KUALA LUMPUR, Jan 29 — The Regional Incentive Payment (BIW) is not a privilege but a critical policy instrument to ensure equitable health care in East Malaysia, Bandar Kuching MP Dr Kelvin Yii told Parliament today.
Speaking during the motion of thanks on the Royal Address, Dr Yii said recent cuts and restructuring of BIW have disproportionately affected health care workers serving in Sabah, Sarawak, and Labuan – regions already grappling with doctor shortages, geographical challenges and higher living costs.
“BIW is not a privilege,” Dr Yii said, referring to concerns raised by the Malaysian Medical Association (MMA) over official characterisations of the allowance. “It is an important policy instrument to ensure fair and sustainable health services in regions facing workforce shortages and structural challenges.”
The DAP lawmaker highlighted Sarawak’s ongoing difficulty in attracting and retaining doctors, citing data showing that 43 per cent of medical officers posted to the state failed to report for duty.
Dr Yii said this reflects a serious recruitment and retention problem that could worsen if incentives are weakened.
Sarawak’s doctor-to-population ratio currently stands at about one doctor for every 510 people, compared with the national average of one doctor per 406 residents, he added.
This translates into roughly 21 per cent fewer doctors per capita than other states, with hundreds more needed, particularly in specialist fields.
Under the new public service remuneration structure, newly appointed medical officers posted to East Malaysia now receive a flat BIW rate of RM360 per month. This replaces the previous progressive system based on a percentage of salary, under which the allowance could reach up to around RM1,000 monthly.
Dr Yii described the change as a “significant reduction” that risks undermining morale and discouraging health care workers from serving in more challenging postings.
Citing MMA estimates, he said restoring the earlier progressive BIW system would cost about RM4.2 million a year, based on roughly 700 new medical officers posted annually.
“This is a small amount in the context of national expenditure,” Dr Yii said, adding that the returns in terms of service continuity, patient safety and workforce stability would be substantial.
Failure to address the issue could further deepen Malaysia’s health workforce crisis and accelerate the outflow of medical professionals overseas, he warned.
About 30 per cent of Malaysian medical graduates reportedly choose to work in Singapore, drawn by better pay and clearer career pathways.
“This issue is not merely about allowances,” Dr Yii said. “It is about regional equity, recognising the sacrifices of health care workers, and the government’s responsibility to ensure equitable access to health care for all Malaysians, regardless of where they live.”
Dr Yii urged the government to review the BIW cuts and reinstate the previous salary-based system, calling for transparent consultations involving the Health Ministry, the Public Service Department and professional bodies.
“Investment in health care workers in East Malaysia is not a financial burden,” Dr Yii said. “It is a strategic investment in the resilience of our national health system, patient safety and the well-being of the people.”
The BIW issue has sparked controversy following remarks by a minister who described the regional incentive as a “privilege” rather than an entitlement, drawing strong pushback from health care workers and professional groups.
Medical associations and doctors have warned that cuts to BIW under the new public service remuneration system risk worsening staff shortages in Sabah and Sarawak, where hospitals already struggle to retain doctors.
