MAM reaction - Sunday Times - 14/8/2005

link to article in The TIMES

MAM wants justice for all
Dr Martin Balzan

I thank Professor Albert Fenech (The Sunday Times, August 7) for sharing the Medical Association of Malta's view that the current pay package for the medical profession (Professor Fenech included) is completely inadequate, considering the training and responsibility it entails.

MAM also shares Professor Fenech's disappointment that, to date, the government has not brought forward any decent financial proposals. MAM is saying that it has a collective agreement with the government on how all doctors have to be employed and remunerated. Furthermore the law of the land and EU directives expressly forbid employers from identifying any individual and offering him or her preferential treatment for similar, if not identical, work.

All specialists save lives, and one cannot say that a life saved by cardiac surgery is worth any more or any less than a life saved by a "balloon procedure" which cardiologists can so skilfully perform. An obstetrician performing a caesarean section indeed saves two lives, but of course no obstetrician expects to be paid twice as much as his colleagues.

What about lives saved in intensive care, in the special care baby unit, in accident and emergency, or indeed in the medical wards? Are these lives worth any less? The answer is clearly "no", and MAM is saying "no" to discrimination, "no" to illegality.

The Sunday Times readers will appreciate that MAM has not brought any names up in the media, of either a first, second or indeed third cardiac surgeon. Although, as Professor Fenech rightly states, it could have been anticipated that the issue would be personalised by people who wanted to derail it from legality, justice and fairness to a mud-slinging exercise.

Unfortunately, the surgeon who decided to stick up for his rights rather than lie low and suffer in silence (and perhaps have the dignity of being left in peace), has had to bear the brunt of this attack. I remain convinced that Professor Fenech is too much of a gentleman to be any part of this.

MAM is trying to explain that this is an issue of MAM (on behalf of all doctors) vs. employer, and not MAM vs. somebody in particular. MAM officials have indeed made it their business, and that of the 700 doctors they represent, to know that this cardiac surgeon, as Professor Fenech very aptly put it, has "job title and job description that are both different from that of the consultant they involved".

Thanks Professor, but legally that is defined as "discrimination" and, in trade union terms, "breach of collective agreement". In consequence there are "grounds for industrial dispute" or better, in layman's terms, "asking for trouble" and as professor currently put it "a tragedy of errors".

However, I must, for the umpteenth time, clarify that in no way does MAM doubt the merits of this cardiac surgeon, neither the very fact that he deserves the money he is being paid directly or indirectly. But, according to Maltese law, that contract with those conditions has to be offered to all other specialists; with any deviation from the present collective agreement having to be first negotiated and agreed to by MAM.

It is also a matter of great satisfaction that Professor Fenech agrees with the 700-odd MAM members who felt that The Times editor was completely out of line when he appeared to be labelling members of the medical profession as "monkeys".

Professor Fenech's esteemed signature would have been a most welcome addition. However, may I emphasise that from the profession's side the editor's clarification and apology for his gaffe are accepted and the episode is to be forgotten.

I am also sure that Professor Fenech would have no qualms to advise "Roamer", his long-standing admirer and supporter, that such unacceptable language levelled at respected professionals is counter-productive to any respectable argument.

MAM calls on the health division to come forward and offer all members of the profession the same contract what has so far been offered to just one cardiac surgeon. Failing this, MAM expects a clear and convincing legal justification in the public interest and transparency of public finances, rather than unnecessary, emotional media spins and personal attacks.

Dr Martin Balzan, MD, MRCP, FEFIM, is general secretary of the Medical Association of Malta.

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