Al-Ahram Weekly Online   2 - 8 April 2009
Issue No. 941
Egypt
 
Published in Cairo by AL-AHRAM established in 1875

Second opinions

Unity among doctors pressing for better pay and conditions is on the verge of splintering

An ordinary general assembly of the Doctors' Syndicate was called last Friday amid growing differences among the profession on how best to pursue their demands for better pay and conditions, reports Reem Leila. The general assembly, which was attended by nearly 5,000 doctors, convened to discuss the protest scheduled in front of the Ministry of Finance on Tuesday 31 March at 2pm, and a second demonstration, to be staged before the People's Assembly (PA) as it discusses the government's general budget. Private clinics will also be closed on Thursday 9 April.

The group Doctors Without Rights (DWR) stressed in a statement that Tuesday's strike was not simply to protest that the second stage of agreed allowance payments has not been paid but to press a range of doctors' demands.

DWR have pursued their campaign for a basic minimum wage for over a year. "Steering the protest in this direction of course removes any mention of the minimum wage from doctors' demands, which has been a fundamental demand in every syndicate general assembly held since 1 February 2008," the statement said.

While the campaign was initially backed by the Doctors' Syndicate, the syndicate board withdrew support after doctors voted for a two-hour symbolic strike during the general assembly. Syndicate chairman Hamdi El-Sayed dismissed DWR as unrepresentative of a majority of doctors. Two days after the syndicate's general assembly meeting, the board unilaterally postponed the strike -- saying that such action could not be taken until its legality had been established -- prompting DWR to stage a one week sit-in in the syndicate's Cairo headquarters following Tuesday's protest. According to El-Sayed, the syndicate's board agreed that doctors who want to protest can strike on 9 April by closing private clinics. Doctors working at both private and public hospitals are totally prohibited from striking in order not to jeopardise the health of patients.

"A case concerning the legality of strikes by doctors is currently being heard by the administrative court," said El-Sayed.

Khaled Abdel-Rahman, a member of the Doctors' Syndicate, pointed out that the syndicate's chairman agreed on 9 April action only because it is a Thursday, a day on which private clinics normally close. "The board do not want us to conduct a real strike. It is treating us like children by giving us a small toy to distract our attention from the bigger goal," he argued.

During the Doctors' Syndicate general assembly meeting El-Sayed quoted Prime Minister Ahmed Nazif as saying that incentive payments due to be received by specialists and consultants in June might not be paid because of insufficient funds. Nazif is reported to have announced on 7 March that the funds necessary to grant the incentive payments might not be available for another two years. It has also been suggested that the government is seeking halve the LE1 billion allocated for improving doctors' pay.

The DWR, which has been involved in a long-running campaign for a LE1,000 minimum wage for Ministry of Health doctors, criticised Article 3 of ministerial decree 318 -- which implemented the "doctor's incentive payment" scheme -- because it tied the payment of incentives to the "availability of finances". Mohamed Rakha, a doctor at Al-Abbasiya Mental Hospital, is sceptical of the government's claims that sufficient monies do not exist to fund the incentive payments. "It's a paltry sum. If there was real concern about doctors the government would find the money for these payments."

Abdel-Rahman Shahin, official spokesman at the Ministry of Health, insists that Health Ministry allocations from the overall general budget will not be reduced and the ministry is still proceeding with its plans to improve doctors' income.

"The five-phase improvement plan which started in April 2006 will end by June 2010. The final phase of enhancing doctors' payments will start next June," said Shahin. He estimates that the plan has already cost LE1 billion since 2006, a significant proportion of the ministry's annual LE10 billion budget. Shahin quoted President Hosni Mubarak, who has assured the public that "the government will not reduce monies allocated to either the Ministry of Health or Education".

The DWR has consistently rejected government offers of wage increases in the form of incentive payments, claiming they are subject to arbitrary decisions by hospital management. Abdel-Rahman explained that pay raises in the form of conditional monthly incentive payments are unreliable because their payment is subject to the whims of hospital management. "Incentive payments are subject to monthly assessments and the conditions surrounding their payment are unclear. If any problems happen at work you can lose 50, or even 100, per cent of incentive payments," says Abdel-Rahman.

Shahin responds to such charges by pointing out that over the last three years the ministry has raised the wages of all newly graduated doctors, doctors under training, juniors, first- aid men and nurses. "The final phase will cover the remaining categories, which include consultants and senior doctors," explains Shahin.

In an open letter to the prime minister, sent at the beginning of March, DWR demanded that incentive payments be converted into allowances "in order to put an end to the government's pretext for its failure to grant the incentives and in order to ensure that they are paid regularly at the start of each month with the rest of doctors' salaries". It claimed that many doctors had yet to receive the agreed payments and that "ministers have made several promises about other allowance payments which were never implemented."

DWR have also criticised the syndicate's refusal to include two proposals presented by doctors in the general assembly's final recommendations. The first called on the syndicate to hold to account members who work in hospital management and were involved in the "exemplary punishment" of doctors. The second recommendation concerned the "day of anger", on which DWR members want to hold protests and sit-ins in hospitals across the country on 12 April.

DWR pointed out that the proposal was ignored even though Essam El-Erian, a member of the Muslim Brotherhood and the syndicate's secretary-general, has been the victim of arbitrary dismissal from a Ministry of Health hospital.

"It seems that the syndicate is determined not to stand up in any real way to the Health Ministry's punishment of doctors," DWR's statement charged.

An extraordinary general meeting of the Doctors' Syndicate has been scheduled for 24 April to evaluate the situation.

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