By Evie Andreou and Annette Chrysostomos
Furious Health Minister Giorgos Pamboridis on Monday told state doctors they were not above the law as his ministry tries to reduce waiting lists but is being stymied by medics’ refusal to clock in for overtime.
In a very public spat, Pamboridis challenged the doctors to punch their time cards like every other public servant and prove how many extra hours they were doing. They said they wanted to be paid by the case and not by the hour and are also averse to queuing up to clock in with other hospital workers because it is humiliating.
The row escalated after Pamboridis last week said time cards must be introduced in state hospitals as part of the government plan to reduce patient waiting lists.
The ministry’s proposal provides for the pilot trial of a combination of overtime that would make better use of hospital’s infrastructure to carry out afternoon operations, and also a pilot programme for referrals to the private sector that would offer subsidy coupons to patients who wished to go private.
Pamboridis said a prerequisite for doctors’ overtime was the use of time cards.
State doctors union PASYKI, had been trying to justify their refusal to use clock in since the system was installed in July last year by citing among other things, unfair terms over their overtime pay. Ex-PASYKI head Maro Kontou had even said that it was “humiliating for doctors to stand in a queue with other workers”.
PASYKI head Soteris Koumas, told state broadcaster CyBC radio on Monday that it was agreed a few months ago that overtime for state doctors should be paid per case and not per working hours.
Koumas said that while PASYKI had agreed to discuss the issue with the health ministry last October, “this did not happen, and now they are blackmailing us that if we want to be part of this scheme, we have to punch cards,” he said.
“I myself, told you in December that you are not allowed to exclude yourselves from law provisions, no one is above the law,” an irritated Pamboridis replied on radio.
“You need to abide by the law just like the rest of thousands of civil servants, and that’s not a threat, it is obvious,” Pamboridis said. “Stop giving excuses and come punch your cards as the law provides”.
He added that he had asked state doctors to clock in on a three-month trial, and based on the recorded results he had personally pledged to find a solution with the finance ministry that would differentiate state doctors from the rest of civil servants towards finding a fairer overtime pay system, but that they declined.
“Don’t tell me we are blackmailing you, and that you are working more hours. Prove it. You will be able to say ‘here you go, we punched our cards, these are our hours, pay up’,” Pamboridis said.
Koumas said that the minister only suggested this two weeks ago.
He said doctors never said they would not clock in but they would expect the findings to be accepted by the ministry.
“We said that with the card comes obligations for the employees but also benefits, and we want those to be discussed,” Koumas said.
The association for state contract doctors, SESIK, said the two issues should not be linked. One concerned an administrative tool for working hours and the second was a reduction of waiting lists, it said.
“It goes without saying that any application of the punch card should be […] connected with compliance to European directives on working hours, acceptance of on-call as hours of continuous and active work, and adequate compensation for the extra hours worked” SESIK said.
Meanwhile, the health ministry said the pilot programme to reduce waiting lists was starting to be implemented and that private clinics had already been informed of the details.
The total cost of the undertaking which will be carried out in two phases this year will be around €8 million. According to the ministry, the total cost of phase A amounts to €3,220,620 and phase B €4,588,000.
The detailed programme was presented at a news conference on Monday by the ministry’s permanent secretary Christina Yiannaki along with Pamboridis.
The specific cost for each treatment was listed and specifies the number of people who are currently waiting for various procedures.
“Dozens of patients will be referred from the public to the private sector,” Yiannaki said.
She said the programme was based on voluntary overtime for all health professionals in the public sector who had expressed an interest. It was designed, she added to make the best use of human resources and the infrastructure in hospitals.
Yiannaki gave examples. For instance, the number of people waiting for a cataract operation is currently 1,833 with a waiting time of 15 months. Of these patients, 1,000 will be sent to private clinics with which the ministry has agreements, and 833 will be treated in the public hospitals.
During the first phase, referrals to the private sector will relate to surgical operations for umbilical hernia, unilateral and bilateral inguinal hernia, cataracts, and diagnostic tests for MRI, Pap tests, and ultrasounds for the lower abdomen and for thyroid.
The waiting list for Pap tests numbers 6,887 with a waiting period of 24 months. All will be referred to the private sector at a state subsidy of €60 each.
Each surgery has a specific fixed price. The cost for cataract surgery is €1,000. The government had already set this up during the recent nurses’ strike.
As there will be a subsidy of €700 for each cataract surgery from the government, the potential patient will be able to choose a private clinic and pay the difference of €300.
This system will work only if the public sector staff complies with the system of punching in for overtime, Pamboridies stressed. Where this criterion is not met, the minister may proceed with the referral of all cases to the private sector, he concluded.