Czech doctors strike in protest against low wages

In February and March 2007, a large number of Czech doctors went on strike in protest against the insufficient payments of the General Health Insurance Company for the treatment of patients. The protest was widely supported in the Bohemia and Moravia regions, despite some criticism from the Association of General Practitioners which considered the action to be counter-productive. Nevertheless, this action may be an indication that further protests will follow.

On 14 February 2007, doctors went on strike by closing their surgeries in protest at the conduct of the biggest Czech health insurance company, the General Health Insurance Company (Všeobecná zdravotní pojišťovna, VZP). Their dissatisfaction stems from two factors, namely the low amount they receive for individual healthcare payments and the delay in payments from VZP.

Reasons for strike action

The Association of General Practitioners of the Zlín region (Sdružení praktických lékařů Zlínského kraje) organised the strike action. In a ‘Declaration of general practitioners of the Zlín region’ the doctors expressed their dissatisfaction with the remuneration of general practitioners in particular and also with the ill-devised policy of the Ministry of Health of the Czech Republic (Ministerstvo zdravotnictví České republiky, MZČR). Among other things, the doctors are demanding that VZP pay them CZK 50 (about €1.80 as at 22 May 2007) a month for each registered patient. The insurance company offers doctors CZK 36 (€1.30) a month for each patient, which is just CZK 1 (€0.04) more than last year. At a meeting on 5 February 2007, the association’s declaration was approved by more than 90 general practitioners who treat adults and representatives of general practitioners for children and adolescents in the Zlín region.

Support for strike action

A large number of doctors from the Bohemia and Moravia regions answered the Zlín doctors’ call. The largest number of doctors taking part in the strike action was in the South Moravian region – about 60% of general practitioners in this region closed their surgeries for the entire day on 14 February 2007 in support of the protest. Practices were also closed by doctors in the central-eastern Olomouc and Prostějov districts; the only medical care available on that day was emergency care provided by doctors in emergency facilities. In Bohemia, most doctors supporting the strike merely closed their surgeries for 15 minutes at 10.00 or distributed information leaflets in their practices highlighting the strikers’ demands. As a lot of areas in the Czech Republic are currently witnessing an epidemic of respiratory illnesses, many doctors were not able to or did not want to go on strike. Doctors from South Bohemia did not back the strike at all. ‘Paradoxically, this protest could be counterproductive, and for that reason we distance ourselves from these activities to some extent,’ stated Lubor Kinšt, the Vice-President of the Association of General Practitioners (Sdružení praktických lékařů České republiky, SPL ČR).

The Czech Medical Chamber (Česká lékařská komora, ČLK), in turn, supported the strike. Its Chair, Milan Kubek, expressed support for the strike, saying that doctors have the right to attain better incomes and insurance companies have the finances to afford higher payments.

Legal framework

The Director of VZP, Pavel Horák, responded that when paying for treatment the insurance company was proceeding exactly according to the current legislation. Decree No. 619/2006 Coll. defines the value of medical care and the amount of payments for healthcare paid out of health insurance. It also stipulates regulatory restrictions on the volume of provided care paid for out of public health insurance for 2007. The Minister of Health, Tomáš Julínek of the Civic Democratic Party (Občanská demokratická strana, ODS) issued the decree. Minister Julínek also considers the doctors’ protest as being unrealistic since representatives of doctors and insurance companies agreed on the amount of payments and the insurance companies have no mechanism to change this.

The doctors are therefore demanding an amendment of the decree setting out the payments for medical care. According to the Chair of CLK, Mr Kubek, such an amendment should increase doctors’ incomes by 10% from 1 April 2007. This demand is supported by the shadow health minister, David Rath of the Czech Social Democratic Party (Česká strana sociálně demokratická, ČSSD). ‘Payments and limits for this year were specified by the decree of the Health Minister, Tomáš Julínek, and the insurance companies are merely respecting them; the protest should therefore be against the decree,’ Rath stated in an online discussion on his party’s website.

Follow-up protest

The protest was followed up by a further strike on 28 March 2007. This time, however, many more surgeries in South Moravia remained closed, mainly in the Brno and Břeclav district. More than 60 out of 85 paediatricians in Brno closed their surgeries. Besides paediatricians, general practitioners for adults also went on strike this time.

These disputes between doctors and VZP are certainly not isolated cases in the Czech Republic; most disputes are related to the amount of VZP payments for medical care.

Soňa Veverková, Research Institute for Labour and Social Affairs