Dr Victor Grech responds to The Times Editorial - 29/7/2005

link to article in The TIMES

Serving the patient
Victor Grech, consultant paediatrician (Cardiol), St Luke's Hospital, senior lecturer, University of Malta, editor in chief, Image Peadiatric Cardiol, Guardamangia.

With regard to the editorial: At The Service Of The Patient (July 20), I write to request and provide some clarification/s.

The editorial stated: "'The Health Division just cannot pick and choose a doctor and offer him vastly superior remuneration,' the MAM also said. Why not? You pay peanuts and you get monkeys. You issue a call for applications and have to limit your choice to whoever decides to apply, ending up with having to select an applicant that may not be exactly up to the standards you required".

Could the editor please clarify whether he intended to imply that:

1. The Health Division has deliberately trained and produced doctors who are little better than monkeys, perhaps in an effort to keep salaries at a low level and hence obtain savings in salaries? This would be tantamount to a gross disservice to patients from the country's health provider.

2. That the Health Division has found local doctors incapable, perhaps, of any training much higher than that which could be obtained by a monkey? In which case, it would have been logical for the country's health provider to recruit all medical staff from overseas and ignore the local produce.

Whichever scenario was implied, the editor of The Times clearly feels (last sentence above) that the vast majority of the doctors in government employ are not up to the standards required and has not only insulted doctors but also our health providers. Thanks.

With reference to the paragraph: "Let nobody run away with the idea that Dr Manché is the only good doctor in the house. There are many other dedicated and loyal medical practitioners but because of the nature of their work and the conditions they agreed to they cannot constantly give their full attention to their patients within the national health service, as he does.

1. Doctors in this country are obliged to perform private practice because salaries are one-sixth or less than salaries available in, say, the United Kingdom. Unfortunately, none of us were offered the salaries mentioned in your editorial.

2. This does not prevent those of us who are constrained to perform private practice to abandon whatever private work we happen to be doing in our spare time in order to rush in to St Luke's whenever required by our NHS patients. This is a fact to which Mr Manché himself can attest when, this very week, I left St Luke's well past 5 p.m. after he himself asked me to come over from home in order to help with a difficult baby in theatre. And this was to the detriment of my private clinic which was obviously abandoned without a single word of complaint.

I wish to reiterate the obvious in that no specialist in government employ grudges Mr Manché's salary and conditions of work in any way.

Indeed, we all have nothing but the highest respect for his abilities and dedication, which, contrary to the editorial, is quite similar to the rest of the doctors in government employ and somewhat higher than that obtainable by primates other than humans, as our international (often UK/US) degrees and diplomas affirm.

Given the choice, we too would opt for a high (UK-type) salary and ditch private practice. Your editorial deliberately and needlessly attacked, hurt and insulted the medical profession.

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