$100-billion showdown

In what one senior trade unionist has called the largest monetary dispute ever brought before the Industrial Disputes Tribunal (IDT) in its 50-year history, the quasi-judicial body began hearing a case last Thursday between the Jamaica Medical Doctors’ Association (JMDA) and the Ministry of Health and Wellness. The outcome could cost the Government some $100 billion.

“This one is, by far, the biggest case in terms of dollars that the tribunal will award because the Government is saying that it is $103 billion,” veteran trade union leader Lambert Brown, who is representing the JMDA, told The Sunday Gleaner.

“I feel confident and humbled at the same time that I can take on a case which is generally reserved for King’s Counsel,” he said.

JMDA President Dr Renee Badroe explained that under the Government’s compensation review, the association signed a memorandum of understanding (MOU) on March 16, 2023. The agreement addressed two key issues: basic salary, which was settled, and overtime rates, which were to be finalised by March 31, 2023. However, despite multiple government promises, the issue of overtime pay remains unresolved.

“We have made several pitches to the Ministry [of Finance and the Public Service]; several compromises to the ministry to settle the issue, and they keep on pushing back the date,” Badroe said.

Frustration peaked on December 9, 2024, when junior doctors walked off the job. The Ministry of Labour intervened, urging both the JMDA and the Ministry of Finance to resume talks. Despite hours of negotiations, no agreement was reached, and the matter was referred to the IDT on January 15, 2025.

The Ministry of Health’s submission to the IDT, seen by The Sunday Gleaner, states that implementing the JMDA’s proposed ‘Extra Hours Worked’ policy for 2,143 doctors could cost $103.8 billion annually. The ministry currently pays doctors based on April 1, 2021, rates. It claims the JMDA’s proposal would triple current rates and require retroactive payments from April 2023, unlike the Government’s proposal which would take effect from August 2024.

The ministry argues that “for equity, fairness and transparency in the health sector, the JMDA’s proposal could not be accepted on the basis that no other group would be treated differently”.

It said all other health professional groups have accepted the government’s overtime policy.

However, the JMDA disagrees.

Dr Damion Harvey, a JMDA executive, noted the Government’s policy limits extra hours to 15 per week, yet doctors often work 16-hour shifts, sometimes more than once a week.

“When you do a duty from 4 p.m. to 8 a.m. that is 16 hours,” Harvey told The Sunday Gleaner. “I don’t see how that policy can cover the doctors, because the majority of doctors do more than one duty per week in order to ensure that there is adequate coverage 24/7 for each week and 15 hours will not cover even one duty.”

Harvey also criticised the lack of parity across sectors, arguing that if there is a policy of maximum 15 hours overtime per week and a particular group has to be exempted from it, the policy would be flawed as the majority of doctors do a minimum of 16 hours in overtime weekly.

Badroe added that doctors, particularly in rural hospitals, are often on 24-hour shifts up to 18 times a month, in addition to regular 40-hour weeks. This has placed enormous strain on the understaffed public health system, forcing doctors to juggle multiple specialties and respond to emergencies at various hospitals.

“What we are saying is that a person who covers multiple hospitals is doing a different level of intensity work, because they have a higher patient load, and they have to be travelling at nights from one hospital to the other,” she highlighted.

Badroe shared that junior doctors are now having to move in between specialties instead of focusing on one specialty because of the shortage of medical practitioners for the different areas of specialisation in rural hospitals.

“We are saying to the Ministry of Finance: You have not given us enough staff, we now have to do gymnastics to fill the patches. You cannot pay those doctors as you pay a doctor in an urban centre that does not have the same workload. Every patient you see is a medical legal risk, and if you are seeing multiple patients across different specialties that increases your medical legal risk,” she said.

Badroe stressed that overtime has not been optional for doctors since 1992, as stipulated in a long-standing agreement with the Government.

“There are no ifs or buts or questions. You can’t tell the public to only bring emergencies between 8 a.m. and 4 p.m.,” she said.

Tensions flared last Thursday when the IDT session at its Half-Way Tree office was initially declared cancelled.

“If we had to go to prison, we were prepared to lock down the health sector over the procrastination of the government authorities,” Brown said.

The panel, chaired by Dr Noel Cowell, ultimately reversed the cancellation after confirming with the Ministry of Labour that the existing terms of reference were still valid.

The IDT officials were apparently awaiting correspondence from the Ministry of Labour to determine whether it had made an adjustment to the terms that had been agreed to by the disputing parties. The ministry said it should proceed with the existing terms.

Those terms include deliberations on emergency duty allowances and extra hours worked. The hearings will also involve the University Hospital of the West Indies, the Bellevue Hospital, and the Ministry of Finance and the Public Service.

Brown criticised the delay in resolving the matter, which dates back to 2023. He argued that by law, disputes referred to the IDT should be resolved within 31 days or as soon as practicable.

The next hearing is scheduled for May 12, when both parties will present detailed submissions.

edmond.campbell@gleanerjm.com