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Opinions Wed, 12 Oct 2011

Doctors demand solutions to single spine problems

The Ghana Medical Association (GMA) has observed with some concern, the wave of misinformation that has characterized the employer’s responses in the wake of the recent industrial unrest declared to spur the prolonged migration of doctors onto the single spine salary structure among other issues.

In its wake, members of the discerning Ghanaian public have variously been misinformed about how the doctors have stalled the process of migration through among other things, refusing to sit with other labour groups, how the delay had been occasioned by inability to sort out internal relativities, how doctors had refused to submit to the arbitration mandate of the National Labour Commission (NLC) and finally how we have been demanding payment of salaries under the single spine on October 7, a non pay day.

It is important to explain upfront that throughout this SS negotiation, the GMA has always sought to proactively avert crises by issuing timely preemptive warnings aimed not only at safe guarding the best interests of our members, but at penetrating the process of creating a desirable fair wage structure in Ghana with sufficient integrity to stand the test of time. Two examples amply demonstrate this: in the wake of the outgoing government’s hasty declaration of an un-negotiated salary increment in early 2009, it took the GMA to wholly reject that approach on account of wide distortions in relativities that had been sighted in the health and in other sectors. Secondly, in the immediate aftermath of the botched migration of teachers unto the Single spine salary structure, it was again the GMA that rose to caution the Fair Wages and Salaries Commission (FWSC) to adopt a thorough and professional approach in so far as doctors were concerned as we were certainly not in the mood to countenance any such implementation that adversely injured our members’ interests.

As is often the case, the doctors were roundly castigated for preventing manna from coming to people, most of whom were clearly not privy to the errors that had informed the GMA’s caution. Much later, with the emerging ruckus from the camps of the civil servants, the Prisons Service and the teachers, perhaps, people better appreciated the doctors’ perspective. In the recent crises therefore, members of the public may wish to exercise some restraint in the manner in which they castigate doctors who have done nothing short of keeping faith with the negotiating process. We wish further to address the above specific issues as follows.

Resolution of Distorted Relativities In 2009, the GMA drew attention to wide distortions in the relativities contained in the final draft report of the Single Spine Consultant. Indeed so embarrassing were the distortions in the health sector that the FWSC had little option that to contract another consultant to conduct a job reevaluation, after it had independently confirmed the existence of such widespread distortions and after other health unions had expressed their own levels of dissatisfaction. The Ghana Medical Association cooperated fully with this process, attended all the meetings and contributed immensely to the resolution of these problems.

Indeed as part of the process of resolving the distortions, doctors sat together with other health workers in a meeting at Ange Hill Hotel, East Legon, to deliberate extensively on a point by point basis, all the job positions in the health sector, how they related to others, and what scores they should attract. Needless to say, this was an exacting and agonizing but necessary process. It is therefore an absolute slap in the face, not to mention complete falsehood, for FWSC and others to claim today, that the doctors have refused not only to sit with other health workers, but to blame the delay on our internal inability to recognize our relativities. Having gone through this exhaustive process, the GMA certainly cannot sit aloof for the FWSC to again to begin making alterations to what has been comprehensively discussed without any objective scientific basis. This indeed remains one of the major contentions of this current impasse.

Again, at a meeting held in the Ministry of Health in December 2010 when key decisions were taken on the creation of new positions and job titles and abolition of others, the Ghana Medical Association sat in full conference with other non doctors to deliberate on these matters. The facts above should clearly demonstrate that when it has been found necessary to do so, we have fully engaged with the others. In fact not only have we sat with other health labour unions, we have deliberated extensively with the bigger Trades Union Congress on a number of the hurdles that all parties have had to cross in the implementation of the single spine pay policy and the ample evidence is undisputable.

We have however always been wary of engaging in fruitless and acrimonious discussions where doctors have always been the easy target of others, who instead of making a forceful case for their own salaries and conditions of service, expend more adrenaline comparing themselves to doctors on the basis of a certain narrowly interpreted principle of ‘we work together’. While not disputing the latter, it is a widely held norm in international health labour practices that though healthcare delivery is clearly the established product of team effort, each member brings in their own unique qualifications, roles and responsibilities and should be adequately recompensed as such. What we have seen in Ghana’s health sector is quite the opposite, where others have in times past been known to negotiate and agree on their salaries with their employers only to backtrack and reject same on account of what may have been negotiated by doctors. It is clearly not an accident of history that on any fair and objective job evaluation and grading exercise, doctors will assume pride of place.

And while we are on the subject of sitting or not sitting with others, perhaps, it is pertinent to point out that in days gone by when the GMA had attempted positioning itself to be able to speak in a grandfatherly manner on behalf of others, we have been told straight in the face that each union in health had their own collective bargaining agreement/certificate so we should mind our own business, in the best demonstration of the dzi wo fie asem policy. How then do these same people turn around and accuse doctors of refusing to sit with them?

The fact of the matter is that after working endlessly through the process, inviting the Chief Executive of the FWSC to countless GMA Council meetings, offering him the platform to address the general assembly (November 2010) and after numerous unfulfilled promises on the migration date, the leadership of the GMA finds itself in a position where it is no longer able to provide a realistic timeline to its long suffering members. If the CEO of FWSC and others were to be believed, doctors should have been migrated in April 2011, and then came the June 2011 date and finally, September 2011. The question is, when exactly are doctors going to be migrated unto the single spine structure?

Are doctors really the ones stalling the process of migration?

Even before the FWSC could confirm the existence of distortions and decide on its resolution, the GMA was busily engaging the services of consultants and putting crack negotiating teams together to spear head its approach. We have since submitted a comprehensive proposal to the FWSC on the salaries inclusive of the market premium. The FWSC did make a counter offer to which the GMA gave a robust response. In that response, we clearly outlined why certain fundamental assumptions informing government’s negotiating position ought to enjoy significant reviews. For months, the FWSC is yet to move the discussion forward when this ought to have been resolved months ago.

While we grapple with these issues, members on the spine are given a 20% salary increment in a negotiation in which the Ghana Medical Association was an active part despite not benefiting from it. In our estimation, the FWSC has become extremely comfortable with having doctors in no man’s land; buried in the old salary structure without a 2011 review and yet not migrating us unto the new salary structure, the venue for all future salary review under the new pay policy. This dilemma is clearly unacceptable to our members who are daily confronted with economic realities.

National Labour Commission The belated incursions of the National Labour Commission are typical and not so surprising. Indeed according to Mr. Austin Gamey, “The law prohibits them from engaging in strikes of this nature and that is the reason why they have been given special dispensation under the law for their matters to be judiciously handled within 72 hours when they feel dissatisfied.” It would appear that the likes of the NLC and Mr. Gamey understand their mandate more as one of preventing industrial unrests rather than proactively addressing the real concerns of the unions. Had the GMA been strike happy, it will not have given the NLC and all concerned with the resolution of this problem a good two week notice, far in excess of the 72 hours they require to resolve this issue. It is fair to reflect at this point that by not being proactive in its mandate, the National Labour Commission is flouting the law, and especially in view of its often selective interpretation and application of the law that often injures the interests of the labour unions.

7th October pay day As for the spurious allegation of doctors demanding to be paid on a non pay day of 7th October, 2011, as churned out by the FWSC, the least said about it, the better. It has never been on the table.

The way forward The Ghana Medical Association commits itself to actively engaging with all the stakeholders with the view to bringing a speedy resolution to this deadlock in a manner that will assuage the concerns of our members and the general public.

Sodzi Sodzi-Tettey

General Secretary

Ghana Medical Association

10th October, 2011

Columnist: Sodzi-Tettey, Sodzi