EurWORK European Observatory of Working Life
Young doctors leave to work abroad
Hungarian trainee doctors are unhappy with their wages, claiming they earn less than fast-food restaurant workers. Since 2004, at least 3,000 physicians have left to work abroad, creating a growing problem with some 1,500 medical posts unfilled. The government has plans to retain young doctors, but resources are limited. The Hungarian Chamber of Doctors supports the trainees’ organisation, the Resident Doctors’ Association, in putting pressure on the government.
Doctors in Hungary, as in other central and eastern European countries, face poor pay and prospects, particularly if they are trainees. In the previous six or seven years, at least 3,000 doctors and trainees have left Hungary for better salaries and working conditions abroad. Data from the Hungarian Chamber of Doctors shows that 8% of all Hungarian-trained doctors practise abroad, and of these 10% left Hungary straight after graduation. Growing numbers of physicians, surgeons, anaesthetists and other specialists are heading for countries such as the UK, Germany and Sweden.
In spring 2011, members of the Resident Doctors’ Association (MRSZ) argued that they should earn more money than fast-food restaurant staff and were considering putting pressure on the government. The MRSZ insisted that while well-qualified medical professionals have the knowledge and language skills to get well-paid jobs in western European countries, most would prefer to work in Hungary if they could earn a decent wage that did not force them to accept extra tips from patients, a practice that is widespread in the state-run healthcare system.
Resignations in deposit
The President of MRSZ, Magor Papp, announced that the association was launching a protest campaign in which trainees would deposit resignation letters with a lawyer to take effect at the end of 2011 unless the government was willing to increase their pay.
Doctors were demanding a 100% increase in their salaries. Although this would increase the wage bill doctors by HUF 200 billion (€687 million as at 29 February 2012), the association said that even doubling their salaries would still leave them earning less than the European average. In June 2011, Hungary’s resident doctors’ monthly take-home pay was between HUF 80,000 and HUF 100,000 (€275–€344), while the country’s average monthly salary after tax was HUF 140,300 (€482). Istvan Eger, Chair of the Hungarian Chamber of Doctors, commented that it was not right to tell doctors to be ‘a bit more patient’. Hungarian doctors are among the worst paid in Europe, said Claude Wetzel, Chair of the European Federation of Salaried Doctors (FEMS) before a demonstration organised by the Hungarian Doctors’ Association. He commented that it comes as no surprise that Hungarian doctors have left to work abroad.
With the threat of a mass resignation of doctors on the last day of December 2011, the government left it until the last possible moment to promise significant wage rises. On 29 December 2011, Minister of Health Miklós Szócska promised that the government would allocate HUF 40 billion (€137.4 million) for doctors’ salary increases. The MRSZ welcomed the announcement, and postponed the mass resignation deadline for three months in the hope of reaching agreement with the government.
Hungary’s government has already approved national health reform plans to save hospitals, improve healthcare and halt an exodus of medical workers from the country.
Under the government’s programme, young doctors who commit to practising medicine in Hungary for at least 10 years will receive a HUF 100,000 (€344) tax and contribution-free bonus on top of their monthly salaries for a period of five years. This will effectively double their wages during that time. They must also agree not to accept any gratuity money from patients.
The government will also implement reforms to encourage younger doctors to take over medical practices from older family doctors, said the Health Minister. According to the Hungarian Central Statistical Office (KSH), there are 150–160 vacant medical practices and the average age of family doctors and paediatricians is 56–57. It is therefore expected that a large number of doctors will retire over the next decade.
Medical staff across eastern Europe are on a collision course with their governments, as disputes over pay threaten to hit frontline services. The Hungarian government was faced with this situation at the end of 2011. However, its HUF 40 billion (€137.4 million) solution will not change the healthcare system. Low pay is a key issue, but substandard working conditions and poor prospects for professional development and promotion also play a part in the widespread dissatisfaction of medical professionals. Deep structural changes in Hungary’s healthcare system are needed to stop the exodus and develop the sector.
Máté Komiljovics, Solution4.org