KUALA LUMPUR, March 3 — A public health medicine specialist has called for a detailed review of administrative posts in the Ministry of Health (MOH), saying positions currently held by the elite administrative and diplomatic service (PTD) could be gradually filled by technically trained health professionals.
Former MOH disease control deputy director Dr Zainal Ariffin Omar said the core issue is whether a “generalist” administrator or a specialist with clinical and managerial training is better suited to navigate the complexities of health care delivery.
“The MOH and the Public Service Department (JPA) should conduct a detailed study of each administrative post,” Dr Zainal told CodeBlue when contacted.
“The goal would be to consider filling these positions gradually with technical officers, which could include not only public health medicine specialists (PHMS) but also other allied health professionals who have received extensive training and exposure in health system management,” he said, adding that PTD officers remain relevant in certain functions at headquarters and state level.
Dr Zainal previously served as state health director for Negeri Sembilan and Pahang, and is a former president of the Malaysian Public Health Physicians’ Association (PPPKAM).
His remarks come amid debate over whether the generalist PTD scheme suits a highly specialised health system, alongside calls for a Health Service Commission to give MOH greater control over workforce governance.
Dr Zainal said public health medicine specialists undergo structured, Malaysian Medical Council (MMC)-approved postgraduate training that equips them with competencies beyond clinical knowledge, including health policy, epidemiology, biostatistics, environmental health, and health services management.
Their training also includes field exposure in policy consultation, programme planning, and risk investigation, preparing them for roles across district, state, and national levels.
“PHMS are technically competent, exhibit ‘leadership and managerial expertise’, and are able to perform duties at local, district, state, and national levels,” he said. “They are trained to be effective in health care organisations, hospitals, consulting firms, and community health agencies.
“While their clinical training covers areas like occupational and environmental health, the curriculum is specifically designed to equip them for high-level health systems management, policy formulation, and service coordination.”
Dr Zainal added that public health medicine specialists have historically held leadership roles across the health system, including at state, hospital, and district levels, often alongside medical doctors with additional training in public health or hospital administration.
At the hospital level, Dr Zainal said the current system already includes both medical and administrative deputies, and suggested that a model involving medically trained or public health-trained deputies could strengthen decision-making.
“Both director and deputy would possess a deep understanding of public health principles, epidemiology, and health system challenges, potentially leading to faster, more informed decisions,” Dr Zainal said.
“They could focus on broader strategic vision, external stakeholder engagement, and clinical governance, and PHMS could also concentrate on operationalising health policy, managing population health programs, and overseeing the administrative machinery (finance, HR) with a health-specific lens, rather than a generic civil service one.
“The distinction would be less about ‘clinical versus administrative’ and more about ‘strategic versus operational’ leadership within a specialised field,” he added.
At the federal level, Dr Zainal said the secretary-general (KSU) of MOH need not necessarily be a medical doctor or public health specialist, but should have strong experience in public service and technical administration.
“The KSU is traditionally a PTD generalist responsible for overall ministry administration and finance. KSU should be anybody – not necessarily a medical doctor or PHMS – who has good knowledge and experience in general public service and technical administration.
“There was a precedent when KSU Zaini Ujang was appointed as KSU of the Higher Education Ministry and MOH. He is an ex-lecturer from Universiti Teknologi Malaysia (UTM).
“The alternative, proposed in health service reform discussions, is to have an ‘open system’. The KSU should be a health systems expert (any professional) with qualifications in health administration,” Dr Zainal said.
He said this ensures that the management of the ministry’s vast resources is guided by expertise relevant to the health sector, rather than a one-size-fits-all civil service model.
“In short, I believe in an ‘open system’,” Dr Zainal said, adding that competent professionals from allied health backgrounds could also take on administrative roles. “Current PTDs are not all from admin or business. Some of them have an admin STEM background.”
“Jawatan strategik di KKM tak semestinya mesti ‘doktor’. Competent professionals from allied health also can be in administration, though PHMS have additional advantage of more knowledge, skills, and wider exposure to manage the big scope of public health and important resources,” he added.
PHMS, PTDs Serve Distinct But Complementary Functions
Public health medicine specialist Prof Dr Jamalludin Ab Rahman cautioned against framing the issue as a replacement of PTD officers, saying both administrative and technical expertise are required in a functioning health system.
“This is not about replacing PTD officers with PHMS, but ensuring both are utilised appropriately,” Dr Jamalludin told CodeBlue. He is also a former president of the Malaysian Public Health Physicians’ Association (PPPKAM) and currently campus director at International Islamic University Malaysia (IIUM) Kuantan.
“PHMS brings strength in epidemiology, disease control, health systems, and programme leadership. PTD officers bring strengths in governance, finance, human resources, and administrative management. Both roles are necessary and complementary for a well-functioning health system,” Dr Jamalludin said.
He added that technical expertise may be more readily adapted to administrative roles than vice versa.
“It is easier to train technical experts like PHMS in administrative matters than to train administrators to acquire specialist public health expertise.”
Dr Jamalludin said public health medicine specialists are trained in population health, including disease surveillance, prevention and control, health systems planning, and public health programme management, with leadership training grounded in real-world health system practice.
“They provide technical leadership to guide policies, programmes, and health system decisions,” he said, adding that their role is comparable to clinical specialists, but focused on population-level outcomes rather than individual patient care.
He said public health medicine specialists are best positioned to lead in technical and institutional areas such as epidemiology, disease control, and health systems planning, where their expertise ensures policies and programmes are evidence-based and aligned with actual system needs.
While some may move into broader administrative leadership roles over time, Dr Jamalludin noted that career progression pathways for public health specialists remain limited, as advancement is still largely tied to general management or administrative posts rather than specialist technical leadership.
He also cautioned against conflating health workforce shortages in hospitals with the role of public health specialists.
“PHMS are specialists in population health, not hospital-based clinical specialists providing direct patient care,” Dr Jamalludin said.
He stressed that each specialist group serves a distinct function, and workforce planning should reflect the specific competencies required, rather than assuming interchangeability across roles.
On leadership, Dr Jamalludin said effective governance in MOH requires both strong administrative capability and deep understanding of how the health system functions on the ground.
He noted that administrative roles focus on ensuring systems and organisational processes run smoothly, while leadership involves setting direction and guiding the system’s overall mission.
“The most effective leadership structure is one where strong administrative capability and technical health system expertise work together to ensure the Ministry functions effectively and serves the health needs of the population,” he said, although he acknowledged that such a balance is not always achieved in practice.
CodeBlue previously reported calls to reform or phase out the generalist PTD scheme, with critics arguing that its rotating structure is ill-suited to the growing complexity of health system management.
The analysis noted that over 700 PTD positions in MOH are concentrated in hospital management, state health offices, and human resource divisions, raising concerns about whether generalist administrators can effectively oversee technical areas like workforce planning and service delivery.
Separately, a CodeBlue-published letter by a government doctor framed ongoing doctor shortages as a symptom of deeper structural issues in health governance, calling for the establishment of a Health Service Commission.
The proposal argues that centralised control by the JPA and Public Service Commission (SPA) has limited MOH’s ability to manage recruitment and staffing based on actual system needs.
