35-hour week negotiations in public hospitals

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Negotiations over the introduction of the 35-hour week in France's public hospitals started in earnest in September 2001, following a government announcement that 40,000 jobs (a figure later raised to 45,000) were to be created to accompany the working time reductions. Trade unions have reservations about the job creation figure, and the likelihood of an agreement being reached (and the potential signatories) is partly dependent on the outcome of a day of action called by the unions.

The 780,000 employees of France's public hospitals must change over to the 35-hour working week from 1 January 2002 (FR0003151F), and the government has conceded that the switch to the 35-hour week in this sector will entail the creation of new jobs. The negotiations over the working time reductions, officially launched in January 2001, were held up pending an interdepartmental arbitration process relating to the number of jobs to be created. However, with the announcement by the Prime Minister on 30 August 2001 that 40,000 new jobs were to be created, the negotiations aimed at establishing a national framework for the application of the 35-hour week legislation (FR0001137F) in this sector were relaunched.

Announcement of the new jobs

Public hospitals are presently short-staffed. For the trade unions, there should be new recruitment both to compensate for the effect of the reduction of working time, and also to bring about an improvement in working conditions. The 40,000 new jobs announced by the government at the end of August will mean an overall 5.3% increase in public hospital staffing levels, while the changeover to the 35-hour week in the private healthcare sector has led to a rise in employment of between 6% and 7%.

In response to the announcement on new jobs, the French Democratic Confederation of Labour (Confédération française démocratique du travail, CFDT) stated that 'at last we are going into negotiations at a worthwhile level. It is a good start and we shall have to do our utmost to reach the 7% mark.' The General Confederation of Labour-Force ouvrière (Confédération générale du travail-Force ouvrière,CGT-FO) claimed that 'if we do not get at least a 7% increase in staffing, the reduction of working time will be implemented through restructuring and ward closures.' The General Confederation of Labour (Confédération générale du travail, CGT) said that 'a 10% cut in working time should be compensated by the creation of new jobs equivalent to 10% of existing employment, otherwise the degree of hardship involved in carrying out the jobs is not included in the calculations.'

However, the question arises of who is going to take these new jobs. There is currently a shortage of 15,000-20,000 nurses. In the next four years, due to retirement, 160,000 more will have to be found. However, it takes three years to train a nurse, and there is currently a low intake in nursing colleges. Apart from the many problems it raises, a recent appeal for the recruitment of former nurses who are no longer working, and foreign nurses (particularly Spanish ones), will at best mean that 2,000 people can be taken on.

Acknowledging the problem, the minister responsible suggested the creation of time savings accounts (granting eligibility to paid holiday and/or early retirement) for employees unable to move to the 35-hour week on 1 January 2002.

Apart from the number of jobs, the negotiations over the 35-hour week in public hospitals deal with many other points, such as how the work schedule is to be defined. The government wants to align the hospitals with the rest of the civil service, by using an annual total of 1,600 working hours as the basis. The unions would rather use the 1,540-hour timetable used as the basis for hospital night-shift workers, who changed over to the 35-hour working week in 1994. The issue of whether working time should be defined on a weekly or annual basis is also controversial. Among the unions, CGT, CGT-FO and the independent Solidarity, Unity, Democracy (Solidaire, Unitaire, Démocratique, SUD). have vehemently rejected the idea of abandoning the weekly schedule.

Other issues have been added to these crucial matters, such as rest periods, time on-call, and the future of night-shift workers who are already on the 35-hour week, and for whom the unions are asking for a 32-hour week to be established. Also, the issue of the geographical distribution of the newly-created jobs has arisen, in a context of serious inter-regional inequalities in the French hospital system.

New proposals

On 12 September 2001, during the third session of negotiations, a number of points were clarified. The proposed number of jobs to be created rose from 40,000 to 45,000. The annual length of working time would be set at 1,600 hours but the calculations for individual schedules would vary. The health ministry is proposing 1,568 hours for employees with set rest periods, and/or 1,554 or 1,540 hours (depending on the number of Sundays off) for staff whose rest periods are not fixed. Lastly, night-shift workers would work a 32.5-hour week, ie 1,430 hours per year, as of 1 January 2004.

The quota of overtime currently set at 20 hours per year per employee would fall progressively to 10 hours by 1 January 2006.

In CFDT's opinion, 'we have not achieved everything we wanted, but getting 45,000 new jobs cannot be dismissed out of hand.' The National Federation of Independent Unions (Union nationale des syndicats autonomes, UNSA) and a hospital managerial staff union have expressed similar views.

CGT-FO has acknowledged the significant advances made, but they are not satisfactory for this union, which is concerned that some of the measures will lead to the annualisation of working time, the flexibility of work schedules and previously-gained benefits being threatened. The French Christian Workers' Confederation (Confédération française des travailleurs chrétiens, CFTC) has adopted a very similar stance.

The CGT said that the second version of the proposed agreement seemed on some points to be a step backward in relation to the first. It considers that the number of jobs created is small and has led to the reduction of working time having been bought 'on credit'. The SUD hospital union is also very critical.

The minister asked the unions to respond publicly to the proposals by 27 September 2001. The stances taken up by each union would mainly depend on how a day of action by hospital staff, called for by all of them, turned out on 20 September 2001.


Discussions between government departments over the 35-hour week in hospitals have focused on the number of new jobs to be created. The Ministry of Finance wanted it limited to 10,000. The Prime Minister's arbitration, which ended with the announcement of the creation of 40,000 jobs, clearly favoured the view of the Ministry of Employment and Solidarity. The Prime Minister's decision took into consideration the risk of disputes resuming among hospital workers.

This is not the first time that a government has made funds available when faced with the fear of hospital staff disputes. An agreement on extra investment in hospitals, signed on 14 March 2000 by all the unions except CGT and SUD, involves additional funding of FRF 10 billion over three years (FR0004156F). In spring 2001, an agreement on revamped career paths for certain categories of staff involved expenditure of slightly over FRF 2 billion (FR0104144N). Now, the creation of new jobs will cost almost 10 billion FRF over a three-year period. This amount is not that high compared with the FRF 270 billion spent on running public hospitals. Despite this, the spending announced will further increase a healthcare bill, which year after year exceeds the budget that parliament votes for it (FR0011104F).

For private clinics, which have already switched to the 35-hour working week, the creation of jobs in public hospitals will further exacerbate their recruitment problems, because of the pay differentials between the private and public sectors.

CFDT has stressed that organisational issues and details will be important in further negotiations. The junior health minister sees the announced number of jobs to be created as 'an unprecedented opportunity to organise the hospitals of tomorrow'. However, it might be questioned whether launching negotiations in early September 2001 with a deadline of January 2002, while the staff who will be qualified to take up the new jobs have not even started their training, is genuinely the means of moving towards a new organisation of work in public hospitals.

This lack of preparation and the very short deadlines, are, conversely, fuelling the fear that the switch to the 35-hour working week is going to be used as a means of forcing through a non-negotiated restructuring of the hospital system. For CGT-FO, there is a serious risk that the reduction of working time will be implemented via restructuring and department closures, while CGT has stated that it will oppose an agreement aiming at remodelling the healthcare and social services system and closing units down around the country, on the pretext of reducing working time. (Pierre Volovitch, IRES)

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