Maltese consultant surgeons (1)

George Orwell's Animal Farm includes a much quoted phrase: "... all animals are equal, but some are more equal than others!"

The government is misleading the public with its statement in The Times last week which explained that all Health Division consultants were regarded as equal and that there was no differentiation between junior and senior consultants.

Indeed it is puzzling how, in the light of this statement, Government can justify singling out Mr Alex Manchè as being "more equal" than all the rest and continue offering terms and conditions of service to him that are discriminatory to all other consultants employed within the Health Division.

There has been much correspondence praising Mr Manchè's skills and dedication and these views are shared by all his colleagues within the profession - he is indeed a credit to the cardiac unit.

Yet this is not what is at issue. Mr Manchè has been employed with the Health Division for over ten years and his salary has always been about five times that of other Maltese consultants. This situation has always been a bone of contention and, although morally unjustifiable and unfair towards other Maltese specialist consultants, it used to be legally permissible.

However, following Malta's accession to the European Union, the MAM contends that the situation has changed and that the renewal of Mr Manchè's contract is now illegal.

Dr George Abela, a well-respected lawyer, is also MAM's legal adviser. MAM contends that under European law, the terms and conditions of service offered to consultants must be the same for fellow European citizens as those offered to Maltese consultants.

However, the government has been inconsistent in this regard. Until very recently, another European consultant was also being paid a salary many times that of Maltese consultants.

Just like Mr Manchè, she too enjoys an excellent reputation in her surgical field. However, after EU accession, the government did not offer a renewal "overseas" contract to her since this would have been illegal. Instead she was offered a contract identical to that of Maltese consultants. She is now employed in government service performing exactly the same work as she did before, but is now being paid less than before.

What union worth its salt would not take issue with the government on such blatant injustice and discrimination against the whole of the Maltese consultant body?

Mr Manchè performs about 300 heart operations every year. As a consultant urologist, I am responsible for a total of 1,500 operations every year, yet my salary is one-fifth Mr Manchè's. I am left wondering what formula the government is using to justify this preferential treatment.

Is one heart bypass operation equivalent to 10 operations for kidney cancer or 50 prostate operations? Is one heart transplant operation the equivalent of 15 kidney transplant operations? Is the treatment of a patient with pain from angina more valuable than treating the pain of a patient suffering from arthritis or terminal cancer? Is the medical management of a heart patient more valuable than the treatment of other patients suffering from asthma or diabetes?

Is the rehabilitation of a patient after a heart attack more valuable than the successful rehabilitation of patients on the Special Care Baby Unit, or the Intensive Care Unit?

Even if Government rates heart disease to be more important than any other illness, how does it justify the preferential treatment of Mr Manchè over his two consultant cardiac surgeon colleagues?

Is a heart operation performed by Mr Manchè five times more valuable than the same operation being performed by either Mr Busuttil or Mr Galea?

Within the medical profession, there has always been respect for each other's specialist skills and, indeed in our eyes, all consultants should be afforded equal recognition. Indeed the excellent health service that is currently on offer is testimony to the many different specialities that are now available, each with its own group of consultants.

Professor Albert Fenech contends that the "financial package of doctors employed by the government has been a problem that has been brewing since the 1950s and it is high time it is resolved honestly and realistically. The paltry wages earned give rise to a sense of injustice and inequality among the dedicated and hard-working profession that is at best a distraction from the sense of purpose of our daily demands" (The Sunday Times, August 7).

It would appear from the many letters that no-one would begrudge Mr Manchè his current salary. Indeed one patient commented that "he is worth every penny he gets and should get even more!"

It would also appear that Government is prepared to pay that salary for the services of a consultant cardiac surgeon. In other letters and articles, there have been forceful arguments against changing something that is working well and rather than lowering Mr Manchè's salary, the salaries of the Maltese consultants needed to be improved substantially. Indeed MAM agrees and is fighting for an end to discrimination and injustice.

The analogy of peanuts and monkeys in The Times' editorial a few weeks ago caused outrage in the medical profession. However, as long as the injustice and discrimination persists, this anger will be directed at Government because by paying peanuts, the government is effectively treating us like monkeys! The hospital consultants see this situation as unacceptable and offensive. It needs to be resolved with urgency.