Doctors end strike alert in protracted hospital crisis

More than 2,400 physicians handed in their notice in Slovakian hospitals in September, in protest at the planned transformation of hospitals into joint-stock companies. However, following a vote of no confidence against the government in mid-October, the Slovak President Ivan Gašparovič decided to halt the hospital reform. The physicians continued their protest into November and December, only calling it off when the president signed an amendment to the law on health-care providers fulfilling the basic demands of the doctors.

Physicians give collective notice

Slovakian doctors have begun handing in their notice as part of a protest by hospital physicians, organised by the Trade Union of Physicians (LOZ), which continues (SK1105029I) in most state-owned hospitals. The doctors are demanding:

• the government stop its planned transformation of hospitals into joint-stock companies;

• adequate funding for health care facilities;

• an increase in basic physicians’ salaries to between 1.5 and three times the average wage.

On 29 September 2011, LOZ Chair Marián Kollár handed in the notice of more than 600 physicians at the head office of the University Hospital in Bratislava, saying that the mass resignation represented more than a half the hospital’s physicians.

According to the information available at the time of writing, a total of 2,411 medical workers handed in their notice in Slovakia, many of them anaesthetists. If the latter were to walk out, the performance of operations in the hospitals concerned would be seriously affected.

However, the situation varied considerably between hospitals and regions. The physicians who gave notice should have left their posts by the end of November 2011. However, according to a report in the daily SME on 30 September 2011, Tomáš Szalay, an analyst at the Health Policy Institute (HPI), was nevertheless optimistic and believed that health care wouldn’t be jeopardised.

Doctors say it’s not political

According to the chair of the local LOZ branch in Bratislava’s Ružinov Hospital, Tibor Sedlák, problems in the healthcare sector have been piling up for 20 years, and the situation now needs to be addressed.

One serious problem, in Sedlák’s view, is a reduction in the payments hospitals receive from health insurance companies to cover patient treatment. Being funded in this way, hospitals are not able to cover their costs. However transforming them into joint-stock companies will not solve the problem of a lack of financial resources or improve health services. On the contrary, Sedlák suggests, if hospitals were joint-stock companies, they would try to solve the funding problem by cutting health services for patients.

In mid-October 2011, the government lost a parliamentary vote of confidence and it seemed the physicians would withdraw their notice. However, Peter Visolajský, a representative of LOZ, told SME on 14 October 2011 that the doctors’ initiative is apolitical and would continue despite the fall of the government. Health Minister Ivan Uhliarik told the paper on 27 October that the situation was serious, particularly in paediatric hospitals

Government collapse changes situation

However, the Health Minister has admitted that in the current political situation, while the government has limited powers until further elections are held, the transformation may not be possible. The issue of changing the status of hospitals has been also addressed by the President of the Slovak Republic, Ivan Gašparovič, who took some control of the situation after the mandate of the current government was restricted.

After meeting the Health Minister and speaking to the Prime Minister, Iveta Radičová, President Gašparovič decided not to let reform of the hospitals’ financial structure proceed for the time being.

Finally LOZ agreed on 16 December to end its strike alert after President Ivan Gašparovič signed the amendment to the law on health-care providers that fulfils the basic demands of the doctors. ‘By the president signing the health-care laws, one phase of LOZ’s efforts aimed at improving the situation of Slovak patients and the state of Slovakia’s health care has been completed,’ said Chair Marián Kollár, adding that the doctors believe that they will not have to use extreme measures again.

Ludovit Cziria, Institute for Labour and Family Research