Historic doctors' assembly sparks controversial decisions

Estimate of 10,000 doctors voted on free of charge medical healthcare in public hospitals among several confrontational decisions with government

In a historic gathering, thousands of doctors across Egypt voted on a set of bold and confrontational decisions against the government. The assembly was triggered by an attack against two doctors working for Matariya hospital in late January.
However the decisions addressed an array of other problems and concerns from the syndicate's side, including their rejection of the newly drafted health insurance bill and the medical treatment in public hospitals.
The first decision on their list stated providing completely free of charge healthcare for citizens at public hospitals.
The syndicate secretary general, Mona Mina, said this decision was initiated to debunk purported claims against doctors that they are reluctant to provide adequate healthcare for underprivileged citizens.
"Whenever we rebel for any of our rights, the government holds us accountable for ignoring citizens' right to healthcare, whereas when we ask the government to increase the health sector budget to provide adequate healthcare for citizens, they claim a lack of funds," Mina said during a televised interview on Friday.
According to Mina, some public hospitals require entry deposits up to EGP 5,000 for the Intensive Care Unit (ICU).
The decision to provide free medical treatment in hospitals is already issued but not yet enforced. In July 2014, former prime minister Ibrahim Mehleb issued a decision based on Article 18 of the 2014 Egyptian constitution. It stated that public and private hospitals should provide free healthcare for emergency cases within 48 hours and penalise those who violate such a decision by shutting down the healthcare facility.
"It is very hard to enforce such a decision; doctors are expected to face reluctance from the management while implementing this decision since some of them already face threats from hospital management," Mina said. However she said this requires support from the citizens' side as well. "From now on, we call on any citizen who is asked to pay money in emergency cases at any public hospital to inform us with an official complaint."
Mechanisms to implement the decisions agreed upon during the assembly are yet to be published and distributed among hospitals and until then, any comments on the decisions implementation will be merely speculations, according to the syndicate lawyer Mohamed Shawky.
"The syndicate protocol will formally outline the process of implementing the decisions agreed upon by the assembly, which are all binding for doctors. Other reported comments on those decisions, until the protocol is issued, will be merely speculations," Shawky told Daily News Egypt.
According to Shawky, the penalty forviolating any of these decisions will be strict and doctors can be subject to removal from the syndicate.
Regarding the decision of referring Minister of Health Ahmed Emad El-Din to disciplinary committee, the decision addresses him in his capacity as a doctor and member of the syndicate, not as a minister or civil servant. "The decision is not yet delivered but it is on its way to the minister's office," he said.
Besides the security status of hospitals, more than 90% of Egypt's public hospitals suffer lack of medical equipment and ailing infrastructure, according to the syndicate figures due to the lack of financial resources and low capacity of medical personnel.
The decision to provide medical services for free has raised concerns from the doctors' side.
Hisham Amer, a doctor and manager at the Qasr Al-Ainy public hospital, told Daily News Egypt the medical service is considered non-profit already and cannot be compared to the fees of private hospitals in any way.
Al-Qasr Al-Ainy Hospital, one of the oldest and wide-reaching public healthcare facilities in Egypt, requires EGP 5 to check in to the emergency section."The service price was never equal to its real value and the doctor's profit is negligible. Those fees barely compensate the hospital expenses," Amer said.
He expressed further concerns about the decision, which he said might impose a bigger financial burden on the hospitals that are already rundown and suffer from inadequate funding. "This is simply not applicable; the syndicate cannot control the implementation of such a decision but rather the management of hospitals," he said.
Regarding the security status of hospitals, Amer said it is definitely inadequate given the rate of attacks. However there is a significant improvement, a decrease in the rate of attacks compared to 2011, and the security unrest that accompanied the political uprising. "There are individual violations and malpractice but this cannot be generalised as a common practice for all public hospitals," he said.
Emad appeared in a televised phone interview following the announcement of the syndicate's decision, where he affirmed Amer's views on the syndicate's authority of implementing free healthcare in public hospitals. "The government is the only mandated authority to implement such a decision according to the constitution," he said.
There are divisive reactions among the minister and Matariya doctors around the details of Matariya hospital attack.
The minister said during the TV interview Friday that there has been reconciliation between the doctors and policemen. Meanwhile one of the doctors who was assaulted responded in a phone interview with Daily News Egypt that they were subject to pressures from the police station personnel to be detained for four days pending investigations if they insisted on filing the report against the policemen.
Among the other decisions agreed upon during the assembly was the rejection of health insurance bill for concerns related to funding sources and the quality of public hospitals in addition to the jurisdiction under which fall the institutions expected to supervise the bill.