Health workers union sues government

In November 2007, the Latvian Health and Social Care Workers’ Trade Union adopted the unanimous decision to sue the government for not fulfilling basic trade union demands. The decision to take legal action has been taken because the trade union sees no further possibility to resolve the issue by means of negotiation. The situation is the result of a month’s unsuccessful negotiations on the health workers’ pay increase.

Ongoing battle for salary increases

For a number of years, the Latvian Health and Social Care Workers’ Trade Union (Latvijas Veselības un sociālās aprūpes darbinieku arodbiedrība, LVSADA) has been fighting for increased health worker salaries and compliance with the provision of labour legislation for the healthcare sector (LV0707039I, LV0502101F). LVSADA blames the government for the low salaries of medical workers, as the previous wage increase agreements were not upheld. In addition, the trade union highlights that there are no additional payments for night shifts and overtime work, or allowances for environmental risks. LVSADA criticises the arrogant and condescending attitude on the part of the Ministry of Health (Veselības ministrija, VM). The discussions are usually most heated during the period of approval of the state budget.

It became once again clear in October 2007 that the demands of medical workers were not to be considered and LVSADA called for a discussion on industrial action. Despite the good economic development indicators, healthcare funding in 2008 was allotted just 3.5% of gross domestic product (GDP) – previously, it received 4% – thereby making any salary increase unlikely. Medical workers did not support the call for industrial action and LVSADA continued negotiations with the government, threatening that it would refer to the court if the attitude towards healthcare did not change.

Trade union sues government

On 20 November 2007, LVSADA adopted the unanimous decision to sue the government for not fulfilling basic trade union demands. At the beginning of December, LVSADA filed its statement of claim against the VM with the Administrative District Court. The basis of the claim is that the VM failed to execute the order by the Cabinet of Ministers (Ministru kabinets, MK) on the development of human resources in healthcare. LVSADA considers that the previous negotiations with the VM did not produce any practical results, that the trade union’s proposals on a compromise regarding salary increases were not taken into account and that the options for peaceful negotiations have been exhausted.

The unlawful attitude of the government towards healthcare in Latvia in an international context is further underlined by the fact that the European Commission has brought a case against Latvia to the European Court of Justice (ECJ) for deficiencies in the functioning of the medical emergency services.

The VM has not made a public response to LVSADA’s action.

Family doctors refuse to sign agreements

For their part, at the beginning of December 2007, the members of the Latvian Association of Family Doctors (Latvijas Ģimenes ārstu asociācija, LĢĀA) and the Latvian Association of Rural Family Doctors (Latvijas lauku ģimenes ārstu asociācija, LLĢĀA) refused to conclude agreements with the Health Compulsory Insurance State Agency (Veselības obligātās apdrošināšanas valsts aģentūra, VOAVA) – which represents the Latvian government – regarding the provision of state-paid medical services during the period 2008–2011. The previous agreement with family doctors was concluded in 2004 and it expired on 31 December 2007.

The doctors’ decision was taken because the proposed agreement was not appended with the financial annex on the funding for provision of the state-paid services within the period of the agreement. The state-funded primary healthcare services constitute the main field of activities and income for family doctors. For the past number of years, family doctors have been trying to agree with the government on a service funding model which would provide the means for maintenance of their practices.

The VM considers that the absolute funding allocated to family doctors in 2008 is a little higher than in 2007 and that the doctors’ protest is not substantiated. However, the family doctors have calculated that the present funding covers only 45% of the costs of maintaining a practice, and the planned 20% increase in funding does not help the situation. Furthermore, the family doctors object to several articles of the new agreement which restrict their activities.

Commentary

The discussion on funding of the healthcare sector is ongoing since the middle of the 1990s. Several trade unions operate in the sector, negotiating with the VM and employers. LVSADA has called for industrial action on several occasions but the government was successful in preventing such action either by complying with the trade union demands or by considerably increasing salaries for certain categories of medical workers, thereby dividing the workers.

Raita Karnite, Institute of Economics, Latvian Academy of Sciences

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