Chamber of Physicians object to government law to ban compulsory membership

In the autumn of 2006, the Hungarian parliament passed new legislation on professional chambers in the healthcare sector, which came into effect from 1 April 2007. While the aim of this regulation is to weaken professional chambers in general by terminating compulsory membership, it is primarily targeted at the Hungarian Chamber of Physicians. The latter has been criticised by the socialist-liberal government for its compulsory membership and opposition to reforms. In response, the Chamber is strengthening its position in relation to interest representation.

Interest representation of physicians

In January 2007, the Hungarian Chamber of Physicians (Magyar Orvosi Kamara, MOK) had 44,000 registered members. Two thirds of MOK’s members work as public sector employees, while one third of the membership consists of self-employed workers, mainly family doctors and dentists. In Hungary, professional chambers with compulsory membership, like MOK, are public bodies and are thus not eligible to call a strike. This was one of the reasons why MOK has in the past cooperated closely with the Democratic Trade Union of Health and Social Workers (Egészségügyi és Szociális Ágazatban Dolgozók Demokratikus Szakszervezete, EDDSZ), the largest interest representation organisation in the sector. For instance, in 2003, MOK staged a joint demonstration with EDDSZ, in support of the union’s call for strike action in protest against the privatisation of hospitals (HU0306102N).

MOK has persistently criticised the measures implemented by previous governments since the country’s political transformation in 1989–1990, despite continuous dialogue between governments and MOK. However, the situation changed fundamentally last summer when, following its election victory, the socialist-liberal coalition government launched wide-ranging reforms (HU0607059I).

Far-reaching reforms in healthcare sector

The reform of the healthcare sector received new impetus when Dr Lajos Molnár was appointed Minister of Health in June 2006, following the general elections. The socialist-liberal government’s intention is to operate the state-run healthcare system more cheaply and effectively. For this purpose, a co-payment fee has already been introduced, which should be paid by patients whenever they call on a doctor or attend a hospital. Moreover, the level of subsidies granted for medicines has been cut. A drastic reduction in the number of hospital beds is also on the agenda, and in the long term, the government wishes to eliminate the monopolistic position of the state-run health insurance fund. The militancy of the government in its reform of the healthcare system has generated wide-scale resistance, particularly against the closure of hospitals. In recent months, local communities, professional circles and interest representation organisations staged several joint demonstrations, which were also supported by government opposition parties.

MOK has continuously argued against the ongoing reform measures. It claims that they will cause a deterioration in the previously high standard of medical treatment and increase the administrative workload of physicians, at a stage when they are already heavily overburdened by working hours that are above the mandatory limit.

Making membership voluntary in MOK also constituted part of the government reform programme. The re-elected government justified this legislative change by arguing that a public body with compulsory membership cannot properly represent the physicians’ opinion in relation to the government. At the same time, the government has accused MOK of acting as a ‘trumpet for opposition’. Given this political argument, it seems that the real objective of the new regulations has been to weaken the position of MOK, so that it would be unable to counteract the reforms of the healthcare system.

Repercussions of measures

It is not very likely that the new law will reach its political target. In line with Act XCVII of 2006 on professional chambers in healthcare, MOK announced a three-month period from 1 January to the end of March 2007 during which physicians were required to declare if they wanted to retain their membership. By 12 February, some 30,000 physicians had already declared their intention to maintain their membership at MOK in the period after 1 April 2007.

In order to strengthen its position with regard to the representation of physicians, MOK founded a new union, the Federation of Hungarian Physicians (Magyar Orvosok Szövetsége) as early as May 2002. Nonetheless, the union had only 1,600 members and, until now, was not representative of the sector. In the last few months, however, in response to the government’s reform steps, as many as 13,000 physicians joined the federation. This modern ‘craft union’ aims to represent the special interests of physicians; with such an increasing membership base, it could emerge as a major player in the sector, challenging both the government and the incumbent union, EDDSZ.

Lilla Bodnár and László Neumann, Institute for Political Science, Hungarian Academy of Sciences