MAM reaction to Times Editorial - 23/7/2005

link to article in The TIMES

Dedicated medical practitioners

Stephen Fava, president, The Medical Association of Malta, Guardamangia.

I refer to the editorial At The Service Of The Patient (July 20) on the issue of discriminatory conditions of work offered by the government to a privileged doctor.

Contrary to what was stated in this editorial, the Medical Association of Malta has not embarked on an attack on the person concerned and it was wrong of The Times to personalise the issue. MAM's stance is based on the principle of non-discrimination, irrespective of the persons involved.

MAM has no hesitation in endorsing The Times's praise of the doctor concerned. His "credentials, abilities and absolute loyalty" are outstanding. This was never an issue with MAM.

The issue is that the majority of doctors in the public health service also offer an excellent service and while they are paid "peanuts" they are definitely not "monkeys", as implicated in the said editorial. Indeed it is a tribute to their dedication and professionalism that they offer a sterling service in spite of their ludicrous pay packet.

Malta's public health service ranks among the best in the world. Surely, this is not due to the efforts of a single person. Indeed, the outcomes of all medical and surgical interventions are excellent and surveys have consistently confirmed very high patient satisfaction rates throughout the public heath service. We also have enviable maternal and infant mortality rates.

Cardiac surgery is one in a long list of services introduced locally in recent years. To mention only a few, this includes renal dialysis, renal transplantation, coronary angiography, keyhole surgery, joint replacements, chronic pain management etc. This is besides the daily routine work of many doctors who are regularly saving lives, prolonging life or helping their patients to live a better life. They have also saved the country thousands of liri by drastically reducing the need for patients to be treated overseas. All these "monkeys" are working for "peanuts".

MAM has repeatedly pointed out that there is already a brain drain and the country needs to get its priorities right and give its doctors decent conditions of work. The public sector is already failing to attract and retain an adequate number of doctors in all specialities and this is already resulting in ever-increasing waiting lists, in spite of the high throughput of local doctors as judged by international norms.

No, the government cannot pick a particular consultant and offer vastly superior remuneration. Another two cardiac surgeons doing exactly the same work are treated differently! Even if one were to accept that the particular consultant with a higher salary has different conditions, why were these not offered to other consultants?

MAM insists that the government fully abide by local and EU legislation. I trust that The Times will not support anyone breaching the law, especially if it is the government.

I am afraid that the editorial completely missed the point with regard to the payment of tax. With the country's current financial situation and the government squeezing more tax out of everyone, MAM questions why an individual who earns more than his colleagues has his income tax paid by the government itself?

The editorial questions the timing of MAM's reaction to this situation. Before Malta's accession to the EU the Health Division was able to treat foreign nationals in a different way to Maltese but this has now changed. Also, this particular contract was renewed, without any discussion, at a time when other consultants and doctors were offered abysmal conditions in the notorious document on so-called reform in the public health service. MAM cannot tolerate such double standards.

Finally, the editorial expresses MAM's stance perfectly in the last paragraph. "If the state wants the best for its people then it must pay good money and, yes, offer special packages. The Maltese people deserve it and MAM should insist on it, negotiate better deals for its members and using successful deals as Mr Manché's to substantiate its claims."

MAM's present and previous councils have been striving to do just that for many years but the government always adopted a can't do, won't do attitude in the knowledge that most hospital specialist doctors couldn't just leave their employment and go work elsewhere. However, now that we are in the EU the situation is quite different. If the editor does not believe this, MAM extends an invitation to him to join its would-be negotiating team!

Editorial note: The spirit of the editorial in question was encapsulated in the final paragraph, which Dr Fava and the MAM endorse. The Times wanted to raise the point that rather than jeopardising the continuation of a deal that paid handsome dividends to the national health service and served the Maltese people well, it should be used as a platform to negotiate upgraded packages. One should never cut one's nose to spite one's face. The expression of paying peanuts and getting monkeys was in no way meant to offend and/or insult the many dedicated and loyal medical practitioners in the national health service. It was merely used to press the point that in order to get the best possible material one has to pay good money. Any offence is regretted.

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