COMMENDABLE APPROACH

Regional Health Authority doctors have adopted a commendable approach in not withholding their services, as was done last year, until negotiations for new contracts are completed. The situation today, if only for the time being, is pleasingly far removed from that of 2003, when the majority of the RHA doctors stayed away from the wards, employing the argument that since their one-year contracts had expired on December 31, 2002 this meant they were no longer under a legal obligation to offer their services. Meanwhile, Minister of Health, John Rahael, has indicated that between 30 to 35 percent of the RHA doctors have already signed the new contracts, and several more have “letters of continuation,” enabling them to work at the nation’s hospitals beyond the December 31, 2003 expiry date of their contracts.

The Medical Professionals Association of Trinidad and Tobago [MPATT], however, has called for the negotiations to proceed to arbitration to resolve the issue of the doctors’ contracts, cautioning that it appeared likely to be heading toward industrial action. But although approximately one-third of the doctors have signed the contracts and others have letters of continuation, MPATT’s diplomatically worded threat hangs like the proverbial sword of Damocles over the RHA run hospitals and should be taken seriously. The existing system of one-year contracts, whatever its rationale, is clearly unsatisfactory, and should be replaced by three-year contracts as is the traditional norm. The all too short period of one year for a contract governing doctors in the public health sector, indeed any group of employed persons, has the potential for the creating of almost perpetual disaffection and conflict, and cannot be considered healthy.

The public sector doctors, with specific reference to the junior doctors, have exploited the technicality over the past two years, that with the end of each contract, they no longer have a binding agreement governing their services. What has further complicated the situation, one already made somewhat awkward by a one-year ‘industrial agreement’, is that the doctors are required to sign contracts individually. The RHA doctors have found themselves in a situation entirely different to that facing other doctors at public hospitals, who continue to work directly for the Ministry of Health, and are represented by the Public Services Association, their bargaining body. Admittedly, the thinking behind the creation of the Regional Health Authorities was that all doctors in the public health sector would have been working with the RHAs. But whatever the thinking it has not yet been fully implemented and Government should revisit the rules and regulations of the Regional Health Authorities, and make all contracts for the doctors, not merely three-year but joint. The country, particularly the patients at the public hospitals, can do without the annual unease triggered by the one-year contracts.