Misrepresentation here I hope is due to utter ignorance rather than from a desire to cause mischief or denigrate the profession. The ability to be contacted when on call, and the ability to respond with alacrity when called in to an urgent or emergency case at the hospital, from your home, are essential elements in the practice of a hospital doctor. A telephone and a car are therefore crucial necessities, unlike in most other professions where they are status symbols. Both are therefore subsidised (in the form of a car permit every 5 years), as they are available for private use too. A doctor dependent solely on the government salary would not be able to afford a car at the prices
prevalent today.

The attempt to compare the salaries of teachers with those of doctors is laughable to say the least. The comments betray problems that seems to exist in the minds of a few with the profession in general, and at least some of these are expressions of unadulterated jealousy.

Dear Dr. Rodrigo, do I have to respond to you now? You accept and say, “I have never justified the GMOA. The GMOA is corrupt – no doubt about it. It is a highly politicized organization in its current format. The same way that the police, all government organizations and ministries and almost everything in our island of paradise is corrupt.”

One simple question to you, you can have the pleasure and comfort of ignoring if you wish. Can the GMOA be politicised and corrupt as you agree, IF majority of its members are professionally honest and personally generous humans?

The simple answer is, “NO”. The GMOA is now an association of individuals who exploit once a noble profession for personal gains, privileges and profits without limits. That is the strength of the politicised and corrupt GMOA.

From all what you say and argue you prove that you belong to the present GMOA
ideology, even if you are not a member and not in the country. Read through both your posts. They are all about individual interests, individual demands and individual privileges. Nothing about social responsibility, social obligations, social duties and sharing in a profession that needs a generous collective outlook.

I am not surprised and I don’t have to be told that you are “one of the selfish ones”. Sarcasm will not erase that truth. Other than those migrant employees in the Mid East, every single Sinhala person who left this country, what ever excuse they would give, left on very selfish reasons. Therefore you will not be arguing for the people, but for individual benefits. So there ends this dialogue.

Kusal Perera

Its good that its the weekend and I have time to reply to these comments.

Please let me clarify. I am one of the selfish ones (who after engaging in
slave labour for 10 years as a intern, medical officer, registrar, senior
registrar and as a consultant for one year) who has migrated. I have resigned
from the health ministry though I am still registered in the SLMC as a
specialist physician. You will be able to verify this and also my current role
if you searched online. I therefore am not a GMOA member and have no profit
from a permit, salary hike, driver or a car. [edited] I worry about the harm that these
articles cause. I will not respond to
any more of your comments [edited]. I wished
to correct the misconceptions that you tried to paint by your letter as it was
shared on a facebook page by a friend.

I think that an intern is paid about 25000 per month currently. This comes
to about Rs 40 per hour now – certainly a great reward for the training they
have to undergo to get there and the service that they perform 24 X 7 for a
full year.

Interns are medical doctors! (they are called intern medical officers and
receive registration from the Sri Lanka Medical Council before commencement of
internship) I wonder where you came up with your definition of intern. The
mistake is in your definition of a medical doctor and not with my
interpretation. Please do not use a term if you do not understand its
definition. You will make others as confused as you are. For a post intern
medical officer, there is a limit of 4 hours per day for overtime and that is
only for time spent in the ward. This is the maximum that they can claim even
if they were in the ward with a sick patient for the whole night, or in labour
room or theatre or accompanying a patient who is being transferred. They get
nothing for the other 16 hours that they can potentially be working. When I
worked, we also had to put the BHT numbers of the patients that we saw and the
consultant had to sign off and then the DMO. This is usually during days that they are on
call overnight. So you are looking at a doctor needing to be on call overnight
for every day of the month and grudging them the 1000 rupees per day that they
get for this. No doctor does overtime for the money. You can earn more being a
barber! I do not see you feeling sorry for the poor fellow who has to work this
roster. How unfair do you think it is for this doctor to be on call for 30 days
a month! Would you do this? [edited]

However, being on call 30 days a month is very unusual and reflects a
serious issue with staffing. Doctors working in OPD, emergency units, accident
wards, ICUs, blood bank, Lab and administrative appointments (such as DMO and
RDHS) do not get paid overtime – so your claims are unjustified. [edited]

Also try to understand that the pension is based on the basic salary and that at
the time of retirement, all of the non pensionable allowances, overtime and
telephone allowances disappear and the doctor becomes a pauper on retirement if
he relied purely on his salary. This might make you happy, but policy decisions
should not be made with jealousy.

I have no issues with your demands for teachers to have a higher salary than
they get now. I have the utmost respect for them. However, have you considered
that teachers work less than 180 days per year and that also from 0730 till
1330. They have no regular on calls duties. By your same argument, one could
argue that teachers do tuition and that some earn more than doctors purely by tuition
and that they do not pay tax! Teachers are not regularly demanded to work on
weekends or after school and are certainly never on call! I wonder whether you
are referring to another country. The service they render after school and on
weekends is voluntary and they earn the gratitude of their students. It is not
their duty. May be they too should claim overtime – if it is allowed. For
doctors, it is their duty to work and be on call after hours – they have no
discretion. You are dreaming if you
think that doctors are ‘heavily’ compensated for this. The friends that we went
to school with – the ones that did not do medicine and who went to other fields
are doing much better than the current Sri Lankan doctors. You are looking at a
minority of the doctors who are doing remarkably well and generalizing. Do you
even know that a majority of doctors do not engage in private practice and that
many are burdened by loans that they struggle to pay off? What about the
doctors whom you ‘respect’ and work hard and do not do private practice? Should
they not be entitled to a fair salary? You only see what you want to see – do some meditation and then some research. May be you
would see differently then.

A teacher’s salary was never on par with a doctor’s salary. It is also not
on par in any other part of the world (maybe other than communist countries and wWe are not discussing the benefits of communism here). A doctor is an executive
grade public servant and their remuneration is far less than their non medical
counterparts. However you choose to compare a teacher’s salary with an
executive grade officer. I hope that you apply the same standards to a deputy
director of a ministry and agitate against their salaries too. The problem is
that since there are many doctors, you believe that they are the bottom of the hierarchy
and you try to find similarities between teachers and doctors. Once you realize
where a doctor stands in the public service, you will realize how under
remunerated they are.

A doctor is charged tax for his professional income (at a rate much lesser
than PAYE). Think about it… Rs 1000/- is only 10 AUD – and think of the
responsibility that a consultation should carry (I have concerns about the
responsibility that is actually taken – but we are talking ideals here) If a
doctor is taxed higher than what he pays now, this will be incorporated into
the channeling fee – the patient will indirectly end up paying the government.
This is what happens with every professional fee (lawyers, accountants,
architects, engineers), and that is why professional fees are taxed at a lower
rate. Please understand that where a person has to pay income tax, their
salaries are decided taking the income tax into consideration. It is not very
clever for the government to tax the salaries that it is directly paying. Doctor
salaries and channeling fees are not adjusted for tax payments – hence if you
are suggesting taxing their salaries – you are also suggesting a salary hike.

After this almighty assault on doctors, their incomes and comparing their
salaries to those of teachers, you now claim that the main issue is with the
GMOA. I have never justified the GMOA. The GMOA is corrupt – no doubt about it.
It is a highly politicized organization in its current format. The same way
that the police, all government organizations and ministries and almost
everything in our island of paradise is corrupt. But that is not the mandate
of the GMOA . The GMOA is a trade union for medical practitioners – nothing
more. There is a lot of resentment among doctors in the way that the GMOA is
carrying out its duties. There is an Association of Medical Specialists that is
coming into the limelight. I agree with you that GMOA stinks to its core! But
the doctors’ grievances are true. By these actions, the government is pushing
the medical practitioners further into the grip of the GMOA as it is the only
trade union for doctors with any sort of clout at this time. If the government
looks into the legitimate requirements of the doctors, then the GMOA would be
isolated – and not many doctors would mind it. The strike was not just about
duty free permits – do some reading before you write an article!

What I have mentioned regarding the eligibility for a vehicle and a driver
is true and there is a circular in that regard – which you are clearly not
aware of. It is far better to have a government vehicle with a driver and
maintenance including petrol than to buy a car on a permit. [edit]

I do not have the trade union background that you claim to have. We are
talking about a professional trade union – fighting for the just rights of its
members – medical practitioners. There is no need to have joint fronts to fight
in ‘solidarity’ with other non medical trade unions! The main issue is that the
current GMOA sometimes seems to be going beyond their mandate fighting for
matters not related to trade union issues (such as supporting the former President
at the election) rather than focusing on its members. No thank you – I like
this version of the GMOA (with all of its flaws) better than your concept of ‘Solidarity’.
You sound very much like a Marxist in the 70s who wishes for countrywide
strikes on multiple fronts on every minute issue. The GMOA membership dislikes
every trade union action that it takes – there are lots of arguments at branch
union meetings when a strike is called. There is no walk out like in other
sectors – as you suggest. Ward patients, emergencies including surgeries are
still managed. It is the clinics and OPD that is dysfunctional – resulting in
enough ammunition for the media with no real impact on the really sick
patients. I doubt that there has even been a single death directly attributable
to a strike by GMOA as this is what the membership strives to prevent. This is
unlike strikes by nurses etc., who walk out locking the medicine cupboards and
everything else when they go on strike. This is why the government caves in to
their strikes and allows for doctors to strike for days to weeks – think about
it!

Regarding the paramedical degrees, did you look into the basis for the objections? Did you go through the
curriculum of these degrees to see how it needed 4 years? Do you know that these
courses had about six months of English, a research and an internship-like
program included to stretch this from a three year degree to a four year
program?

I hope that you will read my comments with an open mind. I agree that there is so much wrong with the Sri Lankan public service, and there are many disillusioned people. However if we want the public health sector to be vibrant, then we need to attract the best into all medical fields and make sure that are well remunerated.

Glad a medical doctor had stepped into “correct” me. Unfortunately for Dr.Rodrigo, he’s taken a badly mutilated case to be defended. I’m pretty sure,he’s far out dated with time for he is comparing a world where an “Intern” was paid Rs.12 per hour. So let’s get to basics in a society where social values, ethics and morals have been thrown out of the window by the most noblest of all professions.

Dr.Rodrigo has misread me from the start. I am not talking of “Interns”.Interns are not medical doctors. I am talking of a medical doctor’s first year “gross take home pay”. I have given the breakdown. It is easy to calculate. Add to the basic salary of 26,160, the allowances (both pensionable and non
pensionable) amounting to 61,840 and that comes to Rs.88,000. Then add the telephone allowance of Rs.4,000 and that makes a total of Rs.92,000 only. Now, is the good Dr. telling me, these medics don’t earn Rs.23,000 more from their 120 hour over time and 20% payments to make an estimated Rs.115,000 take home pay ?

It certainly is more, although there are Drs, as I have accepted who are ethical and humane. Yet they too earn close to that which is their due. It is also a fact that, Drs spend time they are required to be on call to earn an extra private income through PP. He is asking how fair is it to “demand that a doctor sacrifices his personal life for this profession?” Well, the medical doctors are compensated heavily for
this. So, how fair is it to demand teachers to spend their personal life after school hours, during weekends and on public holidays taking children to numerous events and activities that have nothing to do with education without any compensation or payment? There needs to be some rational in how public servants are treated.

My comparison with a graduate teacher’s salary therefore was to show how the GMOA had over decades used their authority over human life to enrich medical doctors very selfishly while another noble profession, the teaching profession is left on the way side. The teaching profession needs much more attention than is given by any government to date and I hope Dr.Rodrigo would not ridicule that
need.

I have also done a calculation on how much a Specialist Dr. earns and often without declaration for taxing, which Dr. Rodrigo has not talked about. There again I do accept all are not crazy over money. What is disputed is not what the medical doctors are legitimately paid. What is challenged is the role of
the GMOA that I continue to call a “MAFIA”. It’s the GMOA I accuse of ruining a noble profession. GMOA leadership has completely ruined a profession that during Dr. Rodrigo’s time was a noble profession and respected and lived true to the Hippocrates Oath. But not anymore, as the GMOA drives them to hold patients hostage to win more and more selfish demands and has driven the profession into a “Shylock” business.

Most unfortunately with his long harangue Dr.Rodrigo is trying to justify the GMOA decision to strike for the demand for “duty free vehicle permits” that is an extremely corrupt scheme by now that denies the public of billions of revenue and should be scrapped altogether. In his effort to justify this strike for a duty free vehicle permit for medics, Dr.Rodrigo is meandering into areas that he should not have touched upon. The argument brought forth by Dr.Rodrigo that the government cannot afford a vehicle with a driver and petrol to medical officers afforded to deputy directors in the ministry and therefore they qualify to have duty free vehicles is just stupid, to say the least. IF the government cannot afford that which I believe is nonsense, then how can the government forgo billions of rupees of income on duty that should be used for public good?

If the GMOA is to function as a trade union, the fundamental norm is “solidarity” with other trade unions in their campaigns for rights, which Dr.Rodrigo seems to know little of. The GMOA has been acting as the most destructive association in the health sector in the recent past. Their decisions against other health sector unions have ruined the team work which is a basic need in a hospital. It is not just medical doctors who are all important in a hospital ward. Medical doctors have to work as team leaders with nurses, para medics and even attendants and labourers in a hospital in caring for patients. This team spirit has been completely wiped off by the GMOA that went against all other hospital staff and have made enemies out of team mates.

I mentioned as one example a very recent conflict the GMOA created in the health sector when they went all out in denying the para medics gaining better qualifications for them in reading for the Allied health degree. They used everything from big money to health ministry manipulations to thuggery in denying the Allied health study degree being accepted as a 04 year degree. Where on earth does a decent trade union work day and night to deny the rights of another trade in their own sector?

Sorry, I have to say this. Medical doctors have lost the decency they should have and the GMOA is responsible in creating a very selfish, an extremely money crazy set of doctors who would not hesitate in holding patients as hostage in getting a vehicle duty free every 05 years. GMOA does not think a human life is worth their duty free vehicle. It’s not only people who should say enough is enough.
Even medical doctors with respect and medical doctors who wish to be ethical in their profession who should tell the GMOA they don’t such an association for medical doctors

Pity this land where medical doctors act as “butchers” in competitive, selfish trade.

Kusal Perera