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MEDICAL MUDSLIDE:Medical professionals say forcing nurses and doctors to work so many hours with little pay could result in worsening medical attention for patients

The Taiwan Healthcare Reform Foundation and eight medical groups yesterday drew attention to “dirty tricks” used by hospitals that they say erode the labor conditions and labor rights of medical employees.

Holding signs that read “Angels in white robes, stuck in hell,” “Over-exhausted doctors lead to unprotected patients” and “Physical therapists are not the same as mechanical therapists,” the groups called for better treatment of medical employees.
After publishing a list of hospitals that violated labor conditions on Workers’ Day last year, the foundation said that although the government had promised stricter checks on labor conditions and a NT$2 billion (US$68.6 million) fund for recruiting nurses, “dirty tricks” used by the hospitals made it impossible for these measures to be put into place, with medical employees still forced to work long hours.
Chang Li-yun (張苙雲), who established the foundation, said that in the past decade, a deterioration in labor conditions for medical employees had spread throughout the industry.
Foundation chairperson Liu Mei-chun (劉梅君) said hospitals used five common “dirty tricks” to get around labor rules — illegal cross-professional substitution; obstruction of doctors’ rights under the Labor Standards Act (勞動基準法); labor shortages in related professions (such as social workers or speech therapists); labor shortages resulting in canceled leave or on-call leave; and overtime work without pay.
“One hospital forced non-radiologists to perform X-rays, but when this was discovered by the Department of Health, only the employee was punished,” Liu said, quoting a complaint by a medical employee.
The foundation condemned hospitals that force employees to perform medical duties beyond their expertise and allow them to be punished when it is found out.
Chien Jien-Wen (錢建文), a doctor at Changhua Christian Hospital’s department of pediatrics, said that without rights protection under the Labor Standards Act, doctors are not indemnified against occupational accidents or unreasonable labor conditions.
The foundation said other dirty tricks included using low hourly wages to “buy leave hours” from employees, demanding that employees be on-call 24 hours a day, even on holidays, and demanding that employees take care of too many patients at a time, causing work-related stress and diminishing the care that patients receive.
Maggie Lin (林美琪), a nurse who submitted an article titled “The dark moment of nurses in Taiwan” to CNN earlier this month, exposing the unhealthy working environment of nurses in Taiwan, said: “If hospitals continue to exploit the health of medical workers, it will lead to a situation of ‘patients taking care of patients.’”
Foundation executive director Joanne Liu (劉淑瓊) said the “mudslide of medical employees” leading to worse treatment and health risks to patients should be solved by the department, the Council of Labor Affairs and the National Insurance Bureau.
She called for improved labor conditions to be included among the essential items for hospital accreditation, modifications to the Medical Care Act (醫療法) to punish hospital management for cross-professional substitution and for the establishment of medical labor unions.
Questions:
1. What are the 'dirty tricks' this article is referring to?
2. Why do you think these dirty tricks happen at hospitals?
3. What is the result of doctors and nurses being forced to work many hours with little pay?
4. What should be done to improve these conditions at hospitals?






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