The strike by junior doctors yesterday being monitored by police officers. The Bahamas Doctors Union said more than 400 junior doctors took part in the action.
By AVA TURNQUEST
and FARRAH JOHNSON
Tribune Staff Reporters
aturnquest@tribunemedia.net
FED up with a lack of a resolution over longstanding disputes, more than 400 junior doctors went on strike yesterday forcing the nation’s public healthcare system into “emergency mode”.
Of that number, approximately 200 physicians were on call throughout the country’s network and were resolved to only work on emergency cases, according to Bahamas Doctors Union President Dr Melisande Bassett.
The BDU was called to the Office of Prime Minister Dr Hubert Minnis for an impromptu meeting around 3.30pm in the hope of deescalating tensions and bring both sides back to the table, The Tribune was told.
Labour Minister Dion Foulkes said the meeting was very productive, with a clear path outlined for negotiations chaired by Labour Director John Pinder to resume at the Department of Labour next week.
However, up to press time it was not clear whether the union would end its strike.
The strike has drawn support from several unions, all of which have expressed dissatisfaction over the government’s handling of labour disputes in recent months.
Bahamas Nurses Union President Amancha Williams threatened related health service unions would coordinate efforts to “shut PMH down” in support of doctors if needs were not met.
According to BDU, no essential services were affected as senior doctors, under the Consultant Physicians Staff Association, were still on duty.
“We have emergency staff in house,” Dr Bassett said, “most of the doctors are on the compound. We are here for emergency purposes. The main thing that persons felt was clinics are closed and only emergency surgeries were done. We are still ensuring patient care is not interrupted.”
Dr Bassett explained the decision to make good on a strike certificate obtained last year was prompted by repeated failures on the part of the Public Hospitals Authority to negotiate in good faith over holiday pay; and the issuance of one-year contracts despite assurances from Health Minister Dr Duane Sands that the practice would stop.
She insisted the new PHA board was exclusively concerned with its bottom line and insensitive to the challenges faced by junior doctors.
“Another thing I want to point out is an erroneous figure the PHA has been putting out there,” Dr Bassett said, “as to what we actually take home. We do not take home $80,000, most doctors take home less than $45,000 (a year). We have our base salary and on call allowance but (PHA) makes provisions in their budget for things that we never see. The education loan, they refuse to pay that when we request that. The uniform allowance is a one-time fee so we certainly don’t take that home.
“The pay for meals, we do not see that. We do not get that. And many of us are even not afforded the meals that are listed within our industrial agreement. The medical insurance, not all of us are a part of the medical insurance because it offers very little benefits. I think it’s at a D-level so many have their own private insurance. I don’t think half of the union has signed up for it, if 100 doctors.
“They need to be honest with what they put forward,” Dr Bassett said.
She insisted their grievances were not only about money as she laid out demands for the resolution of several vexing issues before the strike is called off. The union wants intern housing to be reinstated, and greater attention given to the needs of doctors in Grand Bahama who don’t have a proper on-call suite and are allegedly being denied vacation time and casual leave.
“We’ve filed a trade dispute since 2014, we’ve had meetings back and forth, they’ve vacillated, they say they’ll pay, they start to pay, then they’ll stop,” Dr Bassett told reporters outside Princess Margaret Hospital yesterday.
“We’ve had demonstrations, we’ve threatened strike action in the past, we’ve come back to the table. Most recently they told us they would pay us over five instalments and based on availability. To us that is unacceptable and along with the other issues that we face we need resolution.
“The minister assured us that the one-year contracts would stop. However, PHA has just recently given us notification that they will continue to give one, two and three-year contracts when we’ve never had that in the past.
“We expressed to them the difficulties doctors have in getting a simple car loan, a simple mortgage, that has fallen on deaf ears,” she said.
“We think that is a slight and a slap in the face. The vacillation and the fact that we can’t get a definitive answer and just decent dialogue is just part of our issue and things we need to resolve.”
Yesterday Dr Sands told The Tribune he did not think the union needed to resort to a strike to achieve a resolution.
He said he did not want to inflame the matter further, but noted the doctors appeared unwilling to document their working hours.
“I think this is a very unfortunate matter,” Dr Sands said. “We have spent so much time dealing with this and reached a reasonable path to resolution, and it results in patients being denied care. We are now in emergency mode.
“We met with (the) union, we made it very clear the ministry does not support, as a policy, one-year contract for doctors. The challenge of this vacation time is that we need to be able to determine who to pay, and for what, because the doctors are unwilling to have any means of documenting that they are working. We are going to meet as an executive administrative team to try and get this matter because the public is suffering.”
On the matter of documenting work hours, Dr Bassett said the union agreed to a reimbursement form under the former PHA board. She said the new board does not recognise the form and is trying to implement “swiping in to be paid”.
“The issue with swiping in, as we’ve pointed out before, we have satellite clinics that don’t have the means to account for time that doctors do attend work,” she said. “We leave from the hospital, go to these satellite clinics, there isn’t any means of swiping in there.”
The strike follows a mass exercise last year November, when nearly 600 frustrated senior and junior doctors withdrew services over outstanding physician reimbursements and improvements to base salaries.
Representatives from the Bahamas Public Service Union, BNU, the Union of Tertiary Educators of the Bahamas, Union of Public Officers and the Trade Union Congress stood in solidarity with the BDU at the hospital yesterday.
Obie Ferguson, TUC president, stressed public holiday pay is a statutory right that was non-negotiable, and called on the government to resolve the matter immediately.
On behalf of BNU, Ms Williams said: “We will take a stand, if the nurses have to come off the job, we will do that to take a stand with our congress. We are not playing no jokes. We want the money to be paid to the doctors so the Bahamian people can get quality service as needed today.
“So those that are in power, please we don’t want you just to acknowledge, we don’t want you just to call, we want you to make the change today and we will wait patiently and we will stick together like sardines in a can. That’s how we moving.
“The doctor can’t work without the nurse, the nurse can’t work without the auxiliary, the auxiliary can’t work without the gardener…we all will shut PMH down and they have concerns all around here. Our workers here are going through a very stressful time.
“Air-conditions off, the roof leaking, right now presently you have bins all over the place which is a hazard, mould... look at the workers outside they ready to go,” Ms Williams said.
Comments
Chucky 5 years, 2 months ago
Disgraceful to pay doctors 45k
They should all leave and go work in USA for 10 times that
Government taking monies/taxes for healthcare and then starve the doctors.
All those elected are a disgrace.
Sure they’re doctors, and all people rich and poor need them. But that doesn’t mean they have to study 10 years and government can rape them for cheap wages. It’s their own labour and they have a right to be paid properly for it. If not here at home, than who can blame them for going where the money is.
buddah17 5 years, 2 months ago
Sure... Go to America. They can get (say) $70K to start. Less taxes, (say 25-35%) and less medical malpractice insurance. (For a surgeon this can run up to OVER $200K a year.) NOT to mention school loans! (For most doctors mean an additional $150K + long term loan payback...)
Chucky 5 years, 2 months ago
45k a yr in the Bahamas is ghetto house and old beat up car wage.
Doctors in USA live better than you can for 250k a year here.
concernedcitizen 5 years, 2 months ago
read carefully what he is saying , Bassett . These Doctors got an education loan from the government and signed a contract that to pay it back they would work for government at a certain rate .When he says they don't see the education loan , of course they don,t see the cash , part of their salary goes to pay back the loan , when he says they don't see the meal money of course they don,t the money goes to the vendor or vouchers to feed them .However that is all part of their pay in the agreement they signed w the government to pay their tuition .
Porcupine 5 years, 2 months ago
Dr. Sands says, "We are now in emergency mode." Perhaps this can be the new slogan of the next political party that would claim "It's the people's time" or some other meaningless choice of words. Picking up the newspapers each day leaves a thinking person to question if there are other thinking people in this..................................... Which sector in this country is not in emergency mode at present? And, how did we get here? You can't make this stuff up.
Well_mudda_take_sic 5 years, 2 months ago
These so called 'junior doctors', a term that no self-respecting true medical doctor would accept being called, brings into question the qualification of these UWI trained healthcare professionals to practice medicine as true medical doctors. I suspect the medical training received by these individuals may be, at best, on par with what one would expect of a junior physician assistant in many developed countries. If these aggrieved 'junior doctors' were indeed true medical doctors, they would all too easily be able to tell the Bahamian government to 'shove it' as they packed their bags and headed off to the U.S. to write state board licensing and other certification exams to enjoy a lucrative career as an MD. But its unlikely these so called 'junior doctors' have received the level of academic and clinical training that would enable them to pass the necessary exams to practice as an MD in the U.S., Canada or U.K. As a result they are trapped here in the Bahamas as lowly paid unionized labour which suits our government healthcare system and private healthcare insurers just fine from a cost standpoint.
It's a well known that in recent times very few Bahamian MDs who have received their academic and clinical training in North America or the U.K. have returned to the Bahamas to practice medicine on a long term basis, if at all. And that's because of the great shortage of truly qualified MDs in the U.S., Canada and U.K. which helps put these true Bahamian MDs in the driving seat when it comes to compensation negotiations with their foreign employer.
And it doesn't take a rocket scientist to figure out what these dynamics mean for the quality of healthcare available to Bahamians in their own country today. Oh well, the UWI is at least profiting from finding a niche market in the Caribbean/West Indies region for 'junior doctors' trained to a level that leaves them unpoachable by the developed countries. My comments here are not intended to be disparaging of the striking 'junior doctors', but rather an eye-opener to the reality of the financial and other forces behind the poor state of our country's healthcare system today.
Porcupine 5 years, 2 months ago
And your comments are appreciated. Definitely something we need fixed ASAP. The tools on the table are the ones we will use to fix our problems. All ideas, diversity of opinion, are what is needed in these troubled times.
ThisIsOurs 5 years, 2 months ago
I agree with @catisland. There's a misunderstanding of the role of a junior doctor. It would be like saying no self respecting employee would call themselves an intern. The junior doctor's role from my understanding is to do the grunt work under the supervision of a senior doctor and to gain necessary experience to move to the next level which could be a fellowship. Hopefully one day they'll have superior knowledge have their own junior doctors to train.
KDL 5 years, 2 months ago
You are either insane, completely misinformed or both. UWI trained doctors are some of the best there are. Our UK and US colleagues cannot compare to us when it comes to clinical skills or diagnostic ability. And this is well know. UWI trained doctors are practicing at the highest levels all over the world and the university is well known and respected in many academic institutions in the US, UK and beyond. The term junior doctor simply refers to young doctors who either are interns and have not entered into specialisation as yet or have just entered and are not at the levels of registrars and consultants. The assumption that all doctors want to work in the US or UK system is a foolish one. If they all did that who would you have to serve the Caribbean. People have their families and their lives here in the region. In addition US and UK exams are expensive. Not only that but given the ridiculous hours doctors are asked to work many do not have the extra time required to focus on studying for the boards. The US exam is structured very differently as is the entire education system. Everything isnt about money and the grass isn't always greener on the other side. You clearly have no idea what you are speaking of and I find your ill informed, condescending comment highly inaccurate and insulting. Long rubbish comment!
KDL 5 years, 2 months ago
You are either insane, completely misinformed or both. UWI trained doctors are some of the best there are. Our UK and US colleagues cannot compare to us when it comes to clinical skills or diagnostic ability. And this is well know. UWI trained doctors are practicing at the highest levels all over the world and the university is well known and respected in many academic institutions in the US, UK and beyond. The term junior doctor simply refers to young doctors who either are interns and have not entered into specialisation as yet or have just entered and are not at the levels of registrars and consultants. The assumption that all doctors want to work in the US or UK system is a foolish one. If they all did that who would you have to serve the Caribbean. People have their families and their lives here in the region. In addition US and UK exams are expensive. Not only that but given the ridiculous hours doctors are asked to work many do not have the extra time required to focus on studying for the boards. The US exam is structured very differently as is the entire education system. Everything isnt about money and the grass isn't always greener on the other side. You clearly have no idea what you are speaking of and I find your ill informed, condescending comments highly inaccurate and insulting. Long rubbish comment!
KDL 5 years, 2 months ago
jun·ior doc·tor nounBRITISH a qualified doctor practicing at any stage between graduation and completion of specialist postgraduate training.
And to think a simple google search could have cleared this up.for you and saved you the time and effort it.took you to write this ill informed piece. The only real eye opener here is how quickly people are to jump to judge young, hard working professionals over something as simple as a title which is used throughout the world. All this while avoiding the huge issues at hand. Nobody should have to work the kind of hours doctors do. On call is inhumane and outlawed in many developed countries. Worst yet to work for pennies. When I started internship I got one day off a month...let that sink in. Ask yourself in which world that could be fair or right...a young wife and mother. I worked 36+ hours straight twice a week. At least we are compensated for our bank holidays here. I am not from the Bahamas but I throw my support 100% behind these doctors. My only wish is that the doctors in my country had the guts to do something like this. And I know people will say that is what we signed up for but you shouldnt have to give up your entire life to save the lives of others!
ThisIsOurs 5 years, 2 months ago
I agree with most of what you said. I'm not sure where @mudda's misconception comes from about UWI. Their program as far as I know is very rigorous. And those doctors shine when put into international programs. Are there anomalies? Sure, as in every profession.
As to "on call" being outlawed. In the US doctors work heavy service hours on rotation. I believe their rules specify how much rest time they should have in between but they're still required to do the extended shifts. And the rules don't save you from horrible shifts...It's just the nature of the profession. I don't think Dr Sands could complain when they call him out his bed 2am in the morning to perform surgery on a gun shot victim .
Maybe the issue is injecting realism into what it means when out of high school a student says "I want to be a doctor"
KDL 5 years, 2 months ago
While I fully accept that doctors will inevitably work longer shifts than most, in many countries caps have been placed on the number of hours doctors can work. This will vary from place to place. In some cases 16 hours is the maximum while in other 24hr shifts are acceptable. Within our systems we have no such caps. We work as long as it takes to get the job done and in the case of junior doctors, until seniors release them. I also think that while persons need to be given realistic expectations of what it means to be a doctor, we need to lobby as professionals to make conditions better to work in. There is no sense in continuing in a system because "this is how it has always been." A burnt out doctor cannot function at full capacity and the medical profession is notorious for high levels of burn out among workers. At the end of the day the patient suffers. And these statements are all backed by well researched studies (although to be honest this should be common sense). We owe it to ourselves and to our patients to do better. It starts with us identifying unreasonably long hours, and lack of an acceptable work life balance as real problems that threaten our ability to make the best decisions and deliver good patient care. If persons don't see the problem and just view it as the way things are, there will be no drive to find solutions. And I strongly believe there are solutions! So yes I agree sacrifice is necessary and definitely it isn't the glamour persons see on TV and young people must understand this before they get in to the field. However, if we are to practice evidence based medicine we must apply the evidence about ourselves to ourselves. As the old adage goes physician heal thyself.
joeblow 5 years, 2 months ago
This is a two way street, doctors deserve to be fairly treated and compensated, but the public deserve for them to do their jobs professionally, efficiently and competently! Sadly, too many do not do their jobs properly!
TalRussell 5 years, 2 months ago
What a screw-up by the comrade governing illiterates despite their medical training who have failed to understand what must be done brungs PMH out from under third world hospital status, yes, no .... a government that sits ignoring taking action until it's time rungs emergency alarms bells to shout, FIRE at PMH .....Prepare Evacuate!! ....
CatIslandBoy 5 years, 2 months ago
The term "junior doctors" does not refer to their level of expertise, but instead their time of serving at PMH. To compare them to Doctors serving in the United States maybe unfair, but K$45 as a salary is still low. On the other hand, while the pay of public servants in general need to be in improved, a conversation is definitely to be had regarding funding sources.
concernedcitizen 5 years, 2 months ago
The whole truth is not being told , many of the Doctors got help w their university fees at UWI and in Cuba from the government and signed a contract that upon getting their medical licsense would do so many years in the government hospitals and clinics at a reduced rate of pay to pay back their tuition
Damifiknow 5 years, 2 months ago
How’s that national health care scheme working out for you!
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