The worsening shortage of doctors in Sabah is no longer a routine healthcare management issue. It has become a clear reflection of the structural failure of the Federal system in guaranteeing Sabah’s fundamental right to equitable access to healthcare.
Sabah continues to face severe pressure on its public health system — including critical shortages of medical personnel, overcrowded government hospitals, and deteriorating healthcare facilities that have not kept pace with population growth. The gap in healthcare delivery between Sabah and other states in Malaysia is not only still present, but is increasingly widening.
Under the Federal Constitution of Malaysia, healthcare falls entirely under the Federal List. This places full responsibility on the Federal Government for hospitals, clinics, doctors, and the overall national healthcare system. Therefore, any failure in Sabah is not a minor administrative issue — it is a direct failure of the Federal Government.
However, amid the deepening crisis, a major question remains unanswered.
The special provision under Article 95B of the Federal Constitution, particularly the Ninth Schedule List IIIA (Supplement to the Concurrent List), once granted Sabah authority over “medicine and health” prior to its expiry in 1970. Since then, this authority has neither been restored, formally reviewed in public, nor replaced with any equivalent mechanism.
This raises a serious question: was Sabah deliberately stripped of healthcare autonomy without any proper reassessment of the long-term consequences?
More concerning is the fact that, to date, there has been no clear official position from either the Sabah State Government or the Federal Government on whether this provision should be reviewed or reactivated in light of the ongoing healthcare crisis.
At the same time, the situation is further aggravated by the unresolved implementation of Sabah’s financial entitlement under Article 112C of the Federal Constitution — which provides for 40% of net federal revenue collected from Sabah. The execution of this provision remains disputed, inconsistent, and unresolved.
This imbalance is now directly reflected in Sabah’s healthcare system: insufficient doctors, overcrowded hospitals, and services that fall far below the actual needs of the population.
In this regard, Dr Istefan Koh questions whether the Federal Government still has the political will to reconsider the existing constitutional framework, including the possibility of enacting special legislation under Article 95D of the Federal Constitution to provide Sabah with meaningful authority in healthcare financing and administration.
The lack of clarity, delayed action, and absence of structural reform only reinforce one reality — the current system has failed to protect Sabah fairly.
The Sabah State Government has issued a statement on the issue of the shortage of doctors in the state. However, the main question that now arises is to what extent will truly proactive follow-up actions be implemented, as opposed to just an announcement about the current situation.
The people of Sabah can no longer accept excuses.
They are facing overwhelmed hospitals, a critical shortage of doctors, and a healthcare system under severe strain.
And to this day, no real and decisive solution has been taken.
Dr istefan koh
Head of health bereau
Parti warisan
