Foreign doctors say Non! to `slave labour´ wages
Pay rows threaten French health minister's political future.
With some things their disappearance is desirable
With some it is regrettable
But with others it is frightening.
Who will operate on you tomorrow...?
Militant doctors are threatening to take the French government to court over its treatment of almost 7,000 practitioners whose qualifications were gained at universities outside the European Union.
The French Health Ministry is coming under increasing pressure as clinicians, angered by its slow response to resolving issues of inequality, walk out of hospitals and clinics throughout the Republic to support their demands for action. However, they have been keen to reassure the public that emergency cover would continue to be provided ‘in all cases’.
A recent four-day stoppage – the second in less than a month in a campaign that has been gathering momentum over the past two years – highlighted their anger at being paid less than half that received by their colleagues with similar EU qualifications, as well as their lack of recognition by the French health authorities. Demonstrators took to the streets of Paris, many waving placards calling for a halt to ‘modern-day slave labour’ in French hospitals.
Dr Talal Annani, president of the National Union Group for General Practitioners with Diplomas outside the European Union (Inpadhue), which is campaigning on behalf of the doctors, said that clinicians with non-EU degrees – many of whom are French nationals – were paid only 1,800 euros a month compared with the 3,800 paid to colleagues with equivalent qualifications obtained in the EU. ‘These men and women come mainly from Morocco, Tunisia and Algeria, and also from black Africa,’ he explained. ‘They are in an intolerable position – apart from being paid up to three times less than a French doctor, they can neither establish their proper bona fides nor work in private clinics. Their career development suffers accordingly.’
Halde (High Authority Against Discrimination) – the French government’s anti-discrimination body – denounced the doctors’ ‘precarious’ situation and agreed they were suffering salary discrimination ‘although their responsibilities are identical to those of other hospital doctors’. In May, under its wide-ranging judicial powers, Halde gave Health Minister Xavier Bertrand four months to address the situation. If he fails to comply to Halde’s satisfaction, Inpadhue will ask it officially to censure the health minister, a move that would trigger serious political repercussions for him.
On 13 July, M. Bertrand promised to amend the country’s Social Security regulations in 2007. Among other things, he proposes to introduce a special examination to be taken by doctors with non-EU degrees, to establish their levels of medical competence and their knowledge of the French language.
However, Dr Annani has urged doctors to step up pressure on the government through further strike action in protest against the apparent lack of political will. He revealed that, starting on 6 September, a series of demonstrations will take place each Wednesday at 14.00. The first will be outside the health ministry, followed by the Hotel Matignon (the French prime minister’s official residence), the Senate and finally the National Assembly. Inpadhue also warned that unless a fair and just solution to its grievances is found, the demonstrations would continue throughout October, November and December.
‘The health minister has merely confirmed that proposals to remedy the problem will be submitted before the end of the year. But that does not change that fact that we do not agree with them,’ Dr Annani pointed out. ‘For example, we believe that the new examination will not take into account the experience that each doctor has acquired.’
Inpadhue wants doctors from outside the EU with over five years’ service in French hospitals to be exempt from having to take written examinations, preferring instead that they be assessed professionally on the basis of their qualifications and work experience.
Dr Annani added: ‘And what will happen if the minister’s proposals are not accepted and the law is not changed? Will these doctors have to wait a further 12 months before anything is done? We also deplore the ill-will that has been created. Theoretically, hospital doctors on strike could be ordered to perform emergency duties. But we have no official status so hospital managements cannot compel us to work.
‘Earlier this year, Inpadhue met the health minister twice – on 23 March and again on 6 April. Xavier Bertrand promised us he would give a clear directive on our status by the end of April. But today, more than 7,000 personnel are still in this no-win situation. The 4,000 in training will be obliged to return to their own countries and the remaining 3,000 are working in municipal or university hospitals.
‘France has effectively created an unacceptable ‘non-status’ situation in which non-EU degree qualified doctors are working in public hospitals but are not officially recognised as doctors. Our members have no papers to justify their professional status and would not, for example, be able to prove they were doctors if they needed to go into a pharmacy and buy controlled medicines.
By allowing this discrimination to go unchecked the government is actively exploiting these highly trained and responsible men and women – the very people whose skills they need to ensure the safe and efficient operation of French hospitals and clinics.
‘It is little short of a disaster. The country is crying out for more hospital doctors yet the authorities refuse to recognise those with non-EU qualifications and employ them only on short-term contracts. Foreign doctors, some of whom are in their forties and who have vast experience, find this extremely frustrating and humiliating and deplore the instability and lack of career prospects.
‘That is why they are on strike.’
Meanwhile...
Surgeons, anaesthetists and gynaecologists are facing a professional crisis unprecedented in their history.
More than 3,000 of them, out of a total of 7,000, are taking industrial action at clinics and hospitals throughout France in a long-running row with the health ministry over a review of their pay and allowances. They are also angry at what they say have been unacceptable rises in the cost of their professional insurance cover and are demanding that premiums be capped.
They accuse health minister Xavier Bertrand of bowing to political pressure exerted by the powerful insurance companies and allowing them to make huge profits, whilst refusing to address the doctors’ claims.
The three professional associations representing the clinicians – UCDF (poster photo), the surgeons’ union, SYNGOF for the gynaecologists and obstetricians, and AAL, which represents anaesthetists.
In 2004, when surgeons began limited strike action, an agreement was reached under which the health authorities promised to look at the issues. ‘However,’ say the unions, ‘nothing has been done since then. We are fed up with the delaying tactics of officials responsible for public health.’
At the start of the summer heatwave, UCDF president Philippe Cuq said he had warned the health ministry that his members were merely waiting for such an opportunity to take action. ‘The situation will be made worse because many surgeons are about to go on holiday. In the past, anagements at hospitals and clinics have been used to bringing in extra clinical staff to maintain a normal service and to cope with a rise in cases caused by a heatwave. But this option now appears to be extremely limited.’
Xavier Bertrand denounced the heatwave industrial action as ‘irresponsible’, but strikers countered with: surgeons are rarely called on to deal with heatstroke cases.
Syngof president Jean Marty said that gynaecologists and obstetricians were playing ‘cat and mouse’ with health officials, attending deliveries but refusing to carry out surgical operations. ‘They are now threatening to boycott deliveries unless there is swift response to their two core grievances.’ This, he said, would have to come from both the health ministry, and insurance firms. ‘We need to take united action against the industry,’ he said. ‘On average, my members attend 180 births a year, for which they are paid around ¤54,000. However, their annual professional insurance premiums now cost almost 30,000.’
30.08.2006
