Departing doctors leave IGMH unable to provide outpatient services to children

An acute lack of pediatric specialists in Indira Gandhi Memorial Hospital (IGMH) has forced the hospital to temporarily close outpatient services for children, who make up 40 percent of the hospital’s patients.

Zubair Mohamed, Managing Director of Male’ Health Services Corporation – formerly the Chief Executive Officer of IGMH – said that there were only four pediatricians left after many left claiming to have family and personal problems, while others departed on vacation.

Zubair said that low wages and poor allowances were leading doctors to resign and return to their own countries.

”Most of the good doctors we have are from India,” Zubair said.

”They get almost the same salary as if they worked in India, so it’s not worth it for them to work here.”

A recent salary increase for doctors in India has made it even harder for the Maldives to attract and retain qualified medical staff.

Zubair said that the remaining four pediatricians were now working 24 hours on-call in the emergency and IPD units.

”Forty percent of the patients who come to the hospital are children,” Zubair said. ”They are a large group of patients.”

He said that patients hospitalised were now being given more priority than the patients who visited for diagnosis or treatment.

A pediatrician and a second doctor – a talented psychiatric specialist – left the hospital last week on vacation and have not returned.

”They usually leave saying that they have family and personal issues,” Zubair said. ”Only a few directly say that they cannot work for the low salary.”

As a consequence there would be no outpatient pediatric services available this week, he said.

”Hopefully we will get new pediatricians for the hospital very soon and restart services,” Zubair said. ”We need at least six doctors.”

Future of IGMH

When IGMH begins running as a corporation the salaries of doctors will rise and allowances will increase, Zubair promised.

”Right now all the doctors classed are civil servants, ” he explained, ”so we have to follow the regulations of the Civil Service Commission (CSC) and cannot provide them the allowances and salary as we would prefer.”

He said the new corporation had held a meeting with the CSC and discussed the matter, and estimated that it would take three months to start IGMH as a health services corporation.

Spokesperson for the CSC Fahmy Hassan said that the Male’ Health Corporation had held a meeting with the commission but ”it was not to discuss the doctor salaries.”

Fahmy said the commission in January asked the Finance Ministry how much they would be able to pay for the doctors salary and said that the commission was not legally authorised to pay any salary the commission wanted.

”We are now paying them the highest possible salary the Finance Ministry has agreed to give,” he said. ”We cannot pay a salary Finance Ministry disagrees with.”

Press secretary for the president Mohamed Zuhair said that the government had nothing to do with the CSC’s code of salary.

”The government will try to solve the problem somehow,” he said.

He said that the salaries of the doctors will increase when IGMH starts running under Male’ Health Corporation, “which was the main reason why we established it,” he said.Permanent Secretary for the Finance Ministry Ismail Shafeeq did not respond to Minivan News at time of press.

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CSC takes finance ministry to civil court over salary issue

The Civil Service Commission (CSC) has filed a lawsuit against the finance ministry in the civil court, as it had previously threatened to do unless the ministry reinstated the reduced salaries.

The court confirmed the case was had been lodged and accepted, in an attempt “to cancel a decision taken by the ministry”. Yesterday the civil court returned a verdict in favour of the CSC in its attempt to overturn a decision made by the home ministry to cut the allowances of ‘responsible officers’ in atoll and island offices.

Spokesman for the CSC Mohamed Fahmy Hassan said the commission had informed the finance ministry that it was about to take the issue to court, and would not give out details of the case.

”The [finance ministry] said ‘hey, you decided to go to the courts, so lets see what the court says’,” Fahmy claimed.

Spokesman for the finance ministry Ismail Shafeeq said that the ministry would also not comment on the case now it had become a court matter.

”They are doing what’s right by them, so what shall we say about this?” he asked. ”The ministry can’t stop someone from going to the court”.

Press secretary for the president’s office Mohamed Zuhair said he still believed that the problem could be solved by negotiations.

”The government always wants to talk and solve the problem, and we still can talk and it even though there’s a court case,” he said.

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MPs planning no-confidence motion against finance minister

A group of MPs have announced they intend to put a no-confidence motion against Finance Minister Ali Hashim before parliament.

Independent MP Mohamed Nasheed claimed Hashim’s conduct in his role as minister had on several occasions been “against the law.”

”It’s not only the issue of civil servants salary, he has done many things against the law,” he claimed.

Nasheed has previously said he would pursue a no-confidence motion against Hashim after the finance minister failed to appear before a parliamentary committee investigating the ministry’s treatment of the independent commissions.

“He left the country,” noted Nasheed at the time, adding when the committee requested State Finance Minister Ahmed Assad appear in Hashim’s stead, the ministry sent two junior officers.

“If he doesn’t appear, we’ll make a report to parliament questioning his confidence,” Nasheed warned. “He’s being irresponsible and it’s so unnecessary and uncalled for.”

Today, Nasheed said that the group of MPs had almost finished the necessary documentation “and I will be the first to sign the petition.”

He said he did not yet want to reveal the details of what the petition contains.

Dhivehi Rayyithunge Party DRP MP Ahmed Ilham said he supported the no-confidence motion against the finance minister.

”He bought shares in the Maldives Water and Sewerage Company (MWSC) [without the knowledge of parliament], he is paying salaries to province councillor when they have yet to be approved – these things are against the law,” Ilham claimed.

Former president of Islamic Democratic Party (IDP) Umar Naseer and candidate for the vice-presidency of the DRP said motion was overdue, and accused Hashim “of being unable to read and write.”

MDP MP Moosa ‘Reeko’ Manik said he preferred not comment on the issue before the petition was presented to the parliament.

MDP Spokesman Ahmed Haleem said parliament had failed the last time it tried to press a no-confidence vote (against Foreign Minister Dr Ahmed Shaheed), “and I do not think they can do it this time either.”

He accused Nasheed of trying to make the no-confidence vote to gain support from DRP.

”At first we hoped Nasheed would be a very beneficial man for the country and would do a lot of good, but now I see he does so many things against democracy,” Haleem said.

Minivan News sought response from the finance ministry on several occasions but received no response at time of press.

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‘Strikes lawful but we won’t support them’, says CSC

President of Civil Service Commission (CSC) Mohamed Latheef has said that the commission does not support strikes on principle “as civil servants are working for the benefit of the people, and [striking] is harmful for the people.”

However he said that those civil servants who were striking over the salary issue were using a right accorded them under the law.

He also said civil servants had a right to their full salary this month, and that it was “unfair” of the government to restore only some salaries (at the independent commissions).

Latheef said that all government employees, including independent commissions, “must face the difficulties due to the country’s economic condition.”

“The CSC believes that this is a national issue and it can be solved by speaking. Going to the court is not our first option, we wish this to be solved by talks,” he said.

Press secretary for the president’s office Mohamed Zuhair said it was not the government who decided the salaries of independent commissions, and that “rather it was decided by the parliament and the government does not have any power over it.”

Civil servants salaries accounted for 70 per cent of government’s expenditure, he said, while the independent commissions accounted for only five per cent.

He added that while the CSC might not believe that legal action could be taken against the striking civil servants, “that is not how the government feels about this.”

He said the government would restore the salaries of civil servants when its income reaches Rf7 billion, and the fact that parliament approved a budget of Rf7 billion “does not mean that we have it on our hands now,” he explained.

Spokesman for the Finance Ministry Ismail Shafeeq said that the government would provide civil servants “what we can.”

“Everyone knows the country’s economic condition,” he said.

Shafeeq said that he believes everyone, including civil servants and independent commissions, “must endure the special economic conditions of the country.”

“The finance ministry will be deciding whether or not to change their decision,” he added.

MDP MP Ahmed Easa said he believed civil servants and the independent commissions should both be receiving the lowered salary.

“When salaries are increased the country’s inflation rate gets high,” he said, “and when the inflation rate rises prices rise as well.’

Easa said “the best solution” was for the government to keep the 15 per cent salary money “and cut the import duty for food.”

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IMF warns restoring salaries will “jeopardise” international financing

The International Monetary Fund (IMF) has warned that international funding to the Maldives would be threatened if civil servant salaries are restored to former levels.

“One of the primary drivers of the large fiscal deficit has been government spending on public wages, which has more than doubled between 2007 and 2009, and is now one of the highest in the world relative to the size of the economy,” said Rodrigo Cubero, IMF mission chief for the Maldives.

“Measures that would substantially raise the budget deficit, such as a reversal of previously announced wage adjustments, would also put the program off track, jeopardising prospects for multilateral and bilateral international financing,” he warned.

State minister for finance Ahmed Assad confirmed that international funding might be at risk if the salaries were restored in the manner demanded by the Civil Servants Commission (CSC).

“The IMF have been saying that for a while,” Assad said, reiterating that the government was not capable of increasing civil servants salaries this month.

Permanent secretaries of various ministries had been submitting two salary sheets, he said, “so we know the difference.”

Spokesperson of the CSC Mohamed Fahmy Hassan said according to Maldivian law, the finance ministry had to pay the increased salary this month.

”For instance, if give you  work to do and say I will pay you 100rf when the work is done, after you complete the work is it fair for me to say, ‘Oh, I cant give you Rf100, I only have Rf50′,” he asked.

In response Assad said the IMF only gave economic advice, and was indifferent to a country’s law.

During talks between the CSC and finance ministry yesterday no agreements were made beyond a decision to continue negotiations.

In its statement, the IMF warned that “the Maldivian economy continues to face serious challenges. In particular, addressing the very large fiscal deficit is of paramount importance to secure a stable economy, equitable growth, and lasting poverty reduction.’

“A larger fiscal deficit would drive up interest rates, deprive the private sector of the credit it needs, and threaten growth and employment. It may also stoke inflation and erode the purchasing power of all Maldivians, including civil servants. It is to avoid such undesirable outcomes that the fiscal deficit needs to be reduced.”

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CSC and finance ministry hold talks to resolve salary dispute

After months of trading blows in the media, the Civil Service Commission (CSC) and the finance ministry met this morning to discuss the restoration of civil servants’ salaries.

However neither party would reveal what was discussed in the meeting, saying only that the issue remained undecided and another meeting would be held.

”We do not want to comment on this yet,” said Mohamed Fahmy Hassan, a CSC member who has advocated discussions between the CSC and the ministry.

State Minister for Finance Ahmed Assad also refused to reveal what was raised in the meeting, but said was expecting the discussions to lead to a solution.

Both Assad and the finance controller from the finance ministry were present at the meeting.

In response to the silence, spokesman for the Maldivian Civil Servants Association (MCSA) Abdulla Waheed said he was convinced the discussions would not lead to a “beneficial” solution and that the finance ministry was simply seeking to extend the period of reduced salaries.

”The CSC might agree to keep the salary lowered till the parliament re-opens,” Waheed predicted, threatening a law suit against the CSC if the outcome of the discussions was deemed “an injustice”.

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Civil Servants Association threatens to sue finance ministry if salaries lowered

The Maldivian Civil Servant Association (MCSA) said at a rally yesterday that it will file a lawsuit against the finance ministry if civil servants are given the lowered salary this month.

MSCA spokesman Abdulla Mohamed said the organisation was placing five lawyers on standby.

”The finance minister [Ali Hashim] has personal issues against the civil servants, he’s being stubborn,” Abdulla said, adding that the problems were getting worse “because [Hashim] does not have much knowledge on how to handle a government’s finance ministry.”

”Whatever he thinks is right at the moment, he does. He does not plan things well,” Abdulla claimed.

The ministry’s request that the Maldives Monetary Authority (MMA) and parliament mediate its dispute between the CSC “is not a solution”, he said, insisting that the ministry needed to “follow the law” and pay the full salaries for this month.

Otherwise, he said, the government would be in debt and owe civil servants the rest of the money.

Abdulla further added that the CSC had been careless, and failed to fulfill its responsibility to ensure the deductions applied the independent commissions, judiciary and police as well as other civil servants.

State Finance Minister Ahmed Assad said holding discussions with just the CSC would not lead to a solution, and that the involvement of a third party was needed.

The civil servants would be receiving the lowered salaries this month, he said. “The MCSA has a right to go to court and file a lawsuit if they have problems with the finance ministry.”

In addition, Assad claimed the CSC did not discuss the restoration of civil servants salary with the finance ministry.

”But they did asked us once: ‘is the country still in the state of a economic crisis?’, and we said ‘yes’,” Assad explained.

Governor of the MMA Fazeel Najeeb said the organisation would not outline its involvement in the arbitration process yet, but would speak to the press in several weeks.

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CSC issues pay-day ultimatum to ministries

The ongoing dispute between the finance ministry and the Civil Service Commission (CSC) has heated up, after the CSC warned it would take legal action against any CSC member who prepares a wages bill with the reduced salaries.

A letter circulated among permanent secretaries urged them to send the salary sheets to the finance ministry with the restored levels, and said  employees who prepared the wage bill would have to bear responsibility both for the reduced salary and disregarding the CSC’s directive.

The finance ministry retaliated by threatening legal action against government payroll officers who failed to fill out a reduced salary sheet, while a highly-placed source in the government said political appointees rather than civil servants would fill out the salary sheets.

On 13 January the finance ministry issued a statement directing  all government institutions to make out the salary sheets according to the reduced amount, claiming that the three month period of reduced civil servant pay is to be increased until the government’s “special circumstances” are resolved.

The CSC has meanwhile announced that the finance ministry’s agreement to reduce civil servants’ salary for three months is now over, claimed that all civil servants must receive their full salary starting from this month.

The country’s political parties divided over the issue.

The opposition Dhivehi Rayyithunge Party (DRP) claimed the finance ministry “has no right” to deduct the salary of civil servants.

DRP member Mohamed Hussain ”Mundhu” Shareef said the party was resolute that civil servants would receive the same salaries as before.

“When President Nasheed came to the administration, reducing the amount of civil servants to from 29,000 to 18,000 was not in his manifesto,” Mundhu said, accusing him “of torturing the people”.

Reducing, increasing and resolving civil servants salaries was in the hands of the CSC, he said, and that the finance ministry was unable to set the salary against the CSC’s wishes.

Maldivian Democratic Party  (MDP) MP Mohamed “Colonel” Nasheed said the salary crisis was a national issue and an “economic domino” waiting to fall.

“If the CSC is upset there are a lot of problems we face other than civil servants salaries,” he said.

Nasheed suggested that the government institutions involved needed to get together and come to an agreement.

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Parliament called to arbitrate civil servant pay dispute

The ministry of finance has asked parliament and the Maldives Monetary Authority (MMA) to arbitrate a dispute between the ministry and the Civil Service Commission (CSC) over the restoration of civil servants’ salaries.

Parliament has been asked to act as a mediator as the ministry “does not believe a satisfactory solution can be found through discussions with the commission”.

Until the dispute is resolved, “employees will receive the salary that was reduced due to the economic circumstances,” the finance ministry’s statement said.

The CSC meanwhile criticised the ministry for a lack of communication and unwillingness to meet for discussions.

“They could ask us to sit down and discuss this tomorrow morning and we would be there,” said CSC member Mohamed Fahmy Hassan.

“We’ve sent many letters and made many requests for them to submit information but they have not submitted it to us,” he said.

The CSC was not opposed to the involvement of third parties such as the MMA, he said, but having another government institution like the MMA acting as a go-between “sounds a bit odd.”

“We can discuss the issue with MMA or the People’s Majlis, but there’s going to be no decision made without the involvement of the finance ministry.”

Parliament broke for recess in December and will begin its first session of the year in March.

Waiting game

On 30 December, the CSC issued a circular announcing that civil servants’ salaries and allowances had been restored to their former levels.

Since it was agreed that the pay cuts will be rescinded once government revenue exceeds Rf7 billion, the CSC argued, the salaries would have been “automatically reversed” when parliament approved this year’s budget with a revenue of over Rf7 billion.

However the finance ministry’s statement criticised the commission for the announcement as it came after the ministry had declared that the economic circumstances had not changed.

“And while it did not consult with the ministry, the fact that the Civil Service Commission did not seek the advice and counsel of the Maldives Monetary Authority, the most appropriate independent institution to approach before making such a decision, is regrettable,” it said.

No deal

The pay cuts of up to 20 per cent for civil servants were made necessary due to a fall in government income and an increase in expenditure, the ministry claimed.

In August, the government introduced a raft of austerity measures – including cutting back on travel, controlling capital items purchases, halting renovation and repairs unless necessary and pay cuts of 20 per cent for political appointees ranked higher than deputy minister to alleviate the inherited budget deficit.

Recurrent expenditure on salaries and allowances for government employees was 34 per cent of total expenditure in 2008, a 62 per cent increase from the previous year.

The International Monetary Fund [IMF] has noted that this puts the Maldives in first place among small island nations for the highest expenditure on government employees as a percentage of GDP.

Pay cuts for civil servants were enforced in October following protracted negotiations with the CSC.

The commission exercised clause 43[c] of its Act, which authorise it to alter salaries based on “special economic circumstances” subject to a review in three months.

“The measure proposed by this ministry to determine the special circumstances was the state’s income and expenditure,” the ministry’s statement read. “It was therefore agreed that the economic circumstances would be considered to have passed once the state’s annual income exceeds Rf7 billion, while it was also agreed that the state’s total income does not include foreign aid once-off revenue.”

It further added that the pay cuts were not made for a three-month period, but would be subject to a review to determine if the economic circumstances had changed.

The inclusion of foreign aid in the government’s budget is a particular point of contention, as it pushes the total revenue over Rf7 billion. Actual government revenue excluding foreign aid and once-off revenue was projected to be Rf6.8 billion in the budget.

“We understood it was the total revenue of the government. The ministry’s press release on 25 September said they were not going to exclude anything. This issue needs to be resolved,” said Fahmy.

Special circumstances would be considered to have improved when the state’s “recurring income” reaches Rf7 billion, the ministry said, and “not when it is estimated that Rf7 billion will be received in income.”

Scaring off donors

The opposition-dominated committee selected to review the budget made a recommendation to inject Rf617 million to restore civil servants’ salaries as the proposed budget had Rf7.05 billion in revenue.

While the original budget submitted to parliament had a deficit of 14.8 per cent and was acceptable to the IMF, the alternations made by parliament increased it to 18.8 per cent.

The ministry now estimates the deficit by the end of the year will exceed 18.8 per cent as the government will lose Rf150 million in revenue due to parliament’s failure to pass taxation legislation.

Increasing expenditure at the beginning of the year based on projected revenue was “not sensible at all”, the ministry insisted.

There were four ways the government could plug the deficit – printing money, financial assistance from international monetary organizations, obtaining commercial loans and devaluing the rufiyaa – all of which would have adverse effects of the economy.

Printing money would lead to inflation and a dollar shortage, taking commercial loans would make it harder for the private sector to secure loans and devaluing the currency would increase inflation and the price of imports.

Instead, the ministry reached agreements with the IMF, World Bank and the Asian Development Bank to obtain loans to plug the deficit.

However hiking salaries for government employees without increasing the revenue base was not “a sustainable fiscal or monetary policy”, and these international organisations have since informed the government that they are reconsidering the loans, the ministry’s statement said.

If the Maldives does not have an economic framework that is acceptable to the IMF, it continues, it would not be possible to obtain assistance or loans from other financial institutions.

Apart from potentially losing Rf755 million in assistance from the World Bank and ADB, the donor forum organised by the World Bank and scheduled for March could be canceled.

“Therefore, the ministry believes reducing expenditure is the wisest and most economically sensible way,” it said, adding that expenditure on wages had to be kept low until the economy rebounds.

Fahmy said the CSC was willing to negotiate and wished to meet the finance ministry “to hear their views on the economic circumstances.”

“We have always said that if there is a national crisis we will put the national interest above the interest of civil servants,” he said.

“But it is difficult to justify that to 29,000 civil servants if the government is spending on all the other items in the budget.”

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