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18 July 2007
To : All Medical Staff of HA
You may have read media reports that Hospital Authority (HA) has
put forward a proposal to the Frontline Doctor’s Union (FDU) and Hong Kong
Public Doctors’ Association (HKPDA) on a new career progression structure for
doctors employed in HA after April 2000.
I am very aware that pay reductions since that time have fallen
more heavily on these doctors than any other staff group in HA: alongside pay
cuts and frozen increments experienced by all staff, post 2000 doctor colleagues
the starting salary reduced by 5 points,
6 omitted points and 2 examination points removed, and
the ceiling dropped from pay point 44B to 38.
For a qualified specialist who joined HA in 1999, their take home
pay is now $112,484 (including basic salary, fixed allowance, HLISS in lieu,
gratuity). A qualified specialist (promoted to Resident Specialist) who joined HA
in 2000 and is now a Resident Specialist, will have take home pay of $81,670 –
this is 38% less than the specialist joining a year earlier.
We are particularly concerned to retain younger doctors, with the
largest cohort of post 2000 doctors now graduating as specialists, and so able
to pursue employment outside HA as a specialist.
As part of HA’s wider medical grade review process, we are
proposing a new career progression structure for doctors who joined HA since
April 2000. There are a number of important principles that guide the proposal:
a salary attractive enough to attract and retain doctors when compared
with the private market,
comparable with Department of Health (DH) doctors, recognizing that at
some points HA will be higher or lower, but considering the average
over the full time in the pay scale,
respects the position of doctors compared with other similar professions,
such as lawyers,
allows opportunity to continue progressing towards the same top of the
scale as those joining before April 2000 (point 44B), and
maintains internal experience and qualification relativities.
Attached is an outline of the proposal offered to the Unions
representing this group of colleagues. The table shows the % increases that
would apply to serving doctors upon implementation later this year, depending
on year of entry to HA, progress in passing examinations, and promotion to
resident specialist rank. The proposed increases range from 15% to 38%.
I understand the Unions will be consulting their members, and they
have sought a number of clarifications from HA, and may consider alternative
career progression structures. I welcome any comments from colleagues on the
proposal and encourage you to feedback to your relevant union representative or
to use the online Staff Letter Box found on the front page of the HA.Home
I emphasize that this proposal is a draft offer only and subject to
further negotiation within the funding envelope available, and includes
consideration of other factors such as progression through the new pay scale
and length of contract. We will continue meeting with the unions to finalise an
acceptable new career progression structure and I will keep you updated on
( Shane Solomon )
Year of Service
in lieu Gratuity
in lieu Gratuity
14 or more 38 54,255 16,564 70,819 2,713 8,138 81,670 44B 74,725 22,814 97,539 3,736 11,209 112,484 38%
13 38 54,255 16,564 70,819 2,713 8,138 81,670 44B 74,725 22,814 97,539 3,736 11,209 112,484 38%
12 38 54,255 16,564 70,819 2,713 8,138 81,670 44B 74,725 22,814 97,539 3,736 11,209 112,484 38%
11 38 54,255 16,564 70,819 2,713 8,138 81,670 44A 72,135 22,023 94,158 3,607 10,820 108,585 33%
10 38 54,255 16,564 70,819 2,713 8,138 81,670 44 69,615 21,253 90,868 3,481 10,442 104,791 28%
9 37 51,870 15,836 67,706 2,594 7,781 78,080 42 64,425 19,669 84,094 3,221 9,664 96,979 24%
8 36 49,535 15,123 64,658 2,477 7,430 74,565 41 61,765 18,857 80,622 3,088 9,265 92,975 25%
7 33 43,940 7,975 51,915 2,197 6,591 60,703 38 54,255 16,564 70,819 2,713 8,138 81,670 35%
6 32 41,965 7,617 49,582 2,098 6,295 57,975 37 51,870 15,836 67,706 2,594 7,781 78,080 35%
5 31 40,085 7,275 47,360 2,004 6,013 55,377 36 49,535 15,123 64,658 2,477 7,430 74,565 35%
4 29 36,575 6,638 43,213 1,829 5,486 50,528 33 43,940 7,975 51,915 2,197 6,591 60,703 20%
3 28 34,920 6,338 41,258 1,746 5,238 48,242 32 41,965 7,617 49,582 2,098 6,295 57,975 20%
2 27 33,355 6,054 39,409 1,668 5,003 46,080 31 40,085 7,275 47,360 2,004 6,013 55,377 20%
0 or 1 27 33,355 6,054 39,409 1,668 5,003 46,080 30 38,285 6,949 45,234 1,914 5,743 52,891 15%
HA's Proposed New Career Progression Structure for Doctors employed in April 2000
Proposed Structure : Pt 30,31,32,33,36,37,38,41(RS),42,44,44A,44B
Under HA Proposed structure Under HA Current Structure
If taking fellow = specialist resident, i think i will accept this.
Working as a doctor is not for money. However, if i work so hard, i still can't give a stable and comfortable life to my family, i will definitely seek another way to achieve this basic goal, because this is the primary responsibility of a man.
Our respects are from our act, our knowledge, and our morality. ( not salary )
Also, for the sake of long term development of the medicine, the status and salary of doctors should be maintained. We are not inferior to lawyer and accountants. We are also definitely not inferior to doctors in DH.
We are the one in our time. We should not withdraw one step in the major principle otherwise we will be the guilty in the history of medicine in hk.
I tend not to trust this and will wait for the experts' opinion. It seems for most of the early years the pay will be less than DH and government lawyers. It takes 10+ years to get to the top pay, but that is subject to renewal of contract! It's a clever plan because:
- HA will win the young specialists, because they benefit the most under this new scale
- trainees getting lower pay than other professionals will continue cheap labour with better morale, BUT after years and years when they start to get more reasonable pay, HA can dispose of them by not renewing contracts...
In my cluster, most 2000 and 2001 resident who are now accreditated as specialty fellows continue their contracts as residents instead of resident specialists(RS).
Can anyone from PDA/FDU clarify what is the proposed promotion structure for these staff? What is the max pay points for resident compared to RS? What's the opportunities for these residents with full speciality accreditation to be promoted as RS?
If HA increases the max pay only for post-2000 RS (44B) but create few or no RS posts for qualified fellows, it may be just a trick to keep our salary more or less the same.
You are right. You can be ****ed to remain at 38 forever if the proposed pay scale becomes effective.
possession of internationally recognized fellowship does not mean that possession of internationally recognized mentality
你給我考十年難過A level 十倍的會考,再跟我說貪心。
要做一個大手術, We may need a well trained physician to optimize the medical condition and a very good post-op ICU support. If the patient needs any rehabilitation service, another rehab specialist is required.
When all the excellent surgoen, cardiologist, gastroenterologist, urologist, oncologist....... leave HA, who will suffer ?
The poor, the middle class and you ...........
In the future , if the salary of doctor is too low, all the bright students choose law and account, only the second class student to study medicine, who will suffer ?
Honestly , general medical knowledge is not that difficult but when we touch the subspecialty , the story is different. second class student really can't handle.
not all doctors and fellows are money-minded like you!
you are extremely naive to believe that high pay means high standard medical care.
Open your eyes -- not your brain which is hidden in buttock and filled with money -- to see around: to look at doctors in Venezuela: how those top surgeons still work in their poor motherland, having POOR PAY, though they are capable to have better return in other wealthier countries.
Or a nearby case of Prof S Chung who served in PNG receiving, quoting your words, downgrading salary.
If you feel humiliated by getting such pay in gov hospital, you are always welcome to go to private to earn WHAT YOU THINK YOU OUGHT TO BE PAID.
But don't stay here shouting like a hungry dog and humiliate the dignity of our profession.
remarks: S is Sydney and PNG is Papua New Guinea, for those mind and eyes are blocked by dollars.
Using a special case to cover the general condition is not the cup of my tea.
Mr Lee M/65
Hx of BPH, HT
Attended AE for AROU with UTI on 2003
He was admitted to medical with hytrin and antibiotic given.
UTI was treated but foley could be wean off.
Urologist was consulted. TURP was arranged. He was discharged with foley and urine bag.
The patient was very depressed for carrying the foley and a urine bag. He was very depressed for that.
The doctor in charge wanted to help but he could not do anything. The TURP appt was scheduled in 2005. The patient was unhappy. The doctor in charge tried to search the private TURP information for the patient but the price was ~50000. Patient could not afford.
Patient waited till 2005 but the TURP needed to postphone because many urologist left HA. He needed to wait for 6 months later. However, he developed chest pain during the pre op period. He was found to have IHD. Cardiologist was consulted. Cardiac Cath was suggested but he needed to wait another few monthes. So he continued to live with the foley and urine bad. Finally, PTCA was arranged but two experienced cardiologist left the hospital. PTCA could not be performed in a short time. He could not afford the private PTCA again. He also needed to apply for the funding for PTCA. PTCA was performed after the a/v of the fund and a/v of cardiologist.
After lots of troubles, he lived with his foley and urine bag.
Thanks for the god. He could have TURP in 2007 again when he was 69. However, the experienced urologist left. Post op he was complicated with sepsis and shock. The shock also triggered ACS.
Medical was consulted but ten physicians left the medical department and the on call was taking 8 calls per month. He turned up with tired look. LMWH was suggested. Cardiologist was not a/v. One cardiologist left and one was promoted and one left HA to private.
The patient later developed stress ulver with acute GIB. Surgoen was consulted for urgent OGD. But the manpower in surgical was tight. The first call was a FM rotation and the second call was doing an emergency OT. Lots of fellows left. The middle power was weak. Third call won't be called back so easily in reality. The patient needed to wait for "urgent" OGD.
ICU was consulted but the ICU on call was a second year medical MO only as ICU manpowr was not enough. Medical MO needed to rotate to the ICU as training and as working hand.
Finally, the patient arrested before the urgent PM section OGD. I was just there while he was arrested as i went to that ward for consultation.
Case MO was in OPD although it was 2:00pm already. ( my urologist friend told me they needed to see ~40-50 patients in OPD)
I took the role for CPR as the patient developed VF and then asystole. The CPR failed.
I reviewed the story of this patient finally.
The patient was with his foley and urine bad for years in his final days. He finally could take away it while he was dead. Would it be better if his OT was done while he was younger ? Would it be less suffer if he did not need to live with the foley.
我很多同學都走了,他們沒有錯,時薪低過護士,低過以前中六做part time. 走,能怪他們嗎?
QMH neurosurgical 更試過要人一個月15call!!!
Fellow完,要你做RS工作,不過給Resident contract 和人工你,
既然咁唔公平, 點解FDU啲精英為咗一百幾十又簽咗既? 仲跣埋你大佬喎金...哈哈哈, 果然係精英!
This is the truth. I agree.
However, but when we face a patient with chest infection complicated with septic shock and pre renal failure Cr ~ 700. K 6.7. The patient also got DKA and heart failure and fast AF. Then a specialist and a GP will make difference.
managing a case of common cold and a case of the above patient taking the same salary is acceptable.
I won't envy as i don't like to treat a cold.
Different people should have different role.
But if we manage the above case , we take less salary then this will be unacceptable .
I think you won't disagree with this reasonable suggestion bah ........
I just wonder.
We doctors may not be good at mathematics but we are not stupid. With HA's history of employee abuse and "number games", who is ready to believe? If this proposal is really so good and even better than DH pay, why not just give us the DH system?