LETTER | We welcome the announcement that the government has postponed the removal of the critical service incentive (BIPK) for new appointees to 33 civil service categories beginning 1 Jan 2020.

We were especially concerned that the BIPK will not be provided to new dentists, doctors, medical assistants, nurses and pharmacists starting their service after that date.

As responsible partners of the government, we urge the government to completely reinstate the BIPK.

In addition, we urge the government to appropriately improve the terms of service of all health professionals to retain talent inside the civil service.

As responsible Malaysians, we applaud, respect and support the government’s duty to be fiscally responsible and to demonstrate good financial governance.

We acknowledge that the BIPK, which was introduced in 1992 to attract talent in critical roles in the civil service, is not a permanent allocation and is subject to periodic reviews.

However, it is disappointing that the 2019 review determined that 33 service categories no longer fulfil the talent attraction criteria for BIPK, including the five largest categories of staff in the Health Ministry.

The current over-supply of health professionals is partially because the Health Ministry needs more posts to deliver effective healthcare to Malaysians.

There are also ten other criteria to decide on the BIPK, and health professionals fit at least seven of them: cost of living, hardship, specialisation, additional competencies, uniqueness of service, importance of retention, and encouragement.

We stress how critical our health professionals are. Our 130,000 dentists, doctors, medical assistants, nurses and pharmacists save lives in cities, villages and remote jungles from Arau to Tuaran.

They work long hours in an “underfunded, understaffed, overworked and overstretched” service, sacrificing nights, weekends and holidays at the physical and emotional cost to themselves and their families.

Many are motivated by duty and patriotism, remaining in the civil service despite better pay and environment in the private sector or other countries.

Malaysia must appreciate their service and sacrifice, by adequately compensating our health professionals in financial and non-financial terms.

The decision to remove BIPK could reduce the effectiveness of the health service, already suffering from fewer positions and an emphasis on contract over permanent posts.

In the short-term, the morale and stature of the health professionals could be negatively affected.

In the long-term, we could reduce our ability to attract talented Malaysians to our health service and see more departures to the private sector or to other countries.

All this could reduce the effectiveness of our health service, which will affect the health and well-being of all Malaysians.

We urge the government to reinstate the critical service allowance for all five categories of health professionals.

Firstly, health is a critical profession, and it is unjust that health professionals are not fairly compensated for the same work and in the same service grade.

The BIPK can be 15 to 25 percent of take-home pay, a significant amount when the cost of living is rising.

If Malaysians want good healthcare, then we must first help our health professionals to adequately care for their own families.

Their services and sacrifices cannot be taken for granted, as they are also humans and citizens with rights, emotions and personal needs.

Secondly, the morale and dignity of the profession must be preserved.

Labelling health as non-critical is a signal that health is not important, which can reduce the public’s trust in our health service.

It can also affect the stature and morale of the professions, or even signal to young Malaysians that the health sector has no viability.

Financial compensation in the civil service already lags behind the private sector, and therefore the moral support of the government is crucial.

Thirdly, we must work hard to attract and retain talent in our public healthcare service.

The private healthcare sector in Malaysia and elsewhere already pays much more than our public sector, even with the BIPK.

Therefore, appropriately increasing the salaries of our health professionals is the correct direction.

The Malaysian public healthcare service cannot lose the human capital that we have invested in over the years, especially to other countries.

Finally, we want to enhance the effectiveness of public healthcare service.

Public service cannot deliver effective care if its professionals are not compensated fairly, have low morale, are distracted by the reality of their financial commitments, or constantly leave the service.

This has negative consequences for the effectiveness of our health service.

As responsible citizens, professionals and partners, we will continue our service with passion.

While we are aware of broader macro-economic issues of fiscal sustainability and stagnant wages, we highlight these other considerations in our desire to continue delivering effective healthcare to all Malaysians.

Healthcare is a critical service to Malaysia, and better health will lead to social and economic progress.

We urge the government to reinstate the critical service allowance for all five categories of health professionals, for better terms of service for all civil servants and to deliver effective healthcare to all Malaysians.

The above is signed by Dr Khor Swee Kheng, Amrahi Buang (Malaysian Pharmaceutical Society president), Dr Ganabaskaran Nadason (Malaysian Medical Association president), Dr Leong Kei Joe (Malaysian Dental Association president), Mustafa Abd Majid (Malaysian Association of Medical Assistants president) and Sharipah Asiah Syed Junid Aljunid (Malaysian Nurses Association president) on behalf of the professional associations mentioned.