Doctors strike over pay and working time in Catalonia

From late March to early May 2006, the Doctors of Catalonia trade union called a series of one-day strikes in a dispute over several important sectoral issues, including the regulation of working time, pay increases for doctors, collective bargaining and the regulation of the medical profession. It seems likely that these disputes could prompt additional action in other regions of Spain.

Strike action begins

A series of one-day strikes were called on 27, 28 and 29 March 2006 by the trade union Doctors of Catalonia (Metges de Catalunya, MC), a professional trade union that has a majority representation in the medical sector. Participation in the strike was high among most of the region’s health organisations, although some large public hospitals in Barcelona with company-level collective agreements did not join the strike action.

As the strikes continued, participation gradually increased to 10,000 doctors in 50 hospitals and 950 public and state-supported health centres. The minimum services available remained relatively high, despite criticism of the striking trade unions. Nevertheless, some 250,000 medical appointments and 2,100 surgical procedures were cancelled as a result of the strikes.

Union demands

The trade union’s demands were centred around three main areas. First, there was concern over the regulation of working time. According to MC, poor regulation of working time could lead to average working weeks of up to 48 hours, which is above the legal limit and affects the quality of service provided by the union’s members. In addition, some doctors rejected the extension of the working day by six additional hours, which was established in the sector a year ago.

Secondly, a considerable pay increase was demanded, particularly for staff in state-subsidised health centres.

Thirdly, issues relating to collective bargaining and the regulation of the medical profession were raised. MC’s most important demand was to have its own agreement (not including other health workers) and to set up a Medical Profession Council that would serve as a forum for bargaining and regulate the development of careers in medicine and of the medical profession.

Results of bargaining commission

A strike bargaining commission was set up by the MC, the Regional Ministry of Health of Catalonia (Conselleria de Salut de Catalunya), representing the public health sector, and the employer organisations of state-subsidised health centres. The Trade Union Confederation of Workers’ Commissions (Comisiones Obreras, CC.OO) and the General Union of Workers (Unión General de Trabajadores, UGT) disagreed with some demands that they considered to be of a corporate nature.

After the first few meetings, it became clear that agreement could not be reached on the regulation of working time, that some progress could be made in relation to pay, and that the union’s third demand regarding collective bargaining and the regulation of the medical profession was opposed by both the Catalan Public Health Service (Institut Català de la Salut, ICS) and also by the trade unions that had not called the strike.

Agreement reached

Pressure from public opinion and the medical profession led to the conclusion of a last-minute agreement on 8 May, as more hospitals with company agreements had threatened to join the strike. As a result, MC relinquished its demand for a separate agreement. However, considerable pay increases were achieved by the union (about €2,000 annually), particularly in the state-subsidised medical centres.

A Medical Profession Council has also been set up, following union demands, to represent the Catalan government, the employer organisations, the trade unions, the colleges of doctors and the universities. It will discuss and attempt to reach agreements on two major issues: regulation of the medical profession, and the terms and conditions of employment in the sector. However, it will have no authority to enter into bargaining on collective agreements in the sector.

The council will discuss areas of importance to the sector’s workers, such as the working conditions of resident doctors, the duration of working time, doctors’ participation in the management of health centres and careers in medicine. Agreements reached by council members will not be binding and will be subsequently brought before the bargaining commission for further negotiation and implementation.

Commentary

The general trade unions, which are organised according to occupational levels, are satisfied that no ‘profession agreement’ was established. Such an agreement would have marked a split with the rest of the health workers and could have led to significant consequences in the health sector. The Catalan government considers that the new system now has the advantage of being better regulated and more consistent than previously. MC claims that ‘the profession has been re-evaluated’.

However, it now seems likely that some of the issues raised by MC and the agreements reached will prompt further disputes in other regions of Spain. Moreover, workers in the private healthcare sector in Madrid went on strike over pay and working time in December 2005 (ES0601101N).

Fausto Miguélez Lobo, QUIT-UAB