Fears of brain drain among doctors - 6/3/2005

The Times

Fears of brain drain among doctors
Cynthia Busuttil

Martin Balzan, the Medical Association of Malta's general secretary.

The brain drain among doctors is alarming and the announced shortage of doctors in the United Kingdom was bad news for Malta, the Medical Association of Malta's general secretary, Martin Balzan, said yesterday.

Many doctors are already leaving our shores when they are trained enough to be able to shoulder responsibility and the situation could get worse following the announcement that the British National Health Scheme (NHS) needs doctors from abroad. A number of adverts by UK recruiting agencies have already appeared in the local press.

Dr Balzan said there was already a shortage of doctors at all levels and it will be a big problem to replace experienced staff as it took several years to train a doctor.

He explained that similar shortages were also felt both in the UK and in Germany. Doctors from Eastern European countries found it much easier to work in mainland Europe, especially in countries bordering their homeland.

"Some doctors from Eastern European countries who were working in Malta have already resigned because they can find better paid jobs closer to home," he said.

The Maltese health system was losing a number of its specialised Maltese doctors, with three consultants handing in their resignation recently, Dr Balzan said.

Doctors' salaries in the UK, which are at least four or five times those of Malta, were among the reasons why doctors were opting to leave for Britain. He explained that the basic salary of a junior doctor in Malta was Lm4,000 to Lm5,000 annually, which was increased if the doctor worked a 58-hour week. On the other hand, junior doctors in the UK earned about 45,000 (circa Lm28,200).

"Unless the working conditions here - including remuneration - are improved, higher specialised training is organised better and doctors' long-term career prospects are ameliorated, we will continue losing doctors," he warned.

To top it all, Dr Balzan said, the government was sending the wrong message to doctors who wished to pursue a career in Malta. In recent weeks the association lamented that some doctors have been denied their letters of appointment despite obtaining post-graduate qualifications, passing the Public Service Commission selection process and being assigned more responsibility. At the same time a number of vacancies across many specialisations remained unadvertised, despite the availability of trained personnel.

On a different note, a fully trained specialist who for personal reasons just returned from the UK faced the humiliation of being only offered a casual post at the level of a newly graduated doctor, he said.

Maltese doctors are even leaving after they complete their two-year housemanship at St Luke's Hospital. He said doctors who graduated just two years ago were already looking for a job in the UK. Dr Balzan said 85 per cent of doctors who graduated in 1999 and 50 per cent of 2001 graduates have left Malta.

The European Working Time Directive, the first phase of which was implemented in Malta last August, aggravates the doctors' shortage. The directive lays down that trainee doctors can work a maximum of 58 hours a week and trained doctors are allowed a 48-hour week.

When contacted, a spokesman for the Health Division said it was beyond the division's control whether doctors decided to leave Malta and looked for a job abroad.

"Most doctors leave for the UK to carry out post-graduate training, which to date is not available in Malta. Major efforts are being made to structure local post-graduate training programmes to try and minimise such exodus," he said.

The spokesman said the phenomenon of doctors moving overseas was not a new one but had happened over many years. He said that although the possibility of a brain drain does exist, this was not likely to be imminent.

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