Just like the constant mutation of the coronavirus, the Jamaica Medical Doctors’ Association’s (JMDA) fight over demeaning work contracts seems a recurring issue, with ultimately one major casualty of the unending war – helpless citizens.
One year ago, under former president Dr Elon Thompson, and with local COVID-19 cases at a total 750 with 10 deaths, the JMDA’s battle cry was that of 120 doctors sidelined due to COVID-19’s pinch on the Government’s ability to pay them.
Fast-forward to last Friday, after issues over short-term work contracts forced a public health meltdown amid a total COVID-19 caseload of 50,242, with 1,082 deaths, newly installed JMDA president, Dr Mindi Fitz-Henley, is hoping another ‘sick-out’ will not be necessary next year, once the Government decides to take doctors seriously.
For now, the COVID-19 caregivers turned wage-warriors are standing down.
“This is going to end up being a yearly problem because every year at the end of the senior house officer period, which is a one-year contract, there is a surplus of doctors against no available contract or post,” Fitz-Henley explained to The Sunday Gleaner after 548 junior doctors called in sick last Thursday, sending the healthcare system into a frenzy.
She continued, “Every single year we are going to end up with the same problem; this is the same thing that happened last year. But the 120 doctors who were rehired then, the Government was able to show that there was a need for them to add more posts to the system and that’s the only way they could finance the payment.”
“That’s the same thing that needs to happen now. We do not want it to be a yearly event because the bottom line is there is no question that the doctors are needed. Right now we are operating on a negative,” she said, adding that the healthcare system has lost 100 doctors and that interns will not be added to the sector until September.
On Thursday, hundreds of patients turned up at public health facilities across the island unable to receive medical treatment, as no doctors were available. Some were forced to travel for miles home and back for appointments that had to be rescheduled.
Those doctors on the ground are trying their very best to keep things going, said the JMDA president, adding that the medical practitioners scored a brief win following a meeting with health ministry officials late Thursday evening.
“We were able to get them to recognise that they were in breach of the heads of agreement, as these contracts that they were offering to persons for July were only approved for persons who got contracts for March or April for the field hospitals or the COVID surge in specific units. By offering for persons in July, that was against what was previously agreed,” she said.
“So (at the meeting) all of those persons who were offered those (short-term) contracts were switched to three-year contracts in keeping with our heads of agreement. That was a very big win.”
Government agreeing to pay overdue gratuity was another plus from the sit-down.
Last week, Thompson supported calls from the current JMDA president for a “needs analysis” on doctors to be conducted in the healthcare system. Outside of that, the Government needs to be “straight up” with the doctors, he argued.
“We need to go into the hospitals and identify the areas of weakness in regard to human resources, equipment and so forth. There is a HR deficit and with the needs assessment we will find out what you need to make the system functional and effective and what you (government) can pay for it,” charged the immediate past president of the JMDA.
“They created a few posts last year and even with the creation of 120 posts, we are still not clear how many persons have been appointed. That’s another thing,” Thompson added, also levelling some of the blame on institutions like The University of the West Indies that churn out doctors yearly, with little acknowledgement of the realities on the ground.
“Again, the university will be disingenuous and say ‘well, there is a need’, but everybody knows there is a need except for the Ministry of Health, the employer. So ‘(as UWI) we just going to put out doctors; our job at the med school is just to put out doctors because med students are among the highest paying school fee people’,” he said. “There is a win-win until that doctor leaves medical school.”
Tempers flared last Tuesday night in a JMDA online meeting as members reacted to Government’s defiance over the concerns and the “disrespect” meted out by Health Minister Dr Christopher Tufton and members of the affected health regions.
Among those hit hardest by the implications of the short six-month/one-year contracts were pregnant doctors who, if repeatedly given short-term contracts, will not be eligible for maternity leave over a three-year period.
“I already think that our maternity laws are foolish but this makes it worse if in your first year of employment you get pregnant and you are given a six-month contract as an intern and as an SHO you have one year,” one pregnant doctor shared with The Sunday Gleaner, who asked not to be named.
“If the health regions are allowed to give six-month and one-year contracts, at what point is a woman legally eligible for paid maternity leave? I am a pregnant doctor and I realise that where we are heading at no point, based on these contracts, is the woman truly eligible for paid maternity leave.”