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Public sector doctors have threatened to withdraw their services from Monday, February 18, 2013, over issues arising from their migration onto the Single Spine Salary Structure (SSSS). But the Chief Executive of the Fair Wages and Salaries Commission (FWSC), Mr George Smith-Graham, says their action is premature. The doctors have threatened to start with the withdrawal of outpatient clinical services from Monday, February 11 to February 17, 2013 and attend to only emergencies and inpatient services. That would be followed with the total strike on Monday, February 18. The General Secretary of the Ghana Medical Association (GMA), Dr Frank Serebour, said doctors had adhered to the processes of the law, but there had not been any solution to issues arising from their migration onto the SSSS. He explained that the grading of district directors and medical superintendents was referred to the Ghana Health Service Council (GHS) on November 4, 2011 by the National Labour Commission (NLC), but had since not yielded any solution. Dr Serebour said the position of the association was that any doctor being made a medical superintendent or district director had to maintain his or her grade. Thus, a specialist being made a medical superintendent would still retain the grade of specialist, but would not assume a lower grade upon assuming the position of medical superintendent or district director. As it was now, he added, the positions as graded by the FWSC eroded whatever grade a doctor had and made him or her worse off, as such an arrangement did not consider his or her expertise or skill when he or she assumed that administrative position. But Mr Smith-Graham said that assertion could not be acceded to because the positions were management functions, and any discussions on them were the preserve of the managers of the health sector and not the doctors. On the issue of the market premium, Dr Serebour explained that previously, the market premium had always been a percentage of the basic salary. However, he said by a unilateral decision of the government, the market premium was made an absolute figure in 2012. The impact of that was that doctors were made worse off with any adjustment of the basic salary. Dr Serebour said if the issue of the market premium was not addressed, the prescribed premium by the National Labour Commission (NLC) of 1.0 for medical officers and 1.2 for doctors above that grade, would whittle away with time. He also mentioned the recovery of the conversion difference that had resulted in the reduction of the salaries of some doctors in January, 2012. But Mr Smith-Graham said contrary to those assertions by doctors, work was in progress for a standard guideline on market premium payment to workers who attracted that allowance. He said the committee in charge of that was chaired by the Vice-President. In the meantime, until the guidelines came out, what the doctors were enjoying was an interim market premium. He added that technical post-migration challenges accounted for the conversion differences. The resolution of the challenge was inter-sectoral and involved the Ministry of Finance and Economic Planning (MOFEP) and the Controller and Accountant General's Department (CAGD), among others. Mr Smith-Graham, therefore, advised the doctors to hasten cautiously. Meanwhile, the press statement released after the First National Executive Council Meeting of the GMA held in Accra on January 25, 2013, catalogued the arduous developments on the issues of market premium, the recovery by the government of conversion differences paid to doctors when they were migrated onto the Single Spine Salary Structure (SSSS) and the payment of the market premium. The doctors said they first raised their concerns about the issues in a press statement on January 27, 2012, particularly on the recovery of the conversion difference. The Minister of Finance and Economic Planning directed the Controller and Accountant General's Department (CAGD) to suspend the recovery, but the directive was not adhered to, and it was given after some monies had already been deducted from their salaries. The GMA with other health sector workers then wrote a communique on February 9, 2012, to the Minister of Health at the time complaining about the recoveries made and the fact that it had resulted in a reduction in their pension contributions. This was copied to all stakeholders, including the National Labour Commission (NLC). Another letter by the GMA to the acting Director of the Ghana Health Service (GHS) about the non-resolution of the placement of district directors and medical superintendents, followed on February 16, 2012, and this was also copied to the NLC. On April 1, 2012, the GMA issued a press statement in Koforidua, still raising concerns about its issues that had remained unresolved. A press statement was further issued on May 27, 2012, while also threatening some actions if issues about their conversion difference, market premium and the grade of medical superintendent and district directors remained unresolved. The association then followed that up with a complaint at the NLC on May 26, 2012, with the latter acknowledging the complaint on May 31, 2012, and summoning the GMA as petitioners and the Fair Wages and Salaries Commission (FWSC) as respondents to appear before the NLC on June 6, 2012. Four months after that, the NLC on September 20, referred the GMA's petition of May 28, 2012 for compulsory arbitration, which was to start on October 3, but never came off.