Nurses divided over doctors’ resignation campaign

The resignation campaign by hospital doctors in the Czech Republic has led to an offer of cash for hospitals by the government. However, the health minister will not guarantee the money will be spent only on doctors’ pay, and the country’s 80,000 hospital nurses are divided over the doctors’ action. Some support the campaign, arguing that there is a need for health care reform and to retain doctors. However, others believe nurses should also share in any wage increases.

Campaign brings promise of cash

Minister of Health Leoš Heger has reacted to the doctors’ campaign, ‘Thank you, we’re leaving’ (Děkujeme, odcházíme), by promising hospitals CZK 2 billion (about €82.3 million as at 4 March 2011) for wage increases. Mr Heger, a member of the conservative ‘Tradition Responsibility Prosperity 09’ party (TOP 09), described the crisis in health care as ‘exceptionally escalated and extremely urgent’. The Trade Union of Doctors (LOK-SČL), whose action (CZ1101019I) focuses on health care reform and doctor’s pay, welcomed Mr Heger’s offer. However, LOK-SČL’s Chair, Martin Engel, and President of the Czech Medical Chamber (ČLK), Milan Kubek, want the health minister to sign an agreement which would ensure that the money would be allocated to hospital doctors, and that doctors who have given notice would be re-employed if they so wish.

Mr Heger, however, has refused to provide such guarantees, saying that the decision is up to the directors of individual hospitals and that he is not entitled to order them to re-employ doctors nor to give the extra money to doctors only. He said the agreement proposed by the doctors is an ultimatum that sets ‘almost vassal requirements’.

Response by hospital nurses

Support for the doctors from the sector’s 80,000 hospital nurses is divided. They feel the doctors’ action directly endangers their jobs. The Czech Nurses’ Association (ČAS), representing about 15,000 nurses, does not agree that the money that has been pledged should go only to doctors. This opinion is shared by Prime Minister Petr Nečas, a member of the conservative Civic Democratic Party (ODS). However, Martin Engel, for the doctors’ union, says the nurses will have to wait for further reforms to improve their wages as they did not join the doctors’ action.

Some nurses formed a separate support group, after an extraordinary meeting of ČAS on 21 January 2011 ordered members not to back the doctors. As part of the action ‘I am a nurse and I fully support the “Thank you, we’re leaving” campaign’, this group is gathering signatures to support the doctors’ demands. Apart from a salary increase, these include:

• a new system of lifelong learning;

• commercial, voluntary, additional insurance;

• a more transparent system of financing health care.

The breakaway nurses’ group say it is a matter for the individual nurse whether to resign. In an open letter they add:

We cannot say that our group would not appreciate a wage increase for all health care employees, but currently doctors are preferred. The priority at this moment is to maintain availability of care, withdrawal of doctors’ notices and their return, and therefore mainly their requirements must be met.

Originally, the doctors’ action was fully endorsed by the Trade Union of the Health Service and Social Care of the Czech Republic (OSZSP), representing about 25,000 nurses (as well as employees in other sectors). However, they do not support Martin Engels’ latest declaration that nurses should wait for a pay increase. The union’s Chair, Dagmar Žitníková, declined to comment on Mr Engel’s statement. Nevertheless, she added that hospitals themselves should decide how to spend the money promised by the health minister. She stated: ‘Management in each hospital knows best what the situation is in the given facility and how to allocate money.’

Soňa Veverková, Research Institute for Labour and Social Affairs (RILSA)