MAM President responds to letter in The Times - 12/1/2005
Doctors' remuneration
Stephen Fava, president, Medical Association of Malta.

I refer to the letter by Victor Spiteri (January 31). This made very enjoyable reading as it contains lines of reasoning that are so original that I have never encountered them before.

Mr Spiteri seems to be mixing up the public sector with the private one. The remuneration of doctors in the public health service has nothing to do with fees charged in the private market. Notwithstanding Mr Spiteri's suspicions, which he failed to substantiate with facts, all statements about doctors' remuneration in the public sector contained in my first letter are true. Indeed, they have not been denied by the government. After all, even government officials admit that doctors' pay is ridiculously low. The fact that Mr Spiteri found them so hard to believe further reinforces the point.

Once the subject of private specialists' fees has been raised, may I point out that even these are quite low not only when compared to those charged overseas but also when compared to what is charged by other professionals as well as non-professionals locally. This is especially so when one considers the degree of training and responsibility required by specialists.

Mr Spiteri failed to appreciate that to specialise a doctor needs to undergo at least seven years of postgraduate training and that he has to get through exams that have a 70-80 per cent failure rate. Apart from being very hard work, this also involves considerable expense that the doctor has to pay largely out his own pocket.

With regard to undergraduate training, most present day consultants and specialists did not receive any stipends. In any case, stipends or not, studying for a doctoral degree at the university is not quite like going on a paid holiday, as Mr Spiteri seems to think. Anyone who has been to the university can vouch for this.

That many doctors are leaving our shores is not a threat but a statement of fact. An individual doctor has every right to compare his career prospects and conditions of work locally with those overseas and then make his choice. With Malta's accession to the EU, the flood gates have just been opened. It is naive to think that such a brain drain is something "good". Not only will our national health service deteriorate but the expense to the government will start to spiral upwards because the need to refer patients for overseas treatment will again start to increase. Does it make sense for the country to invest thousands of liri in the university to produce doctors and then lose them to other countries? By being stingy in doctors' salaries, the government is unwittingly making Maltese taxpayer subsidise foreign health services.

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