A Bogus Doctor Argument I
April 20, 2003
by Dr Winford James
Bogus! That's how I see one of the lines of attack of NWHRA and SWRHA doctors in their withholding of their services to the state and the public as they negotiate for better wages. And insensitive and unenlightened as well!
Now, being a professional myself, I have absolutely no quarrel with the doctors wanting the highest salaries they can get. They must be well paid because of their extensive tertiary training, their specializations, and the special value of their expertise to our health and general well-being. But I do have a quarrel with their reasoning, especially their anti-Tobago line of attack.
Now, they do not put it quite this way. What they say is, as their advertisement put it, that 'discrimination against Trinidad doctors is discrimination against Trinidad people'. And how are Trinidad people being discriminated against? Well, you see, the doctors working with the Tobago RHA are being paid better than they - much better, they say. Since there is no special difference between their qualifications and those of the Tobago RHA doctors, and since that kind of wage distinction is not made anywhere else in the twin-island state (so they say), then the distinction - nay, the discrimination! - must be a matter of political policy and arbitrary as a consequence. So the Tobago RHA doctors are being specially favoured - but for no good reason.
This is decidedly a bogus, insensitive, and unenlightened basis for industrial action of the kind that the N/SWRHA doctors are taking.
Yes, it is true that the Tobago RHA doctors are better paid than the 'Trinidad doctors', though the Ministry of Health disputes the extent of the difference. But there are very good reasons, for this development, since it was not always like this. The fundamental general reason is that, compared to its counterpart in Trinidad, the health services sector in Tobago was, and potentially still is, in a state of intolerable crisis. There is only one hospital but you couldn't get enough doctors, especially specialists, to work there. Preventable deaths occurred facilely, if not routinely, as patients sought relief for easily curable conditions. (And, in this regard, one remembers the tragic preventable passing of Brendon Gray's little daughter.) It was routine to fly patients with conditions that should have been treatable domestically to Trinidad by helicopter. It was even more routine for nurses to accompany patients by plane to Trinidad for treatment of conditions that were handled as a matter of course at the Port of Spain General Hospital. Tobagonians who had, or could borrow, money, rejected the health system in the island and regularly resorted to private solutions in Trinidad and abroad.
The basic point here is that circumstances in Trinidad were far better, and had long been this way, than those in Tobago. It was a situation that cried out for improvement, if not equity. And one way of achieving that improvement was to make it attractive for doctors to work in Tobago. How do you make it attractive? You could improve the infrastructure - that is, build a modern hospital with all the specialty sections; put down facilities for testing and treating all conditions tested and treated in Trinidad; establish the administrative support systems.
But these improvements are not there yet. Look how long it has been taking to build a new hospital, and it en build yet! So, the easiest (interim) route was to attract doctors with financial incentives. Use better pay to motivate them not only to come to Tobago but also to stay for a good while.
The 'Trinidad doctors' are calling this discrimination. Discrimination? Bogus!! This is rational, enlightened, ameliorative action in a state of longstanding crisis. This is what the Americans call 'affirmative action'. What should have been done? Should we have continued with the old state of affairs where many simple matters had to be referred to Trinidad, where children met preventable deaths, where people turned away from a wretched service?
The position of the 'Trinidad doctors' betrays both an alarming ignorance of recent medical history in the country and thinking that is innocent of maturity and responsibleness. I understand that they have gone beyond the Tobago discrimination tack to saying that they should even be paid more than the Tobago RHA doctors, because they have more work to do and more stressful situations to deal with. If this is true, then it makes matters worse - not only because the truth of their comparison is not easily evident, but also, and more importantly, because of the utter crassness of tying salaries to degree of stress. Speaking as subjectively as they now, I'd say that, in that case, teachers, especially those in the non-prestige schools, should be paid the highest salaries in the land!
There is a great irony in the action of the 'Trinidad doctors', and it is that, given our social and education history, it is Trinidadian doctors who stand to gain most from employment in Tobago. To be sure, some Tobagonians are benefiting as well, but our political system has yielded far, far more Trinidadian than Tobagonian doctors.
The crass attitude of the 'Trinidad doctors' makes me recall the charges of discrimination - made by people who, like the doctors, should have known better - against the Robinson administration when it decided to build both a deep-water harbour and an international airport in Tobago. My ears still ring with the clamour that Robinson was treating Tobago specially and giving away Trinidad money to Tobago! And I still see the placards.
Well, look back now, judge the value of those two institutions, and see the shamefulness and stupidity of the charges.
A Bogus Doctor Argument I | A Bogus Doctor Argument II
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