“Rich Doctors, Highly paid medics shun rural postings” is misleading, and needs to be corrected

Media Release 

The National Doctors Association points out that the front page report by Post-Courier on the 29/05/15 is misleading and needs to be corrected. The reporter who wrote this could have done her thorough and deliberate investigative journalism before writing the front page news. In answer to last Friday’s reporting, the following are points of relevant that all health conscious citizens need to know;

1. National Doctors Association negotiates with the Department of Health and Department of Personal Management every three years for good salary packages for its members and doctors working in the public health systems including health tertiary institutions and departments such as School of Medicine and Health Science, UPNG and Defence Force, respectively. The recent award signed (2014-2016) is being implemented while some are yet to be implemented.

2. Award signed is a legal document, and all public health agencies, public health institutions and departments employing doctors must honour the award to its fullest.

3. All doctors are contracted on a 3-year period. The award does not talk about appraisal as a conduit to the implementation of the award. If hospitals are doing that then it is wrong. Appraisal is designed to do three things; (a) to monitor workers so that workers salary points can be maintained or increased incrementally, (b) to assess whether the worker keeps his or her job when the term of the employment expires (contract renewal), and (c) to promote a worker to a new job above his or her current job.

4. The last three awards signing to date including the current one has overwhelmingly reduced the attrition rate of national doctors leaving for greener pastures (outside of public health sector employment and into private practice, private sector employment and overseas employment). The Association on behalf of the national doctors has thoughtfully negotiated this to attract and retain doctors in the Public Institutions. The government of Papua New Guinea must be happy on this one and give credit where it is due.

5. To the connotation that doctors are highly paid is ludicrous. In comparison to other countries, Papua New Guinea Doctors are lowly paid. For example, in Israel, its doctors are highly paid here. For example, a resident medical doctor is paid $US10, 000/month (ten thousand American dollars a month). Israel has twenty thousand (20,000) doctors working in Israel that has a population 8 million people. Therefore, the ratio of doctor to population in Israel is one doctor to 400 people. A resident doctor in PNG gets close to two thousand kina a month (PGK2, 000/month) after tax. It takes about 27-32 years to train a specialist medical officer/doctor however; this does not even get a good package. Sadly, the specialist doctor is paid 30% of what is paid to the first year Resident Medical Doctor in Israel in a month. Do you call that a high pay?? The doctor to population ratio in PNG is one doctor to 17,000 people. The government of PNG and people must salute the doctors for serving the government of PNG in difficult circumstances with dignity and distinction.

6. In the Public Health System, a doctor must be located in the level four to seven hospitals, and that is at the district hospital and upwards as outlined in the current National Health Service Standards. Provincial Hospitals and the Provincial Health Authorities must create positions at the district hospitals. The only province that has done that is Enga Province. To attract doctors at the district hospital, administrators/hospital board/hospital management can give extra incentives to attract doctors. This is mentioned in the National Doctors Award.

7. All young doctors wanting to do post-graduate training will now have to work in a district hospital for a year before being accepted for post-graduate training. The School of Medicine and Health Sciences, UPNG recently made this decision. Surely, this decision will also allow doctors wanting to further their studies will at least spend a year in a level four (district) hospital. All district hospitals must be technically equipped so the doctor present can work as a doctor there (Most of these hospitals are not well equipped).

8. In the medical world, a medical doctor graduate gets a bachelor of medicine and bachelor of Surgery (MBBS) or MD. It is a 4-5 year course. In places like USA, you must have a first degree first before you attempt the MBBS program. Divine Word University is starting a new rural doctors program and soon Enga Provincial Government will introduce a medical school once its new hospital is built. Doctor training in all medical schools in the world graduate its candidate with a MBBS or MD, and are trained to work anywhere in the world. The School of Medicine and Health Sciences (formerly Medical Faculty) graduate doctors in the MBBS program, and at present 37% of these graduates are working overseas and in the private sector carrying the flag of PNG and the School of Medicine and Health Sciences with distinction. Training of doctors to suit the local need or flavour is not right. The post-graduate Rural Masters Program instituted by the SMHS is a good program intended for the rural setting. All doctors trained in PNG must get an undergraduate degree in MBBS that is exportable.

9. School of Medicine and Health Science (SMHS) must be acknowledged for training doctors in the MBBS and BDS (Dentistry) programs. It is about time, the government fully resource the SMHS to increase the doctor output that are internationally compatible, and has been the tradition to date.

10. All hospitals in the country must be fully equipped and resourced so that a doctor can deliver to expectation in accordance to the National Health Services Standards. To date, the Health Department has rolled out to 15 provinces.

11. PNG is perhaps the only country in the world where it’s clinical structure in seeing and treating a sick patient is very complex. In the chain of duty; a patient may be seen by an Aid post Orderly, Community Health Worker, Nurse, Health Extension Officer and Doctor. So, where will this rural doctor’s training that will happen fit into? The line of clinical profession were created and trained because of lack of nursing colleges and lack of doctors “before and early independence. The School of Medicine and Health Sciences is now producing 35 to 40 doctors a year. Fiji’s School of Medicines produces 70 plus MBBS graduates every year. PNG is no way near what Fiji is producing at present. The government of PNG needs to fully resource the School of Medicine and Health Sciences, UPNG, so that it can produce 100-200 MBBS graduates per year. Whilst doing that, doctor positions have to be created also. Once the literacy rate of Papua New Guineans rises in par with the western world, literate Papua New Guineans will now want to see a doctor than the other cadre of workers stated, and that is the irony of human mindset development and the country must be wary of that.

12. The government must consider converting the current School of Medicine and Health Sciences (SMHS), which is under UPNG to a separate university of its own, with its own budget, administration and targets.

13. Lastly, any development that happens in the country will be tested over time, but the human resource (employees) must not be tested. The fundamental growth of a nation or an institution is 100% vested on the workforce. So employers must not play marbles with the workforce. This must be known outright flat across.

Thank you.

Dr. James Naipao

National President

National Doctors Association