This circular introduces legitimate and, indeed, the concept of "gainful employment" in the health sector with all that that implies as consequences and excesses.The provisions relating to "exercise the sideline," authorized in the health sector for over a decade, recently created a controversy again since the signing of a circular, dated April 14, by the previous Minister of Health Mr. Barkat. Indeed, this circular, which has not been mentioned publicly, causing the ire of a large number of doctors, teachers, trade unionists, patients and their families, who cry to the killing of Health public and denounce the same time a serious drift of the health system in unequivocal terms, namely "the commodification of health and sick." This circular, they are now demanding the cancellation by the new minister, introduced and legitimate the concept of "gainful employment" in the health sector with all that that implies as consequences and excesses. Relying on the provisions of Article 44 of general status of the Public , now provides that the circular " university hospital practitioners, practitioners of public health specialists, including those occupying the positions of Chief department and unit head, are licensed to practice in private structures gainful weekends and holidays . Further, it is said that "this lucrative ... should not be at the expense of support for users of public and jeopardize the continuity of public service "by subjecting them to leave.
A precision supposed to be a safeguard against the excesses, abuses and deviations in the practice of such a provision, but already is obsolete in view of the very numerous and troublesome precedents peppering activity complementary to some doctors and other university hospitals over ten years. Who does not mind, today, a disturbing and moving testimony of users health victims of this system. As proof, the former Minister Barkat had to sign, December 20, 2009, circular No. 003 prohibiting the department heads or units to perform an additional activity for a premium compensation , following "the malfunctioning multi-level public health facilities, to the excesses and over-identified in the implementation of the complementary activity. The former CEO of University Hospital of Oran, Dr. Attar has learned to his cost what it costs to punish doctors who have totally exceeded provisions of the sideline. This will be the beginning of hostilities against him. Subvert the wage demands of doctors
Debate "intramural" the consequences for patients and the health system for the exercise of the additional activity has always led to a deep malaise when This is the deal openly and publicly. One of our only two players to have agreed to speak openly happens to be a trade unionist, Mr. Mechri, the representative of the union section of SNAPAP CHU Oran: "We witnessing a very serious drift whose governments do not measure the effects. It is a killing of Public Health. This will clear all gainful employment services. How these services will they be managed? How to take care of sick when you see that residents, doctors and others who provide the bulk of care are in private clinics because there will be no check on their presence or not in service? We should not kid ourselves ... But what is worst, fundamentally, is that this circular has been made simply for not responding positively to demands wages of public health practitioners and medical specialists. They said well, we do not increase but, here, go into the lucrative private practice to compensate you, only the poor population will pay the consequences. "Indeed, today, which is tipped to do not sure that is accelerating the deterioration of the support of the population and quality of care at public health facilities.
This vision is fully shared by two professors, heads of departments of the University Hospital of Oran, Science Council members who requested anonymity. Indeed, these two professors, who are 30 years of career behind them, have always opposed the sideline. And explained: "If the state wants more social justice, we must level up and not down. Today, a department head in Algeria in a teaching hospital with over 20 years of career affects the equivalent of 1000 euros or 100 000 DA! Compared to neighboring countries, it's just a humiliation, coupled with a failure status and responsibility of department head. Where it is necessary to retrofit services, hospitality, equipment, care for the sick The public sector is flush with the private, on the contrary, urges physicians to go underground with circular catastrophic. We must move towards a revaluation very consequent wage and they are universally recognized status. "For another manager, a solution had been subjected to the former Minister Yahia Guidoum up the sideline" If unable to raise wages, they could simply allow the departments of public health structures to give one or two beds in private, we can evaluate this activity, this avoid any diversion of patients, supplies, etc.. The doctor is on-site service and everybody wins. But here we are pushing to become illegal. "President of the Scientific Council of the University Hospital of Oran decline our request arguing that as he could not comment because the issue divides the board members entirely scientific. By cons, Dr. SE Sidhoum, an orthopedic surgeon in Algiers, has given testimony without requiring anonymity on this topic, defined also as an activist for human rights: "The complementary activity no interest that a certain minority of practitioners teaching hospital. They are those who want their cake and eat it too. I believe our medical profession is seriously ill, plagued by unhealthy practices at the top of his pyramid. The early introduction and without careful forethought, there is more than a decade, this law called the additional time to address theoretically the low salaries of university hospitals and practitioners in the absence of an efficient authority in the field has led to serious abuses. I was stunned when he heard one of my patients tell me that he had paid 70 000 AD a professor at a hospital, university said, a neighboring wilaya of Algiers, to be placing a total hip replacement at the hospital! It is sad to see the cancer at an advanced stage, turned away from hospitals to get to operate 'in private for a fee ranging from 140 000-250 000 AD and for a few months of survival. Everyone, in some departments, knows these dishonest practices, the wife of the room wizard. "He continued further:" These serious abuses among others and the decay of the moribund public sector are the result of non-health policy. The liberal practice of medicine and especially in surgical specialties must be clearly codified. Why do the authorities concerned do they refuse to date to create a nomenclature of surgical procedures, as happens in all countries of the world? Why are social security funds do not they reimburse the operative procedures performed in private? "
This is another reflection that is shared by a boss of a private clinic who wants this policy choice in place of that of 'sideline. For those who perform any gainful activity will not want to recognize when we have requested.
Remaining patients lying in hospital units, shuffled from one place to another like common packages, waiting for doctors and the right to health care and recognized by the Constitution.
Djamila Loukil, Freedom (July 24, 2010)
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