To the leadership of the Ministry of Health (KKM) and to all Malaysians who depend on our public health care system, I write this open letter with a sense of urgency and disappointment, following recent statements that KKM will “slowly discuss agreements” to prevent doctors from migrating.
This sudden concern, while welcome in theory, raises a difficult question: why is action only being considered now, when the warning signs have been visible—loudly and repeatedly—for more than ten years?
For over a decade, Malaysian doctors have voiced the same issues: chronic underpayment, the destabilising contract system, severe understaffing, and the escalating workload placed on a shrinking workforce.
These were not mere grumbles from a few individuals. They were consistent, nationwide warnings from house officers, medical officers, specialists, and professional bodies. Our concerns were documented, measured, repeated, and accompanied by clear solutions.
Yet the response was silence, delay, or temporary cosmetic measures.
Instead of prioritising workforce stability, the Ministry pressed on with expanding services, launching new initiatives, opening new clinics, and meeting KPIs designed for public display rather than system sustainability.
We watched as expectations increased while manpower dwindled. We watched our colleagues burn out. We watched talented doctors leave for countries where their skills are valued and their sacrifices respected. And we watched KKM treat each departure as an unfortunate but isolated event, rather than the symptom of a deeper structural failure.
Today, when the system is visibly strained and waiting times, service delays, and manpower gaps can no longer be hidden, we suddenly hear about “talks” to stop migration.
This reactive posture is not a sign of strategic leadership. It is a sign that the crisis has finally reached a point where the public is feeling the consequences—and only then does the Ministry respond.
The issue of underpayment, especially, has been long dismissed. But underpayment is not simply about financial dissatisfaction. It is a reflection of value. When a doctor earns less than RM12 per hour during a 24-hour on-call—while managing life-threatening emergencies, bearing legal risks, and carrying the emotional burden of life and death decisions—the message received is unmistakable: our welfare is not a priority.
Doctors are not asking for luxury; they are asking for fairness. They are asking for a wage that reflects responsibility, severity of workload, and international benchmarks.
Similarly, the contract system—introduced in 2016 and repeatedly labelled “temporary”—has produced exactly the damage doctors predicted from day one. It fractured the medical career pathway, created uncertainty for specialist training, and robbed young doctors of long-term stability. Many left simply because they saw no future in a system that refused to guarantee one.
None of these outcomes are surprising. They were forewarned. They were preventable.
The irony today is painful. After years of dismissing the structural problems driving doctors away, KKM now seeks “agreements” to keep them in the country. But retention cannot be achieved with committees, dialogues, or promises of future meetings.
Retention requires structural reform: fair pay, a clear and respected career pathway, humane workloads, safe staffing levels, and leadership that listens before the crisis erupts—not after.
Doctors do not want another round of “engagement sessions”. We do not want more surveys or task forces that take months to produce predictable conclusions. What we want is decisive action. What we want is acknowledgement that years of silence and delay contributed directly to the current crisis.
And what we want, most of all, is a health care system where the people running it—its doctors, nurses, pharmacists, and allied health staff—are treated with dignity, fairness, and respect.
Malaysia’s doctors are not leaving because they lack patriotism. They are leaving because the system has made it increasingly difficult to build a stable, dignified, and sustainable career here. If KKM is serious about stopping the exodus, the Ministry must demonstrate that it finally understands this reality.
Because after a decade of warnings, memos, and pleas for help, the only thing that arrived slowly—far too slowly—was the response.
The author is a doctor working in the Ministry of Health. CodeBlue is granting the author anonymity because civil servants are prohibited from writing to the press.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
