Doctors in the public health system are working between 90 and 120 hours per week for basic salaries that start at $1.5 million annually at the lowest level, permanent secretary in the Ministry of Health Dr Kevin Harvey disclosed yesterday.

At the level of chief medical officer, regarded as the highest in the system, the salary ranges from $5 million up to $5.9 million with a mid-point of about $5.5 million.

However, while Dr Harvey pointed out that these salaries are complemented by allowances and overtime payments, the issue is of sufficient concern to Health Minister Dr Christopher Tufton, who is hoping that the recommendations of a task force established last year to review doctors’ working hours and conditions will be implemented.

Tufton and Harvey, as well as Chief Medical Officer Dr Winston De La Haye were guests at yesterday’s

Jamaica Observer Monday Exchange.

Dr Harvey said the task force came up with three main recommendations. The first addressed the hours being worked by doctors who pay up to $3.3 million per year in tuition fees while earning their medical degrees.

“Doctors are working between 90 and 120 hours per week, so that’s one challenge,” Harvey said. “What we’ve seen, benchmarking other jurisdictions, is these hours being capped for the week from as low as 50 to maybe up to a maximum of 90 or 80 hours per week because of the issues related to safety, security and the well-being of doctors. They are recommending that we adopt a process where the hours of our doctors are limited.”

The second recommendation dealt with the doctors’ conditions of work and suggested that public health facilities be adequately staffed.

The third recommendation was for doctors to receive a liveable wage, if the hours are to be cut. That liveable wage, he said, amounted to $6 million, which would be a combination of the basic salary plus an average of overtime.

“As you can imagine, majority of the doctors’ salaries lean to the overtime, so if you then cap the salary they would want to see themselves being paid a liveable wage,” he said. “We recognise that each of our hospitals are open 24 hours a day and hence that’s 168 hours per week. Our doctors are essentially like most of us, employed for a 40-hour workweek. So we are employing persons for a 40-hour workweek to staff 168 hours. So, what this results in is an adjustment in how we staff the full 24 hours on an employment basis, rather than staffing only 40 hours and running the others as overtime.”

He added that doctors also receive a travelling allowance, and those at the consultant level get what is called an ’emergency on call’ allowance.

“What you have to understand, though, is that the overtime is what makes up the salary. So, for the consultant you don’t get overtime, you get an emergency on call [allowance] to cover you for the time you work beyond the 40 hours. Those in hospitals, they get the overtime in terms of additional hours worked, and then for those in primary care and clinics they get what’s called an incentive allowance, which could be somewhere close to maybe around 60 or 70 per cent of the basic salary. Also, the charge per hour for overtime isn’t a lot. It’s maybe running between $2,000 and $4,000,” the permanent secretary explained.

Last week, Dr Tufton, in his sectoral presentation in Parliament, said the report and recommendations are being reviewed and further discussions with the stakeholders and the Ministry of Finance will take place to implement the agreed recommendations.

Tufton added that his initial impression is that, if implemented, this could lead to better and safer working arrangements for doctors and an increase in the number of doctors employed within the system, leading to greater throughput of patients in some areas and further reduction in waiting times at hospitals.