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The Ghana Medical Association (GMA) has stated its reservations about variations they say have been made in a memorandum of understanding (MoU) signed by the association and the Minister of Health without recourse to the GMA. Following the work-to-rule schedule embarked upon by the GMA, an MoU was signed between the GMA and the Minister of Health, Dr George Sipa-Adjah Yankey. The MoU, among others, stipulated that salary negotiations which commenced in 2008 should be concluded, and that the salary for doctors for 2008 be increased by seven per cent with effect from January, 2008. That effective January, 2009, 10 per cent of basic salaries of doctors, including house officers were to be paid to them as on-call duty facilitation allowances and the same shall be paid to doctors not housed in official government accommodation. That arrears in respect of the salary increment and allowances were also to be paid in two tranches, in July and August, and discussions in respect of conditions of salaries shall commence in June, 2009 and end by July 31, 2009. Addressing a press conference at the end of the 4th National Executive Council meeting of the GMA in Bolgatanga in the Upper East Region, the President of the GMA, Dr Emmanuel Adom Winful, said in the aftermath of the signing of the MoU, two letters were dispatched on separate dates by the Minister of Health to the Minister of Finance and Economic Planning on the need to treat the agreement as urgent. �These occurrences notwithstanding and in the light of the nationwide interest shown in the work-to-rule schedule, the GMA wishes to categorically state its reservations about certain unilateral variations of the MoU by the government without recourse to the GMA�. He said they were appalled by a letter signed by the Minister of Finance postponing payment of arrears due their members from July to August 2009 and which is now to be done in four tranches, in violation of the two tranches as earlier agreed upon. Additionally, he said they were uncomfortable with the silence of the Ministry of Finance on the issue of the on-call duty facilitation allowance. Dr Winful said after deliberating on the matters, the National Executive Council of the GMA was calling for a reversal of the said aberrations of the original agreements and demanded total implementation of the stipulations of the MoU. �Further to this, we call on the National Labour Commission to urgently address these thorny issues and not wait till full-blown crisis before coming out to mislabel GMA�s industrial actions. He said they were determined to explore all options available to them, including legal avenues to ensure that agreements reached were respected. He said if labour-management relations between GMA and the government was allowed to deteriorate to a stage where agreements mutually reached could not be relied upon, it would have serious implications on the industrial front. Dr Winful said regarding the 2009 salary review, the government had proposed a seven per cent increment for the health sector, which in their view, did not factor the economic realities that informed the recent 17 per cent increment to other public sector workers.