New recruiting policy could lead to doctor shortage:
The health ministry has asked Indhira Ghandhi Memorial Hospital (IGMH) to recruit doctors without offering them a migration allowance.
The migration allowance is a very important factor in attracting foreign doctors to the Maldives.
Miadhu reported that Dr. Mohamed Razi, senior medical officer at IGMH, said he was concerned that low salaries for doctors combined with the cancellation of the migration allowance would make it very difficult to employ doctors.
IGMH and other hospitals were struggling due to the shortage of doctors, he said.
Razi said he believed IGMH would be able to increase salaries and benefits to doctors once it was privatised.
Source: Minivan News 30th December 2009
Thursday, December 31, 2009
Migration allowance cut and Civil service Commission: The drama
Read this two various article written in january 2009 and december 2009. You will understand the drama staged by Civil Service Commission, Maldives which managed to create its own hatred on Doctors.
Latest news on 30th december 2009 from Miadhu"
Latest news on 30th december 2009 from Miadhu"
Doctors worry the elimination of migration allowance
Dr. Mohamed Raazee of the IGMH has expressed concern that the Health Ministry had asked the IGMH to recruit the doctors without promising a migration allowance, which encourages the much needed expatriate and local medical doctors to work in the Maldives. Dr. Raazee also said he believed that the decision was made by the Civil Service Commission, and said that when the salaries were revised this year, migration allowances were not paid for the new doctors. He also said that if that allowance is not paid for the new expatriate doctors that would not be paid for the new local doctors as well. He also said that he is concerned about the low salaries being paid for the doctors as well.
Dr. Raazee also said that the because of the unattractiveness of the package, they are finding it very difficult to recruit doctors and IGMH and other hospitals are barely surviving because of the shortage of doctors.
But he said that once the IGMH is privatized it would bring independence from the civil service and IGMH can then increase salaries and other benefits for doctors and other employees. He also said that already an “Article of Association” is drafted and he believed that the change would come next year.
Once the change is made IGMH would be managed under a public-private partnership and of the 5 parties which expressed interest to manage the IGMH, one party is being evaluated for possible management handover.
A flashback news from March 2009 from Muthuim's blog:
Thursday, 26 March 2009
Maldivian Doctors Vs Civil Service Commission - A clash which might jeopardize the medical profession!
It’s saddening to witness a scenario of tug-of-war between Maldivian Medical Association and Civil Service Commission of Maldives (CSC). The situation initially heated up when the CSC revised the pay structure which resulted 13-42% deduction in doctors salary. The pay structure was revised with the main objective of pay increment to civil servants following the government decision to allocate further 1 billion rufiyaa to the purpose. But the expected happy news from the government turned out to be a nightmare for doctors by the unfair means it was delivered by CSC.
CSC is repeatedly opposing the fact there is any reduction in the pay, which is an act simply to fool/confuse public on the issue and spread hatred against Maldivian doctors. They even have publicized grossly inflated and erroneous figures to show doctors are being paid excessively. In fact in a meeting with Nurses Association the President of the CSC has apparently remarked that "even though doctors may be angry with us, now (we have made sure) public is against them”. BUT all this while it is their actions and silly application of 'rules' that has vastly reduced the services being rendered to patients, in terms of OPD patient numbers and ease of follow up.
| Post | Pay till 31st Jan 2009 (Total in Rf) | Pay from 1st Feb 2009 (Total in Rf) | Deducted Amount (Rf) | Deducted % |
| Medical officer | 13077 | 11375 | 1702 | 13% |
| Senior Medical Officer | 14786 | 12335 | 2451 | 16.6% |
| Senior Registrar | 22441 | 14565 | 7876 | 35% |
| Consultant | 26517 | 17390 | 9127 | 34.4% |
| Senior Consultant | 37481 | 20920 | 16561 | 44.2% |
(The simplest rule one can see in this is the higher the qualification and the level the higher amount of salary is deducted as the reward)
After doctors enquired this controversial- revised- pay- structure a ‘migration allowance’ has been included to fill up the deducted amount. BUT the CSC circular number (188-B/2009/8) clearly states the various allowances which can be listed under the ‘other allowance’ kind. It hasn’t revised since then which could give them authority to include whatever they wish. The regulations clearly indicate ‘migration allowance’ is not a permanent solution rather it’s a temporary trick CSC attempted to calm the heated situation. Therefore doctors who will get recruited after March 1st will not be entitled with this ‘unknown-fill-up” Migration allowance. Also this allowance might get investigated by anti-corruption board (cases such happened in past where CSC allowed allowances later were made to re-pay from servants own pockets)
The result of the pay deduction is not just a problem of medical professionals getting less salary; more importantly it might risk the future of the whole health sector. In this globalize world opportunities are open for qualified professionals as they are always in-need everywhere like here in
This issue should have been resolved peacefully at first place. Instead various sources within government and CSC hurried in blaming doctors negatively in public which lead the profession in risk.
- The decreased pay to medical doctors means the availability of qualified expatriates will decrease.
- The decreased pay and most crucially the negative image (hatred) public has for the profession might change the minds of our youths who previously admired to pursue carrier in medicine.
- Already graduated doctors might seek jobs abroad and their migration together with the above reasons will decrease the country’s medical professionals.
CSC claims they have revised it having dialogue with concerned people and did it with points given to technical, professional (skill and knowledge), and interaction with the public together with the leadership ability. Which is always pleasant to say but the truth is Maldivian doctor were never communicated or consulted with this issue (to whom its mainly related) and with the ‘fair’ pointing system, presently a doctor who has to handle life-risk situation in ICCU is offered a lower salary than a laboratory technician or a radiographer. (How on earth a medical doctor can be equaled in any professional way with someone taking a simple X-ray?) Please before comparing different professionals reflect on how much sacrifices, how much time and money one spend/use to become a doctor. By ignoring the qualified professionals with technical skills and knowledge there is great fear, the country might face the condition of ‘brain drain’ which will be very costly for the betterment of the nation.
I call CSC to respect the rules and regulations and refrain from spreading false information on this issue and end the defamation campaign it’s carrying out against the doctors. We have given you high-profiled post and giant salary in order to serve us with justice and honesty. There is nothing positive we can achieve by blaming each other instead it will only harm the people of this country.
Tuesday, December 1, 2009
Expat doctors deserting Maldives
A article published in minivan news gives more introspective view on current scenario of salary cut and doctors mentality to stay on..
Source : Minivan News
Source : Minivan News
"Expatriate doctors are deserting the Maldives because of poor facilities and uncertainty over their pay, according to a doctor working at Indira Gandhi Memorial Hospital (IGMH).
"We've lost five expat doctors in the internal medicine department in the last four months," said Dr Ibrahim Shiham. "Only one has been replaced, and from an island so not a new recruit."
Foreign medical staff are vital to the country's health services and comprise 85 per cent of the country's doctors, according to Shiham, most of whom come from India with some from Nepal and Pakistan.
Many are showing reluctance to renew their contracts, Shiham claimed, because the latest round of cuts to government salaries have added to the uncertainty that followed the efforts to standardise civil servant renumeration in January.
"What actually happened was a lot of pay scales were streamlined, and doctors' basic salary, including allowances, was ultimately down 30 to 40 per cent. So what [the government] did was invent another allowance to take it to the original break-even level. But the extra allowance has no legal standing, and in theory doctor's salaries got a major decrease."
With their salaries "propped up and not in the rulebook", many expatriate doctors "started talking about leaving and looking for other opportunities," according to Shiham.
"People who've been working [in IGMH] for 14-15 years have begun leaving in the last four months," he added, when their contracts come up for renewal - something he says was rare in the past. "They realised that once they sign the contract there's not much they can do [if the allowance is withdrawn]."
Deputy Director of the Health Ministry, Abdul Samad Abdul Rahman, said three specialists and six medical officers had left the Maldives in the last two months, and that replacements were declining offers because of the lower wages. CEO of IGMH, Zubair Mohamed, meanwhile told daily newspapers Haveeru that departures from the hospital were a "normal occurrence" and that “doctors are always leaving because their contract has expired."
Because of its reliance on expatriates staff, particularly from India, the Maldives is also competing with the burgeoning Indian medical sector to attract staff.
"Even in Indian government hospitals, which have to compete with the private sector, a medical officer in Delhi undergoing training would get 52,000 Indian rupees, around 16,000 -17,000 Rf," Shiham said.
Moreover, Male in particular was proving an unattractive destination for foreign staff because of high living costs and the need to leave families behind. The lack of facilities was also professionally unsatisfying, a particular issue for attracting senior staff, he explained.
"Here [at IGMH] I am only able to do 30-40 per cent of what I am trained to do because of a lack of facilities - out on an island, maybe five percent. Even equipment for kidney biopsies or needle for taking bone marrow samples. Doctors' skills are underutilised and referrals overseas are common practice."
Impact
The loss of medical staff is placing pressure on those who remain and affecting the amount of time doctors have to see patients, Shiham said.
The rule is we see four patients an hour, 15 minutes for each," he said. "If we start seeing a patient every 5-6 minutes, then the patient is not being seen properly, even if he might be happy he's seen a doctor. The level of documentation will also go down, and that will later attract a lot of litigation. The patient loses, the doctor loses and the system loses."
Appointments were starting to being made through contacts, a situation Shiham describes as "embarrassing." The pressure to thin the growing queues of patients was also leading to staff being recalled from other critical roles.
"I cannot stomach it when a medical officer is pulled off ICU (intensive care) to see a few more flu patients just because people are starting to shout outside. We don't have a doctor on duty 24/7 in our critical care unit," he said."
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