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Obstetricians at Lisbon hospital go on strike
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     Doctors working in Portugal’s largest maternity hospital, in Lisbon, have begun an 11 day strike. The strike aims to prevent the exodus to other institutions of obstetricians trained at the Alfredo da Costa Maternity Hospital. It also seeks to ensure that agreed overtime payments are honoured.

    The strike began at midnight on Monday 17 May and was due to continue until midnight on 28 May, according to the Portuguese Independent Union of Doctors.

    Alvaro Cohen, spokesman for the union, said that all state doctors in the obstetrics department have joined the strike, 98% of those in gynaecology, 88% in anaesthesia, and 76% in paediatrics.

    The union said that services such as the emergency department, haemodialysis, and oncology would continue. Outpatient consultations were being rescheduled, it added.

    Carlos Arroz, secretary general of the union, said: "The Alfredo da Costa Maternity Hospital delivers on average 6500 babies a year¡ª500 to 600 a month¡ªand deals with the most complicated cases from all parts of the country.

    "For the past two years all of the eight doctors who completed their training in the maternity unit left to work in other maternity hospitals elsewhere in the country. We are having a serious problem replacing our medical staff, so we are worried about the future of the institution.

    "Thirty per cent of the doctors working in the maternity hospital are aged over 50 already, and many of them continue to do shifts in the emergency department when they are not obliged to any more."

    Ana Margarida Pereira, a press officer for the health minister, Luis Filipe Pereira, said that backpay for overtime worked in previous years but not paid at the time had been sent by the government to the hospital about two weeks before the strike. The amount, about €320 000, is due to be distributed to the doctors.

    But the union claims that junior doctors have been left out of this payment, even though they are entitled to it.

    Dr Branco also pointed out that another reason for the strike was the need to invest in more modern equipment. "We are reaching a point of no return," he said.

    ¡ñ The Portuguese Ministry of Health wants junior doctors who are in specialist training posts to cover shifts in the emergency department without being paid.

    The ministry recently sent a document to the boards of Portuguese public hospitals explaining the measure. If implemented it will cut expenses for overtime set aside in the state health budget.

    The ministry is expecting to reduce the amount of overtime expenses allocated to junior doctors by more than half.

    Carlos Cortes, president of the Portuguese Association of Junior Doctors, said: "We totally reject the proposal of working in emergency departments on an unpaid basis. The non-payment of professional work will never be a way to assure the financial sustainability of institutions.

    "It is at the very least unfair to propose this measure for junior doctors, as they often work overtime without any additional payment, and the minister of health knows that. We await clarification from the Ministry of Health."(BMJ Tiago Villanueva)