Woefully inadequate working hours, conditions and salaries for Doctors must be addressed

Dear Editor,
The public health system has been plagued with a plethora of problems, ranging from shortages of drugs and medical supplies to prolonged waiting time for patients at outpatient and even emergency departments. Very often, patients’ frustration, disappointment and anger are usually directed at the doctors and nursing staff, many of whom are not responsible for the mismanagement that occurs on a daily basis.
The doctors themselves are frustrated with the system, and have made known their concerns about drug shortages, equipment failure, and inadequate and untimely laboratory results — all of which have a severe impact on clinical management of patients.
At some departments in the GPHC, it is the norm for doctors to work 96 hours per week. This happens when doctors work “on call” every three days. In extreme instances, some departments require doctors to work from Saturday morning at 8 am to Monday at 4 pm, a total of 56 hours continuously, in addition to the average work week.
It should be noted that GPHC is regarded as the best staffed public hospital; one can only imagine how many more hours doctors at the regional and district hospitals across Guyana have to work.
Many of the doctors believe they would be able to provide a better quality of service if the public health system adopts the European Standards of Work for Physicians in Guyana.
When physicians are “on call,” they are required to be physically present in the hospital compound. This is to ensure that, if needed, they would be immediately available. The public hospitals would usually designate an area wherein these “on call” doctors can be found, if needed. The basic requirements are a secure room, with toilet and bath, a cot, table and chair. These basic requirements are not met by most of the institutions, forcing doctors to sleep on the corridors or in their cars.
At the GPHC, for example, both male and female doctors are required to share the same room, with few beds and limited toilet facilities being available.
Many Government Medical Officers are unhappy with their remuneration, especially the younger doctors. A first-year GMO at GPHC receives a salary of $181,808. A second year GMO at GPHC gets a salary of $218,169. A third-year GMO at GPHC gets a salary of $261,802. Many of these doctors have complained that these salaries are wholly inadequate, especially with the increased cost of living.
The allowances that a doctor receives across the public health system vary. The doctors at GPHC would get a monthly housing allowance of $20,000, but most of them complain that they are unable to rent a house in or around Georgetown for this sum of money. They also receive a meal allowance of $500 per call, which is far less than what an actual meal would cost. If a doctor decides to buy a real meal while “on call”, s/he would often end up spending more than $1000.
Doctors are given a $3000-per-month cell phone allowance, to be used when on call to get in contact with their registrars or consultants. Most young doctors complain that this sum is inadequate, and they are seeking an increase in this allowance.
Doctors are required to work ‘’on call” — that is, for extended periods after their regular 8-hour shift — during the work week, from 4 pm to 8 am Monday to Friday, and on weekends from 8 am to 8 pm Saturday, Sunday and holidays. For each on-call session, the doctor is paid $2500 as an “On Call” allowance, which the PPP/C Government had agreed would not be taxed. The APNU/AFC has now imposed a tax on this “On Call” allowance.
Many doctors in the public health sector are contending that the Granger Administration is rewarding party loyalty over medical competence and meritocracy. Many young doctors are complaining that scholarships for further training have not been properly advertised, panels are not balanced, and results are often skewed. They feel efforts must be made to have an open and transparent system wherein persons are promoted based on their assessed competence, or sent for postgraduate training based on merit.
Our medical doctors deserve better. They should earn better salaries and allowances, have reduced working hours to improve patient outcomes, experience better working conditions in the hospitals, and be subjected to a fair and equitable system that would allow for promotion based on merit, rather than a party card.
As the Government prepares to lay the next budget in Parliament, I hope the many concerns that doctors and other medical staff have raised about their remuneration and conditions of work would be considered.
Sincerely,
Dr Frank Anthony, MP