The stalemate between the Public Service Commission (P.S.C.) and the doctors working in Samoa’s public hospitals over salaries and overtime rates shouldn’t even be an issue if you think about it.

Currently, the Government’s 2023/24 SAT$1.08 billion Budget for the new financial year is before the country’s legislators, and after it is subject to rigorous debate by both sides of the House, it will be passed. The Ministry of Health (M.O.H.) is getting the largest slice of the Government’s money plan with a $146.5 million allocation, which is an increase of $6 million from the previous year. It is great the Ministry has been given the largest allocation in the 2023/24 Budget as health is a key policy platform for the Government. 

But how do we expect medical workers to deliver on the health outcomes, which are tied to Samoa’s long-term development plans when our national doctors and nurses continue to be underpaid and overworked in the country’s public hospitals, which the majority of our people use?

We ask this question because it is at the heart of the grievances that Samoa’s national doctors and nurses have been raising with successive Samoa Governments. The fact of the matter is that the delivery of the country’s public health services is being strangled, almost choked by the shortage of medical workers and specialists, which has led to them taking on added responsibilities and working extra hours.

This is why we are shocked at the latest developments in this long-running saga, in which countless studies and inquiries have been made over the years, that somewhat reached the same conclusions highlighting the need for better remuneration and working conditions for our health workers.

In yesterday’s edition of the Samoa Observer, an article (P.S.C. moves to cut doctors’ overtime) correspondence between the P.S.C. Chairman Nonu Saleimoa Lemauga Vaai and the Director General of Health, Aiono Dr. Alec Ekeroma over salaries and allowances for doctors confirmed how the P.S.C. and the M.O.H. are worlds apart in terms of their positions on the issue.

Despite objections by the M.O.H. staff to the base salary being promulgated by the P.S.C. for the Ministry’s Medical Operations Department, Nonu confirmed that the commission intends to go ahead and the changes will go into effect on 1 July 2023, overlooking calls for the policy to be reviewed.

Even a letter from the Health Director General to the P.S.C. dated 4 April 2023 wasn’t enough to convince Nonu and the commission of the current state of Samoa’s public health system, and the impact that the P.S.C. policy will have on the workforce when it goes into effect next month.

To give the P.S.C. insights into the current capacity challenges that the M.O.H. faces, Aiono used the paediatrics department of the hospital as an example, saying it should have at least four consultant specialists to cover the usual clinical work; the after-hours rosters; adequate supervision of junior staff; and performance improvement audits.

"Yet we currently have only one or two Consultant Specialists in employment per discipline – necessitating a need for overtime claims in order to achieve adequate service provision," the Health Director-General said. "If the Ministry was to accept your pay rates proposal, the majority of these senior medical officers, who have to provide extensive after-hours cover would be greatly disadvantaged, earning far below what they are earning now for the time committed and work produced.”

A letter of response dated 20th April 2023 from the P.S.C. Chairman to the Health Director General made it clear that the Ministry's request to increase the salary range for the consultant specialist is not supported and will remain as is.

We are gobsmacked at the decision by the Nonu and the P.S.C. to knock back the requests from the M.O.H. which will see the Ministry’s Senior Medical Officers disadvantaged and result in them working longer hours for less. Where is the justice in Senior Medical Officers continuing to provide extensive after-hours cover in our public hospitals and consequently earning less for the time committed and the work produced? What are the P.S.C. Chairman and the commission hoping to achieve with the position that they’ve taken on this issue? Don’t they see the health of citizens as a top priority for the current Administration and don’t they think the salaries and working conditions of Samoa’s health workers are overdue for an increase and an upgrade?

It is time for the Cabinet to intervene and put an end to this saga with the respective Cabinet Ministers taking it up to that level. Due to the gravity of the situation, they should start pushing for the doctors to be paid their dues. There is no class for people in authority when they start debating the rationale of paying people who've undergone specialist training to save lives. Saving lives should be non-negotiable and any government worth their money should know that.