Doctors shocked by pay cuts

The Health Ministry has been forced to intervene to prevent doctors from leaving shifts unstaffed after their overtime pay was slashed by up to two-thirds.

After new policy changes were implemented on January 31, overtime rates changed from being based on doctors’ current salaries to a maximum hourly rate based on a total salary of less than $30,000 per year.

Doctors were shocked to receive dramatically reduced pay earlier this month. Copies of payslips reviewed by the Samoa Observer show doctors were being remunerated, in some cases, at less than one-third of their previous rates. 

Doctors complained to health administrators in a February 11 letter that described the changes as "unjust" and which called for their urgent review. 

“Given the unique nature of our work and the difficult working conditions, such as current severe shortage of Doctors in the service, we strongly feel that this constitutes unfair remuneration for Doctors,” the letter said.

The correspondence was addressed to Ministry of Health (M.O.H.) leadership, the Public Service Commission (P.S.C.) and the Prime Minister.

Two days later, Director General of Health, Leausa Dr. Take Naseri wrote to the P.S.C. to ask that policy changes, approved on November 12, be held until doctors could be consulted with.

The pay changes were first brought to doctors’ attention on January 16. 

In two meetings later that month they voiced their concerns with human resources officials, who promised them the new rates would not affect doctors, and that they were under review.

Doctors requested a meeting with the P.S.C., which was never granted, and on February 11 were shocked to receive payslips that detailed the drastic drop in overtime rates.

“This was a shock to us all and has brought about a very noticeable drop in morale. Doctors feel disheartened, angry and unappreciated,” the letter states.

A source inside the hospital told the Samoa Observer that drop in morale had many doctors refusing to work overtime until the overtime rates based on current salaries were reinstated.

Since Leausa reassured them the changes would be postponed, some have returned to normal work, but others are waiting for their next payslip to confirm the changes happened, the source said.

“We were misled and the manner in which this change was made lacks transparency,” the letter continues.

“We were not given advance warning before this measure was put into effect. The decision to reduce on-call rates undervalues the service we provide and our worth as Doctors in the Ministry. 

"Furthermore, this change will have major financial implications. Many Doctors have factored in their on-call allowances to their personal budgets. The drastic and sudden reduction in income will have far-reaching consequences.”

The P.S.C Working Entitlements and Conditions Manual (W.C.E.M.) 2015 provided the basis for reformed human resource arrangements for the newly merged Ministry of Health and National Health Service.

The stipulations for overtime in the manual state that staff at the A7/L7 salary band and below should be paid their overtime hours, plus half on weekdays, Saturdays and P.S.C. holidays at their “current rate of pay”.

But those working above that band should be paid at the rate of the maximum salary for A7/L7 salaries.

It is understood that all senior health staff are paid significantly higher than the A7/L7 band, and that doctors’ salaries begin at A14/L14.

The exact salary for an A7/L7 employee could not be ascertained. 

But payslips provided to the Samoa Observer showing doctors being paid $13 or $17 per hour for overtime (plus half or double time) suggest the salary is somewhere around $27,040 per year.

A senior registrar, with a Master’s degree enters the Hospital with a salary of $64,140, with an hourly rate of around $30 tala. Their overtime rate before the changes was $45 or $60.

Doctors working as the Head of Unit are paid between $81,600 and $86,569. At the higher end, their expected overtime rate of around $60 or $80.

Leausa was invited to comment on the changed overtime rates and whether they were in line with P.S.C. policy. He did not reply to two emails asking for comment.

The P.S.C. Chair Aiono Mose Sua, whose Minister is Prime Minister Tuilaepa Dr. Sailele Malielegaoi, has not responded to two email requests for comment.

The new Implementation Matrix for M.O.H. human resources (H.R.) describes overtime as the “costliest personnel expense affecting budget and now inherited by M.O.H. since the merge.

“To better manage the situation, overtime must comply with the P.S.C. W.C.E.M 2015 until the review is completed to include Call Backs and On Calls.” Those rates are under review as part of the second and third phases of the policy changes.

Attempts to find the previous formula used to calculate doctors' payments were unsuccessful so precise comparisons could not be made. 

Just last May, doctors were entertaining strike action if their salaries did not increase to match their qualifications, workload and time spent on the job.

The former chair of the Medical Council Motuopua’a Dr. Aisoli Va’ai said: “[doctors] are overworked and tired and the pay is low. When you have that three as a combination, then you have disaster.

“When you are overworked, underpaid, and you’re tired, then you make mistakes.”

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