IN THE BEGINNING : THE PUBLIC SERVICE
The Civil Services Association (CSA) was the recognized, representative body for all civil servants including medical professionals, as mandated under the Civil Service Act, Chapter 23:01. The CSA changed its name in 1971 to the Public Services Association (PSA). The PSA was responsible for representing all public servants including senior public servants such as chief technical officers and permanent secretaries as well as officers in lower ranges including clerical workers, drivers and messengers. Later in 1976, the Salaries Review Commission (SRC) was established to proffer remuneration for senior administrative and technical public servants and high ranking members of the judiciary, etc.
A decision was made by the then administration, in 1994, to introduce new statutory authorities to implement the provision of all Health Services. It should not be forgotten that during this transition the medical profession, through the Trinidad and Tobago Medical Association (TTMA), advised repeatedly against the process by which the change was being made. In reality, it was being done expeditiously and in a top-down manner, without consideration of the contributions from the medical professionals themselves. This new Regional Health Authority (RHA) system was formalized via the RHA Act of 1994 which gave the five (5) newly established RHAs the role as providers of health care and the Ministry would be purchasers of their services. The RHAs were created as independent statutory authorities i.e. they had the right to enact legislation for specific areas of law and were accountable to the Minister of Health. The Ministry of Health however, retained the role of setting the national policy on health, establishing standards and monitoring the RHAs for achievement of these standards, while ensuring that public funds were utilized in accordance with meeting the health needs and improving the health status of the population.
In March 2000, a meeting was held at the San Fernando General Hospital which included senior doctors, junior doctors and most-recently hired house officers. Essentially, the purpose of the meeting was to make a decision on whether doctors should form their own trade union or whether they should remain as the Medical Arm of the PSA. Since there were a large number of public servants present and a smaller number of RHA doctors there (which was pointed out at that meeting) and also because the Medical Arm of PSA was already in existence and had an established track record and structure (though dormant for over ten years), it was decided by majority that the doctors would remain as the Medical Arm of the PSA. Subsequent to this, Dr. Colin Furlonge was appointed as Chairman of this Medical Arm. In an attempt to put a framework in place for the future of the Medical Arm, several persons came together including consultants, registrars, newly appointed house-officers and newly employed interns. There was also representation by doctors from POS, EWMSC and San-Fernando Hospitals. This group of persons engrossed themselves in the task at hand for about 2 years and was able to strategically devise a framework and structure for the remuneration package for doctors. This involved a comparison with international doctors and with local professionals, including members of the legal fraternity and different segments of the private sector. This comparison was necessary in order to estimate a basic living wage for doctors, who were previously on par with professionals in the judicial system in the 1970s. It was clearly established that that there was a 300% difference between what the doctors were earning and what a comparative professional in the judicial system (for example) was earning by the 1990s.
A decision was made by the then administration, in 1994, to introduce new statutory authorities to implement the provision of all Health Services. It should not be forgotten that during this transition the medical profession, through the Trinidad and Tobago Medical Association (TTMA), advised repeatedly against the process by which the change was being made. In reality, it was being done expeditiously and in a top-down manner, without consideration of the contributions from the medical professionals themselves. This new Regional Health Authority (RHA) system was formalized via the RHA Act of 1994 which gave the five (5) newly established RHAs the role as providers of health care and the Ministry would be purchasers of their services. The RHAs were created as independent statutory authorities i.e. they had the right to enact legislation for specific areas of law and were accountable to the Minister of Health. The Ministry of Health however, retained the role of setting the national policy on health, establishing standards and monitoring the RHAs for achievement of these standards, while ensuring that public funds were utilized in accordance with meeting the health needs and improving the health status of the population.
In March 2000, a meeting was held at the San Fernando General Hospital which included senior doctors, junior doctors and most-recently hired house officers. Essentially, the purpose of the meeting was to make a decision on whether doctors should form their own trade union or whether they should remain as the Medical Arm of the PSA. Since there were a large number of public servants present and a smaller number of RHA doctors there (which was pointed out at that meeting) and also because the Medical Arm of PSA was already in existence and had an established track record and structure (though dormant for over ten years), it was decided by majority that the doctors would remain as the Medical Arm of the PSA. Subsequent to this, Dr. Colin Furlonge was appointed as Chairman of this Medical Arm. In an attempt to put a framework in place for the future of the Medical Arm, several persons came together including consultants, registrars, newly appointed house-officers and newly employed interns. There was also representation by doctors from POS, EWMSC and San-Fernando Hospitals. This group of persons engrossed themselves in the task at hand for about 2 years and was able to strategically devise a framework and structure for the remuneration package for doctors. This involved a comparison with international doctors and with local professionals, including members of the legal fraternity and different segments of the private sector. This comparison was necessary in order to estimate a basic living wage for doctors, who were previously on par with professionals in the judicial system in the 1970s. It was clearly established that that there was a 300% difference between what the doctors were earning and what a comparative professional in the judicial system (for example) was earning by the 1990s.
WHISPERS OF DISSENT : THE MEDICAL ARM OF THE PSA
This group then began the negotiating process as the Medical Arm of PSA; days turned into weeks, weeks into months; months into years. During all of these negotiations and deliberations, the PSA core and associated executive were seldom present at any of the negotiations with the Medical Arm and Chief Personnel Officer (CPO) of the Ministry. It was only after a meeting with the Finance Subcommittee of the Government was there an understanding, by the principal, of the disparities in remuneration between the medical professionals and other professionals under the Salaries Review Commission. In fact, at that time, an Intern was earning less than a maid in TSTT and when such evidence was presented, it was enough to cause the Cabinet to accept the reasons why there was a severe disenfranchisement of the doctors; there was a clear disconnect between the doctors as professionals, the level of service that these professionals were providing and the remuneration package that they were earning.
Finally, the doctors were able to get a substantial package signed in December 2001, covering the period January 2001 to December 2002, for RHA doctors. The doctors made no claim for an increase or retroactive payment for the period 1998-2000. The groundwork for this December 2001 package was done almost exclusively and single-handedly by the Medical Arm of PSA who undertook the arduous negotiations and came to a settlement almost autonomously, under the then Chairman. This package gave doctors approximately 100% increase in their salaries. Unfortunately, this success came at tremendous cost which involved several unfortunate industrial actions, since it was a difficult task to get the UNC Government at that time to understand the viewpoint of the doctors.
The Government changed hands from UNC to PNM in the 2001 elections. From the doctors’ perspective there were still outstanding matters to be discussed, since negotiations had not been undertaken for the then current period (post 2001) and thus new negotiations had to be started. The Medical Arm of the PSA approached the President of the PSA, who arranged a meeting with the then Minister of Health. Surprisingly, this meeting was attended by the President and her full entourage as well as the full Executive of the Medical Arm of the PSA. At this meeting, the PSA President questioned the presence of Dr. Jehan Ali and Dr. David Josa as part of the Medical Arm of the PSA. These doctors had always been part of the Medical Arm and they were also senior doctors. As such, the executive of the Medical Arm felt it necessary to have invited their presence. The President of PSA at that time engaged in dialogue directly with the Minister, to the exclusion of the Medical Arm and ended the meeting without giving the doctors the opportunity to speak. This was a clear insult to the doctors present at the meeting since they were treated in a most dismissive manner and it was clear that the President of the PSA and her administration, were not representing the doctors and could not articulate the needs of medical professionals in the public service properly.
Finally, the doctors were able to get a substantial package signed in December 2001, covering the period January 2001 to December 2002, for RHA doctors. The doctors made no claim for an increase or retroactive payment for the period 1998-2000. The groundwork for this December 2001 package was done almost exclusively and single-handedly by the Medical Arm of PSA who undertook the arduous negotiations and came to a settlement almost autonomously, under the then Chairman. This package gave doctors approximately 100% increase in their salaries. Unfortunately, this success came at tremendous cost which involved several unfortunate industrial actions, since it was a difficult task to get the UNC Government at that time to understand the viewpoint of the doctors.
The Government changed hands from UNC to PNM in the 2001 elections. From the doctors’ perspective there were still outstanding matters to be discussed, since negotiations had not been undertaken for the then current period (post 2001) and thus new negotiations had to be started. The Medical Arm of the PSA approached the President of the PSA, who arranged a meeting with the then Minister of Health. Surprisingly, this meeting was attended by the President and her full entourage as well as the full Executive of the Medical Arm of the PSA. At this meeting, the PSA President questioned the presence of Dr. Jehan Ali and Dr. David Josa as part of the Medical Arm of the PSA. These doctors had always been part of the Medical Arm and they were also senior doctors. As such, the executive of the Medical Arm felt it necessary to have invited their presence. The President of PSA at that time engaged in dialogue directly with the Minister, to the exclusion of the Medical Arm and ended the meeting without giving the doctors the opportunity to speak. This was a clear insult to the doctors present at the meeting since they were treated in a most dismissive manner and it was clear that the President of the PSA and her administration, were not representing the doctors and could not articulate the needs of medical professionals in the public service properly.
FROM THE ASHES : FORMATION OF MPATT
After numerous local meetings at various hospitals across the country, it was agreed that doctors could no longer be a part of the PSA. A decision was made to form a Union that would be able to fully represent the interest of doctors. This led to the formation of the Medical Professionals Association of Trinidad and Tobago (MPATT) which was registered in May 2002. After forming MPATT, a lot of open battles were fought with the President of PSA and with the Ministry. MPATT also had to treat with concerted efforts to pursue negative reports against MPATT by certain elements in the Press. At one point in time the environment became so intense that the doctors decided to resign en masse in January 2003 because the RHA was not willing to negotiate with MPATT, although it had to be made clear that MPATT was the negotiating body and not the PSA. At that time MPATT, a legally registered trade union, did not have certification for collective bargaining but certainly had the moral authority to speak on behalf of doctors. To a large extent, the public and the media had recognized MPATT but the administration was refusing to do so.
MPATT was finally able to achieve parity for public servants after having negotiations with the Permanent Secretary of the Ministry of Health over the 2001-2003 period. Since then MPATT has negotiated for salary increments for 2003-2005, has continued to work on behalf of doctors, taking issues to the Industrial Court, report industrial relations offences to the Ministry of Labour, educating the public, and is engrossed in negotiating salaries for the 2006-2008 period. MPATT has positioned itself to be at the forefront at what is happening in the medical profession.
MPATT was finally able to achieve parity for public servants after having negotiations with the Permanent Secretary of the Ministry of Health over the 2001-2003 period. Since then MPATT has negotiated for salary increments for 2003-2005, has continued to work on behalf of doctors, taking issues to the Industrial Court, report industrial relations offences to the Ministry of Labour, educating the public, and is engrossed in negotiating salaries for the 2006-2008 period. MPATT has positioned itself to be at the forefront at what is happening in the medical profession.
FANNING THE FLAMES : RMU STATUS
We have most recently been successful in its application for recognition as the Majority Trade Union for Doctors employed with the South West Regional Health Authority (SWRHA) as of August 24, 2009. This gives MPATT the right and authority for collective bargaining for Doctors in the SWRHA. MPATT assures all Doctors that it will continue to function as the de facto Trade Union for Doctors in the North West, North Central and Eastern Regional Health Authorities, pending our applications for each.
MPATT is grateful for the support received from all doctors in the formative years. These doctors collectively put up a brave fight and were willing to resign their jobs to ensure that all current and future doctors would be treated with honesty and rectitude. We would also like to recognize the selfless efforts of the founding members and their continued support including Dr. Anjelo Fortune, Dr. Patricia Deonarine, Dr. Keith ChuChong, Dr. Lakhan Roop, Dr. Colin Furlonge, Dr. Philip Ayoung Chee, Dr. Dale Hasranah, Dr. Jehan Ali, Dr. David Josa, Dr. Brian Foon, Dr. Neil Persad, Dr. Naushad Mohammed, Dr. Johanna David and Dr. Arun Raman.
MPATT is grateful for the support received from all doctors in the formative years. These doctors collectively put up a brave fight and were willing to resign their jobs to ensure that all current and future doctors would be treated with honesty and rectitude. We would also like to recognize the selfless efforts of the founding members and their continued support including Dr. Anjelo Fortune, Dr. Patricia Deonarine, Dr. Keith ChuChong, Dr. Lakhan Roop, Dr. Colin Furlonge, Dr. Philip Ayoung Chee, Dr. Dale Hasranah, Dr. Jehan Ali, Dr. David Josa, Dr. Brian Foon, Dr. Neil Persad, Dr. Naushad Mohammed, Dr. Johanna David and Dr. Arun Raman.
