses that they need, while the Malaysian government recovers the huge subsidies they spend on these doctors and nurses and reinvest that money in the provision of health care services,” he said.
“This solution has never been done before and I expect there will be a lot of technical and legal issues that need to be addressed before such a policy can be implemented. More studies can and should be done to fine tune the mechanism.
“But in the meantime, in the spirit of Asean camaraderie, no member country should be allowed to take advantage of other member countries in an unfair manner. More so on issues so crucial and critical to the lives and medical welfare of their citizens. It’s simply not right!”
As a long-term solution to address shortages of professionals in various industries across the region, Abdul Rahman urged Malaysia, as current chair of Asean, to spearhead the creation of a shared talent pool of industry professionals. Member nations can draw on this pool via a G2G understanding.
“Malaysia is increasingly being recognised as a destination for quality but cheaper education, which explains the demand for our doctors and nurses in Singapore.”
According to a parliamentary reply in Singapore in 2022, the proportion of non-resident doctors in Singapore who were foreign trained stood at 6 per cent out of 15,423 doctors with active practicing certificates as of December 31, 2021. The main source countries were India, Malaysia, Myanmar, the Philippines, and the United Kingdom.
As for nurses, Singapore’s The Straits Times reported that in 2022, about 25 per cent of registered nurses in Singapore were foreign. Some 13 per cent of registered nurses in Singapore are from the Philippines, followed by Malaysia (5.7 per cent), Myanmar (2.4 per cent), India (1.3 per cent), China (1.27 per cent), and elsewhere.
The number of Malaysian registered nurses working in Singapore dropped from 2,321 in 2021 to 2,117 in 2022.
Prof Dr Adeeba Kamarulzaman, former dean of the Faculty of Medicine at Universiti Malaya, previously said in 2022 that the country’s top university loses at least 30 of its “best and brightest” medical students to Singapore every year.
Health Minister Dzulkefly Ahmad said in a recent written Dewan Negara reply that from 2020 to 2024, a total of 440 health care workers from the Ministry of Health (MOH) emigrated overseas, comprising 381 nurses (87 per cent), 54 medical officers (12 per cent), and five specialist doctors (1 per cent).
He did not specify the destination countries of these emigrating health care professionals.
It was the Najib administration that introduced the unpopular contract system for doctors in 2016 to reduce a glut of medical graduates waiting for housemanship.
Najib’s government also imposed a moratorium on new diploma-level nursing courses at private higher education institutions in 2010 that was only lifted on August 1, 2024, under Prime Minister Anwar Ibrahim’s administration.
Deputy Higher Education Minister Mustapha Sakmud told Dewan Negara that the moratorium had been put in place due to an excessive number of nursing courses.
Fast-forward to today, Malaysia is now facing dire shortages of medical officers, specialist doctors, nurses, and also medical assistants in the government health service.
Dzulkefly said last June that the MOH was having difficulty recruiting nurses despite available positions because “no one wants them.”
According to Public Service Department (JPA) data released to the Health parliamentary special select committee, the MOH had 14,731 vacancies for nurses and 11,776 vacancies for medical officers as of December 31, 2024. These two service schemes saw high vacancy rates of 18 per cent for nurses and 25 per cent for medical officers.
JPA data also showed that the number of filled positions in the MOH only rose marginally by about 4 per cent from 255,472 in 2016 to 264,523 in 2024, far smaller than the 19 per cent increase in approved positions in that period from 267,961 in 2016 to 318,885 last year.
In other words, although the MOH received 50,924 extra positions over the past eight years, only 9,051 additional officers came into service – translating to less than one officer for every five new positions. As of December 31, 2024, MOH had 54,362 vacancies, with a 17 per cent vacancy rate, up from 5 per cent in 2016.
