Doctors, Dentists Threaten ‘Go-Slow’ over Payroll Issues

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Dr. Louise Mapleh Kpoto, President, LMDA

46 doctors cut, 100 more yet to be added to payroll

Building a resilient health sector in the country for Liberians to have access to quality and affordable healthcare is challenged by yet another wave of protests and ultimatums, this time from the Liberia Medical and Dental Association (LMDA) in conjunction with the Liberia Medical and Dental Council (LMDC).

The current threat of the doctors and dentists’ ultimatum over their pending strike to lay down their tools is “life threatening” and their angers would definitely be felt.

The overall unhappiness of the entire medical staff including nurses, occupational therapists, porters, paramedics and healthcare assistants has a nose-dive effect on the health sector which has struggled to rebound since the Ebola epidemic in 2014.

On Friday, May 11, the LMDA and LMDC announced their 72-hour ultimatum which began on Thursday, May 10, over the arrears of three months incentives for 40 interned doctors and the reinstatement of 46 doctors who were deleted from the payroll and classified as ghosts.

Addressing a news conference, the President of LMDA, Dr. Louise M. Kpoto and the Chairlady of LMDC, Dr. Linda Birch expressed frustration over the removal of the licensed doctors, who have completed internship and are currently in the various counties doing their intensive Emergency Obstetric Care (EmOC).

In a special statement read by the Secretary General of LMDA, Dr. Jonathan Hart, he said more than 100 Medical Doctors are yet to be placed on payroll and about 40 interns have not been paid their their incentives for three months.

“What is even more disgusting and annoying, was that while appealing to the doctors to hold on to faith and hope as we negotiate a suitable and peaceful solution, in the same Month of March 2018, the Ministry of Health removed a significant number of doctors from both incentive/payroll and labeled them as ghosts; but they were actively working without their rightfully due salary/incentives,” Dr. Hart said.

“These actions of the government over the years (and recent actions) led to a resolution passed and adopted by the LMDA in our second bi-monthly meeting, held on the 28th day of April, 2018 in Ganta, Nimba County, calling on the Minister of Health to make immediate payment of arrears and reinstate those doctors removed from the incentive and salary within 72 hours as of Thursday, May 10 and regularize the incentive and salary structure of those doctors affected, no later than May 30.”

The LMDA urged Liberians and foreigners to brace themselves for the consequences of their ‘go-slow’, beginning Sunday, May 13.

Furthermore, the LMDA has also urged President George M. Weah on the implementation of the negotiated salary scheme of Medical Doctors and Dentists, as per the November 14, 2016 demands and upgrading of all health facilities.

The Medical Doctors and Dentists emphasized that promises made to them by then President Ellen Johnson-Sirleaf were not met and they are therefore urging President Weah to effect those promises as of July 1, 2018.

They want government fully implement the resolution of the Doctors for the improvement of their lives.

Names of some of the licensed doctors removed from the payroll in March 2018

In the resolution, the Doctors called for improved salaries, insurance and other benefits developed through a policy document and implementation of the salary scheme agreed between the government and the doctors.

The doctors also want graduates who are on intern programs to receive their full incentives, the upgrading of all health facilities to the minimum standard contained within the essential package of health services.

The doctors threatened serious consequences in case of any delay and breach of the implementation of the resolution to include a full boycott of all health facilities in July of this year.

They are therefore calling on the public to prepare for a major health crisis if the government fails to meet their demand, indicating that they are tired suffering of low income despite their services to the nation.

Mr. Sorbor George, Media Officer at the Ministry of Health, acknowledged the issue of arrears on salaries and incentives, but expressed surprised at the LMDA’s statement.

“We are shocked that the doctors will go public with their concerns,” George to the Daily Observer in a telephone interview on Saturday, May 12.  “Three days ago we met with he doctors over the issue of their salaries. We promised them that we would submit the payroll to the Ministry of Finance, which we did immediately following that meeting.”

It may be recalled that, in November 2016, Doctors from across Liberia gave a 72-hour ultimatum in demand for their over three months’ salary arrears. Their arrears were fully paid but, according to them, government fails to improve the public health facilities and improve their salaries. Hart continued: “If the government does not make payment of our salaries, we will take a strike action, we will gather at the Ministry of Foreign Affairs where the President works.”

According to George, for the months of March and April 2018, the intern doctors will be paid according to their status as intern doctors.  For the month of May, their salaries will be upgraded to that of licensed doctors, he said.

“The Ministry of Finance is currently processing their salaries,” George said. “As of May 2018, they will be paid as ‘licensed doctors’, compared to intern doctors as they were before.”

Sorbor George insists that the Ministry did not intentionally take doctors off payroll. The Ministry instructed the Internal Audit Agency (IAA) to conduct an audit and it was the audit that recorded some doctors and other healthcare personnel as ghosts.

“We’ve begun verifying the names and asked people who were recorded as ghosts to come forward,” Sorbor George to the Daily Observer in a telephone interview.

Shortage of Doctors in Liberia

The Liberia Medical and Dental Council said as of September 2017, there were 339 Medical Doctors responsible for the 4.5 million population making the doctor per patient ratio 1:15,000.

The field of specialty is limited

The LMDC statistics, showed that there are currently 250 general practitioners, 21 public health specialists, 16 pediatricians, 12 Obstetrician-gynecologists, , 9 internal medicine specialists, 6 dentists, 6 family medicine specialists, 6 ophthalmologists, 4 psychiatrists, 2 orthopedics, 2 emergency medicine specialists, and one of each specialist in dermatology, ENT (ear nose and throat), infectious disease, neurosurgery, occupational health and pathology.

Norwu Howard, Deputy Minister for Administration, Ministry of Health (Photo: Derek Moore)

The figures show that the number of doctors is increasing, from the 278 reported last year, but with the constrains of motivating doctors beginning with their payment during internship and subsequently placed on government’s payroll is hiccup that would drive many from the medical profession.

George said Nowu Howard, the Health Ministry’s deputy minister for administration led a nationwide performance assessment of the health sector to identify gaps in order to develop solutions. “The IAA representatives sent by the Ministry to the counties could not reach certain areas because they complained of bad roads,” George explained. “Therefore, those employees in the areas that could not be reached, the IAA representatives recorded them as ghosts.”

As a case in point, George told of a human resources officer at the government hospital in River Cess County who the health ministry team met on their excursion, dressed all in black. When asked if he was mourning, the human resources officer answered, “Yes, I am mourning my ghost that was taken off the government payroll.”

5 COMMENTS

  1. The Ministry of Health and various Liberian Medical Associations are in a bitter fight over re-instatement of terminated medical employees and their back pay. This is a serious issue that needs to be resolved as soon as possible.

    First and foremost, the health of the Liberian people is a top priority. While the Ministry of Health and the Liberian Medical and Dental Association personnel wrangle over back pay and reinstatement of medical employees, the sick people
    should not be left alone.

    Argument:
    The Ministry of Health contends that an X number of medical employees, or ghosts, shouldn’t be on the payroll. On the other hand, the LMDA disputes that contention and claims that the Ministry of Health has been misinformed on this particular issue. The question is how did the Ministry of Health come to the conclusion of ghost payrollers? Also, who’s telling the truth or a boldface lie? Is it the LDMA or the Ministry of Health? Secondly, why weren’t the medical employees told not to work from the beginning? Or were they told?

    Paychecks
    I cannot say with an absolute degree of certainty that the government of underdeveloped countries do not pay their employees on time. But, I know for sure that civil servant employees in Liberia sometimes do not get their paychecks on time. Example, without mentioning the names of teachers, it’s been said that some teachers in some counties of Liberia do not get their paychecks on time. Maybe all teachers in general do not get paid on time. If that assertion is true, it can be assumed that all civil servant employees of various Ministries, including the Health Ministry are not paid on time or are not being paid properly. In this scenario, the LMDA might have a point, but the point must be proved beyond a reasonable doubt.

    What boggles the mind is that most of the Ministers of the institutions of our government are foreign trained. So the truth is that while some of those Ministers pursued their education abroad, they worked and earned some money. While they worked, there was never ever a time that they worked and did not get their paychecks on time. Why not duplicate that for the Liberian people in Liberia? What’s so difficult about cutting one’s paycheck on time? Let’s not forget the issue of under performance. If a teacher, a medical personnel or any civil servant employee does not get his or her paycheck on time, sometimes that employee will under perform. It’s a fact!

    The final issue of this shameful saga is that some members of the medical staff in Liberia went to their jobs and performed their assigned duties. The question is this: Were the 33 doctors told not to work because of incompetence, laziness, horseplay, shortage of money or because they created a hostile work environment? Or were they just being stubborn? There is a missing link somewhere. No one is willing to offer a mea culpa.
    Whatever happens, the sick people ought not to be overlooked or forgotten. Please. The powerful and the wealthy will most definitely go to Ghana for treatment. Of course that’s disgrace and a shame!

  2. It is clearly stated in George’s statements in the last paragraph of this story. The IAA did not do the Liberians justice. Why did they consider people ghost when, infact, they were not able to reach them because of so-called, bad road conditions? Most besides, one visit by the IAA to a county for verification is not enough to consider an individual a ghost. For instance, during the verification exercise in 2017, there was an ongoing National Immunization Campaingn that requires even the County Health Officer who is a Medical Doctor to conduct intensive supervision of the campaign in rural parts of the county. With the IAA representatives presence in those counties capitals for a period of two days be enough to capture health workers who are serving in the rural parts of the counties? No. Additionally, most health workers in rural Liberia are from Monrovia. While on leave during the exercise, do you expect them to be capture by that report in the county? No. Obviously, some will be on training in other counties and even abroad. Do you expect them to be capture in this report? No.
    To be real, I do acknowledged; that, indeed, there are ghost names on the payroll and to undo those names, it requires time and good knowledge about the internal working of the MoH with respect to county activities. It is a process, not an event.
    Therefore, the IAA must take full responsibility for the ongoing problems about ghost names and they need to acknowledge the fact that they did not do their jobs well. Today is the LMDA, tomorrow could be other Health Associations because we are also affected by this so called IAA report. The MoH needs to act now otherwise prepare for the consequences to follow soon.

  3. Health and public safety sectors are two of the pillars of Liberia’s stability, so the gravity of the former’s pay grievance and job security can’t be underestimated. On the other hand, it is this significance of the health sector which makes millions of ordinary Liberians expect more due diligence from their revered medical professionals. Let MOD, LMDA, LMDC, and IAA sort out whatever is amiss. For instance, how does one explain to a sick child that caregivers might not help, less than four months of a new government, because of inherited labor problems.

    Put another way, rather than taking a decision that could be misconstrued as an ambush of the new administration, all parties should consider going the route of renegotiation on all the issues. The experience of Ebola, with doctors and nurses dying on the battle field, so to speak, skyrocketed respect for all members of the medical profession. Nothing rashly should be done to obliterate that image of sacrifice from the consciousness of a hopeful people undergoing life-denying pervasive poverty. Not to mention that those who root for crisis are usually the first to flee like frightened rats.

  4. President Weah should focus on generating money; not spending on big projects; that Liberia can barely afford. Invest in AGRICULTURE. There’s where the MONEY will come from; to make Liberia’s Economy sustainable; then you can tackle the much bigger PROBLEMS. *Liberia NEEDS a sustainable source of National Income. That’sMost Important for now.

  5. Hmmm, interesting… the IAA representatives sent to assess and report any gaps within the health sector to the Ministry of Health for subsequent development of solutions, come back with a report that erroneously recorded medical practitioners as “ghost employees” simply because they (IAA) could not reach those areas due to bad road conditions and the Health Ministry accepts it is very troubling.

    With all due respect to the Deputy Minister for Administration, Norwu Howard, this was a poor judgement on her part since she led this nationwide assessment team. Assuming the accuracy of this reporting, Hor. Howard should have questioned the rationale of this assessment report by the IAA before making it final. I wonder as to why the IAA concludes that since the team could not make it in some areas because of impassable road conditions, therefore it was logical to assume that medical practitioners in those areas were nonexistent or “ghost employees.”

    Frankly, the IAA assessment report was incomplete, in my opinion, and Hor. Minister Howard should have rejected it. It would be wise for the minister in charged to withdraw this assessment report pending its final completion. You cannot take an incomplete assessment report and base your conclusion on unverifiable assumption. This could take a well-intentioned effort and turn it into a flaw exercise, which is exactly what had happened to this report.

    That been said, I must thank the Hor. Minister Howard for leading this assessment team not just to identify waste in government but to find solutions and improve efficiency as well.

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