Dear Editor,
When the PPP/C took office in 1992, there were just over a 150 doctors practising in Guyana. Most of them were operating out of Georgetown and the other urban centres. An overwhelming number of them were in private practice with some moonlighting in the public health care system. The cumulative result was a devastating paucity of medical personnel in the country as a whole, more particularly in the public health care system and worst yet, in the rural communities. By the time we left office in 2015, the situation was transformed. There are now nearly 1400 registered medical
practitioners operating in Guyana with almost every community, wherever located, having access to a doctor. Therefore, although substantial progress has been made, from all my enquiries there is still a pressing need for a larger number of more trained medical personnel in almost every part of the public health care system.
Historically, one of the several initiatives taken by the PPP/C to address the paucity of qualified medical personnel within the public health care system was to negotiate scholarship programmes for our students with friendly countries. The most successful of these programmes was the multi-year scholarship programme with Cuba for the training of Guyanese students, largely in the field of human medicine, as well as in other disciplines. Over the years, this programme has graduated medical doctors comprising over 600 young Guyanese from every ethnic group and from every part of the country, more particularly, the children of the working class, who would have never had the opportunity of becoming doctors. Upon the grant of these scholarships and prior to their departure to Cuba, these students were required to sign a contract with the Government of Guyana, through the Ministry of Public Service, which obliged them to enter into another contract upon the successful completion of their course of study to work in the public health sector for a period of 5 years on certain terms and conditions contained in the said contract.
Over the years, this second contract which the newly graduated doctors have been requested to sign, pays them a public service salary, with a gratuity of 22.5 %, payable every six months. This monthly salary is currently approximately $230,000 (gross) or approximately $185,000 (net). It is obvious that this salary is grossly inadequate. Several of these scholarship doctors with whom I have spoken, have all indicated to me that it is the gratuity upon which they heavily depend and with which they are able to purchase a vehicle on credit, utilizing a duty free concession granted to them as part of their contract of service with the government.
It has been drawn to my attention that the final batch of these Cuban scholars numbering 79 returned to Guyana in 2015. They completed their one year internship, as is required, several months ago but are yet to be placed in the public health system. These young doctors are simply at home, frustratingly with nothing to do, while the public health care system continues to suffer throughout the country from a paucity of medical personnel. I raised this issue with a senior medical administrator at Georgetown Public Hospital Corporation (GPHC) who was not even aware that these young doctors have not been placed in the system, but who informed me that the responsibility to do so lies with the Ministry of Public Health. This ministry under the coalition government is managed by two ministers who are each being paid a salary that is over two times what the sole Minister of Health earned under the PPP/C administration. Yet, from all indications, almost every sphere of this ministry is in chaos and embroiled in scandals. But during the 2015 elections campaign, the nation was promised “good governance.” This is yet another example that the opposite obtains.
Additionally, I have been informed by a representative of these doctors that the government has signalled to them that the payment of gratuity from the contract which this batch of doctors will be requested to sign will be removed and that these doctors will be placed on the pensionable establishment of the public service by virtue of which they will receive a pension when they attain the age of 55. Most, if not all, of these young doctors are vehemently opposed to this initiative and expressed a preference for a contract similar to that which their predecessors enjoyed. Indeed, they contend that when they entered into the scholarship programme, it is that contract which they expected to be requested to sign. In short, these doctors are arguing, and I daresay quite rightly so, that they have a legitimate expectation to serve under a contract similar to that under which their predecessors served. It appears that the government intends to request them to sign a qualitatively different contract. Rather than serve under the pensionable establishment without a gratuity, these young professionals have expressed a preference to repay the government the sum of money spent on them and to simply migrate.
I also spoke with Cuban-trained doctors currently in the system serving under their contract and the government has also signalled to them that their contracts will be amended to remove the payment of gratuity and to place them on the permanent establishment of the public service by virtue of which they will receive a pension at age 55. These doctors have also expressed their non-support for this proposed unilateral change to their contracts. They also expressed a preference to exit the public health care system. If the government obstinately pursues these proposed courses of action, the consequences for the public health care system and the people of Guyana will be calamitous. Needless to say, litigation looms as well.
Yours faithfully,
Mohabir Anil Nandlall, MP
