Following two consecutive demonstrations of healthcare professionals this week over financial issues, the Public Hospitals Authority advised yesterday that it remains “fiscally challenged” and cannot expand salaries and benefits given the current state of Princess Margaret Hospital (PMH) and the scope of works needed there.
Junior physicians demonstrated in front of PMH on Tuesday, claiming they are being ill-treated and that they are being denied certain key benefits.
The Consultant Physicians Staff Association (CPSA) held a demonstration at PMH on Wednesday to warn that if their demands aren’t met they will take industrial action.
“We have consistently honored all negotiated benefits under the various existing industrial agreements and I forecast that this will not change,” said PHA Managing Director Catherine Weech, during a press conference at PHA Corporate Offices.
“As it relates to finances, as it seems to be the crux of the matter in this week’s demonstrations, it is important to note that while the Public Hospitals Authority’s budget remains relatively unchanged over the course of the last several years, annually this organization is required to absorb the additional cost for the engagement of new physician interns and senior house officers.
“The general expectation that all Bahamian graduates of The University of The West Indies will be employed by the public health system, in particular the PHA, is one that is not grounded in reality.
“We recognize that we are at a crossroad and that the current business model must be changed to ensure a sustainable healthcare system.
“In order to shed more light, it is important to restate that PHA continues to be fiscally challenged.”
Weech said that the PHA’s approved funding from the government of $216 million and its projected collections from patient revenues of $13 million result in a $25 million shortfall of its projected operating cost of $254 million for the current fiscal year.
She noted that personal emoluments which include salaries and benefits account for $169 million of its actual expenditure.
“Put more simply, 80 cents of every dollar allocated to the PHA is consigned to the payment of salaries and benefits for physicians, nurses and support staff,” Weech continued.
“This is compounded by the significant increases in costs related to the procurement of drugs, vaccines and medical and surgical supplies, which accounts for another $32 million in costs, representing 14% of our available funding.
“This leaves very little funding available for the upkeep and indeed the expansion of our public health facilities.”
Weech pointed to the challenges at PMH that require immediate and ongoing repair.
“While we concur with the positions proffered by both the physicians and nurses that the present state of our physical plant is wanting, it is simply not sustainable to continue to expand salaries and benefits whilst neglecting our responsibilities to modernize and repair our healthcare facilities,” she said.
“Acquiescence to a position that does not reference the already burdened monetary position of the PHA will in no way further the beneficial state of healthcare in The Bahamas.”
CPSA Treasurer Dr. John Dillett II said on Wednesday that their issues range from the lack of resources in the hospital, including medication and supplies as well as non-functioning air conditioning units, and urged the PHA to bargain in good faith.
“The doctors here have not gotten a raise in 10 years,” said Dillett.
“…There’s no pension plan, there’s no health insurance. We have physicians who get illnesses coming to the hospital doing their work and there’s no support for them. That is ridiculous.”
Weech, however, said yesterday that within the past nine months, the PHA has negotiated in good faith with the CPSA and has agreed to all of the non-financial articles with that association.
She said the financial terms are still being negotiated with their last meeting having been held on July 6 and attributed conflicting schedules as the reason for a deferment of their last agreed meeting date.
The Bahamas Doctors Union (BDU) claim they are being denied maternity benefits. They are also demanding holiday pay and allege that medical licenses have been revoked because of changes to licensing requirements, and that contracts have been issued in a manner that is not in line with their industrial agreement.
Weech said as it relates to the doctors, the PHA would have met with the incoming BDU board on August 24.
“Various matters were discussed, most notably maternity benefits, holiday pay and the length of time given on new contracts with junior doctors,” she added.
“The PHA is of the opinion that there are no outstanding matters related to maternity benefits. The PHA did extend an invitation to the BDU for a follow-up meeting to discuss these and any other matters of concern they may have. This offer still stands.”
Weech also addressed the ongoing issues with the Bahamas Nurses Union, which has dominated headlines over the past few months with threats to take industrial action over money owed to it.
“The Public Hospitals Authority has been actively engaged with the Bahamas Nurses Union for the better part of 2018,” Weech noted.
“We are pleased to confirm that outstanding matters brought to our attention by the BNU have been resolved, save for sick benefits and the implementation of a standardized shift system.
“Both the PHA and the BNU have agreed to the overall framework of the standardized shift system, including standard hours of work, minimum rest periods and compensation by way of shift premiums for unpopular hours of work, dating back to 2014.
“The PHA has sought the feedback from the BNU regarding the implementation process for the past four months to no avail.”
Weech said the PHA will continue to seek open and productive dialogue with all of its healthcare partners going forward in order to provide the highest quality healthcare possible to the people of The Bahamas.
Education: Vrije Universiteit Brussel (University of Brussels), MA in Mass Communications