Shift system in hospitals : Tug of war between Ministry and doctors

Introduced on a pilot basis on 1st April this year, the shift system has been extended to all public hospital departments since Tuesday 1st August. While the Minister of Health affirms that the system will benefit both doctors and patients, general practitioners’ trade unions are totally against the shift system.

The new shift system was announced by the Ministry of Health, Anwar Husnoo last Friday. According to the Minister, the system will be beneficial to both doctors and patients. Anwar Husnoo said that doctors will be no longer exhausted and will have more time for their social and personal life. “Instead of working 30 hours in a row, doctors will work 13 hours. Also, instead of working 33 hours per week, doctors will work 40 hours while perceiving two salary increases as compensation. This will bring a standardisation in the public service,” stated the Minister of Health.

Under the shift system, the medical team will be providing the first service starting as from 8 am to noon. They will then resume from 1pm to 4pm. The team working in the night shift will start at 4pm to finish at 8am the following day. They will benefit of one hour for dinner and two hours of rest. “Under the new system, doctors will do two day services and then one night shift before having a day off work,” explained Anwar Husnoo.

However trade unions for general practitioners namely the State and Other Employees Federation (SOEF), the Mauritius Health Officers Association (MHOA) and others are protesting against it. The Medical and Health Officers Association have even approached the Supreme Court for a judicial review of the measure. A first hearing is scheduled for Monday 7th August. Moreover, the meeting to discuss discrepancies regarding the implementation of the shift system, scheduled on Wednesday 2nd August between the Minister of Health and the trade unionists was cancelled. However, Anwar Husnoo refused to receive five trade union representatives.

The minister explained, at a press briefing after the cancellation of the meeting, that it was agreed that only three representatives will be present at the meeting. “However, five people landed in the office. We cannot accept it. If there are so many people present it will be a chaos,” said Anwar Husnoo. The president of the MHOA, Dr. Vinesh Sewsurn, refers to a real lack of planning on the part of the Minister of Health. He invited Anwar Husnoo to attend the General Assembly of Physicians to be held this Saturday 5th August at Unity House, Beau-Bassin.

Ramesh Purrunsing : “Both patients and doctors will benefit”

According to the representative of the Comité Amélioration la Santé, the shift system implemented in our five public hospitals is necessary. “The system will be beneficial to all. As stated by the Minister of Health Anwar Husnoo, the Ministry has already carried out a research which indicated that the public is in favour of the shift system in our hospitals. I believe that the medical practitioners from the trade unions have not advanced enough valuable arguments to go against the system,” says Ramesh Purrunsing.

He further explains that the shift system has been requested since long and he is finally seeing the Minister of Health taking necessary actions. “We see endless queues of sick patients in our hospitals. Doctors are overloaded with work and would work long and tiring shift hours. Patients used to blame the doctors who are in fact not at fault. People must understand that doctors are not robots but human beings like us who need time for their social and personal life. With the new shift system, both patients and doctors will benefit.”

Ramesh Purrunsing stresses that the system will also benefit new doctors joining the service. “Instead of hiring foreign general practitioners it is better to employ Mauritians. Our youngsters spend millions of rupees on their medical studies but when they come back, they do not obtain any work. It is better to employ them than using bank doctors like we did before. This system will also benefit them.” He adds that patients will not have to wait long hours in queues to be treated by a doctor. “They will also not have to take a day off their work to come to the hospital during the day. With the shift system even during the evening or at night there will be doctors attending to patients’ needs.

However, he underlines that in order for the system to work harmoniously, there is the need for all clusters of the hospital system to work hand in hand. “For example, the pharmacists in the hospitals must also adapt to the shift system. A pharmacist has to be present at night at least until 8pm. Furthermore, generalists must be accompanied by a specialist during the odd hours.” Ramesh Purrunsing highlights that our health system is a priority.

Narendranath Gopee : “New shift system does not make sense”

For Narendranath Gopee, representative of the Federation of Civil Service and Other Unions (FCSOU), the arguments advanced by the Ministry of Health Anwar Husnoo are not convincing. “The Minister said that doctors have always fought for the shift system. This is not true. They have never done so. They want to work in a system that will benefit them in the sense that they will have more time for themselves and their families. With the new shift system, they will be working more hours weekly. They will be working 27 days over 28 days and it does not make sense,” he says.

Narendranath Gopee questions who will take the responsibility in case something happens to the patient during the shift system. “For example a patient comes in for treatment at 7.55pm when the doctor’s shift system is nearly over. Ethically and as the doctor has taken the oath, he will take care of the patient. But when the next shift system is on, it is a different doctor who will take care of the patient. So this means that different doctors will take care of one patient. In case something happens to the patient, who will take responsibility? I believe that it is the Ministry of Health who should be held responsible,” he argues. He thus says that the shift system is to the detriment of the patient.

In addition, he states that it is the former trade unionists, who are now advisers to the Ministry, who advised Anwar Husnoo on the implementation of the shift system. “This was done in 1993 by these former trade unionists. This was a long time ago. The health system is completely different now. The shift system would have worked in their times but we believe that it is obsolete in our times.” Narendranath Gopee also alleges that the research done, which indicated a positive response from the public, by the Ministry is a hoax. “The Minister is bluffing. He has not done any research with the public. Anwar Husnoo has refused to share this research data with us and also with the Commission for Conciliation and Mediation (CCM). Why is he refusing to make this research public and do things in transparency? It is thus hard to believe that the research has been really done,” he argues.