By RASHAD ROLLE
Tribune Staff Reporter
AFTER years of enduring substandard working conditions and inadequate terms of service, doctors in the public sector have reached a breaking point, Dr Mucomba Miller, Acting President of the Bahamas Doctors Union, has warned.
He vowed the union will increase its efforts to have its concerns addressed, starting by publicising them.
“The breaking point is now. We haven’t seen this kind of action from doctors in about 20 years. We have a vibrant, active union that is trying to get things done,” he said.
“We have a culture where we are taught as physicians to endure and endure for the sake of the patient, for the sake of the job to ensure that the populous remains healthy. But we now see a shift in the age set of doctors. A lot more younger physicians are in the system and they don’t have much patience as someone in their late 30s and 40s. They want their careers to move forward and so we are seeing and will continue to see more pushing to get changes.”
Among the doctors’ concerns is their lack of holiday pay, which they are entitled to under the Employment Act.
They are concerned about the government’s failure to adhere to a recent Industrial Agreement by increasing the salaries of doctors employed by the Department of Public Health.
They also complain the Public Hospital Authority (PHA) deducts money from salaries of those who claim maternity and sickness benefits from National Insurance Board (NIB) that are “equal to the maternity benefits” female doctors receive from NIB, despite court rulings that suggest this should not happen.
They are also concerned that when working overnight they have found themselves sleeping amid crumbling infrastructure, including in rooms where “sewage infested waters” have exploded from ceilings.
“Doctors stationed on the Family Islands have to be available twenty-four hours of the day seven days of the week to handle emergencies,” Dr Miller added. “Some of these physicians do not get a day off, a weekend or even a holiday in order to serve the needs of the populace as they are the one physician on the island.”
Dr Miller said trying to get the union’s issues addressed is a monthly struggle.
“Every month since we signed that agreement we have been addressing this with them,” he said, adding communication with some officials has been subpar. He said after months of seeking a meeting with PHA’s managing director, one was finally arranged only after he spoke to the press about their concerns on Friday.
Industrial agreements between the BDU and the Ministry of Health and the Public Hospitals Authority (PHA) were signed in 2017 after many months of negotiations. Among other things, it allowed for salary increases, increase in disturbance, rental, relocation and education allowances and for lump-sum payments to be be made.
However, since then, doctors in public clinics have yet to receive their salary increase. “There’s a difference in the salary of people in public clinics and in PHA,” Dr Miller said. “We are all doing the same job but there is this disparity of about $600. We actually sat down with officials to address this and tried to be agreeable with them because we understand it’s a large amount of money. Their lawyers tried to put up a smokescreen but we tried to be agreeable; to date there has still been no progress.”
Doctors have received holiday pay only once since the industrial agreements were singed, Dr Miller said, adding: “We have written over and over and over again about it.”
Doctors are also concerned about having to attend to patients on private wards without pay, particularly when consultants paid to care for those patients rarely show up to do so.
“(Dr Duane Sands) said junior staff is supposed to see public and private patients,” Dr Miller noted, adding: “That’s understandable. However, it gets abused to the point where you can get admitted to the private ward and never see the consultant you are paying to take care of you. You would be seeing junior staff everyday; they would be the ones examining you while the consultant would call the junior staff to do a procedure on their private patient. If that junior staff encounters complications with the private patient, that patient can sue the government. We as taxpayers would end up paying for that whereas if the consultant performs the procedure and gets sued the money gets taken out of their insurance. It’s in these ways the abuses occur. Why are you calling your intern from the ward who is swamped with work to perform some routine lab work for a patient when you can order that in the day?”
Dr Miller also highlighted the concerns of doctors who sought private practice licenses in 2013 but were denied them months later after the new Medical Act 2014 came into force. The new Act prescribed different quality standards, but Dr Miller said it makes “no sense for the Caribbean”.
He said: “A number of doctors were just working in the system but never bothered for a private license even though they were qualified to get them. When they heard the law would change they applied in 2013 to receive the private license but the medical council held all their applications until May 2014. These people applied in December 2016 but their applications were held for six months and then they were summarily rejected.”
It is not clear when the union will pursue legal action to address some of its concerns. “I’m just a representative,” Dr Miller said. “If the body says they want to pursue the government for a judgement for these past years then that’s the course I’ll have to follow.”
As for Health Minister Dr Duane Sands and his performance in that role, Dr Miller said a “wait and see approach” has been adopted.
“We know Dr Sands the surgeon,” he said. “I’ve worked with him in the surgical department. My interactions were positive but politics is a different game. We don’t know Dr Sands the politician. We’ve had physicians who have become politicians before and some were good and some were not good. We’re taking a wait and see approach with him at this point.”