Unions protest against new management models for public services

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Early 2001 saw trade union protests in various areas of the Portuguese public services - notably healthcare and some municipal services - where new management models are being tried out. The changes have led trade unions to protest against what they see as a privatisation of essential services. In healthcare especially, unions are concerned that public health service users may not receive the same quality of services as before, and that employees may lose their status as civil servants.

Over early 2001, some sectors of the Portuguese public administration have seen heated debate and rising conflict over the government's current move to institute new forms of management that, in certain sectors, come close to privatisation. Two sectors particularly affected by this move are hospitals and certain services provided by local authorities. Trade unions have protested vehemently by staging strikes or threatening to strike, holding demonstrations and lodging formal protests with the public authorities.

Health sector

The health sector in Portugal has long been the object of criticism, centred largely around the long waiting lists of patients for public health services and the inefficient manner in which existing resources are used. At the end of February 2001, the platform of healthcare trade unions, which includes the National Doctors' Federation (Federação Nacional dos Médicos, FNAM), requested that the sovereign powers - the President, Prime Minister and parliamentary groups - change the approach currently taken by the Minister of Health (PT9708133F). The healthcare unions are of the opinion that the Minister's approach is tantamount to the privatisation of health services, and that it does not carry out the government's initial programme which had presented a different solution and provided for greater integration of the national health service. The Minister's scheme means that a new statute that provides for the private management of hospitals is already being used in a number of facilities, such as the large Amadora-Sintra hospital complex near Lisbon and the Vila da Feira hospital in northern Portugal.

According to the trade unions, the national health service can be improved by means of local health system management, centres with shared management and "third-generation" health centres, without having to resort to models that approximate to privatisation. The management models preferred by the unions have never been implemented. Until they are effectively put into practice, the unions believe that existing problems such as long waiting lists will be dealt with separately and on a one-off basis. In the opinion of the trade unions, instead of carrying out a reform of the national heath service, the government is, in effect, opening the door to privatisation.

The debate became more heated in February because of the new statute that was put into effect for the Algarve's Barlavento Algarvio hospital. The Algarve Regional Trade Union Federation (União dos Sindicatos do Algarve) - affiliated to the General Confederation of Portuguese Workers (Confederação Geral dos Trabalhadores Portugueses CGTP) - along with doctors', nurses', health technology employees' and civil servants' unions, have protested against the new statute, asserting that:

  • patient services will deteriorate;
  • users will not see any significant benefits, since the "economists' approach" to using certain diagnostic apparatuses and organising consultations with doctors will take precedence;
  • privatisation will come about which, in turn, will cause a breakdown in the national health service;
  • recruitment of foreign workers without training in the Portuguese language will continue; and
  • inequalities will get worse for patients on surgery waiting lists.

The discussion between the Ministry of Health and the unions has been going on for several months, since the statute came into effect for the Algarve hospital. The unions assert that their views should have been heard in negotiations, before the statute went into effect. The workers at the Barlavento Algarvio hospital staged a strike in January and distributed leaflets among the local population.

Employee status

The healthcare trade unions have also broached the issue of employee status, expressing special concern for employees just setting out on their careers. According to the unions, workers wishing to enter the civil service (public healthcare workers have civil servant status) will now have a hard time doing so.

The health sector in Portugal has suffered from a chronic shortfall of labour and from human resource management problems, especially with regard to doctors, nurses and administrative and auxiliary personnel. There are 20,000 fixed-term contracts covering primarily administrative and auxiliary personnel. Government negotiations with the 18 unions in the sector have been troubled. Some of the most important issues under discussion have been: revision of career paths (PT9902131N); "normalisation" of fixed-term contracts; different criteria for overtime pay; calculation of length of service; hardship and hazard pay; and additional health risks involved for certain healthcare professions. The Federation of Public Administration Unions (Federação dos Sindicatos da Administração Pública) has stated that a great many employees are likely to remain on fixed-term contracts until certain activities such as food services, laundry services, reception and security services are privatised.

In the meantime, while involved in the hospital statute debate, the government has proposed going deeper into the issue of collective bargaining and models of employee participation in hospitals. These issues have not appeared on union agendas, which have mostly dealt with the change in the hospital statute and guaranteeing certain employee rights.

Privatisation of municipal services

Since January 2001, municipal employees from Viana do Castelo, Oporto and Cascais have been staging a number of demonstrations over privatisation of municipal services. The CGTP-affiliated Union of Workers in Local Administration (Sindicato dos Trabalhadores da Administração Local, STAL) fears that some municipal services might be discontinued altogether. As an alternative, it has proposed better training and qualification of personnel working in these services instead of the wholesale transfer to the private sector. In Viana do Castelo, in northern Portugal, the private company Aguas do Minho e Lima has now taken charge of water supply and distribution, as well as basic water and refuse treatment and sewage for the whole district. In Oporto, the Porto Gestão de Obras company is now in charge of street and pavement construction. In Cascais, just outside Lisbon, a private company is now handling refuse collection and street cleaning.

In Viana do Castelo, workers fear that jobs in the local port may be in jeopardy. The reason is that the statute classifying port workers as civil servants has recently been changed. Along with it came changes in the 35-hour working week that port workers had been enjoying as public administration employees. Among other demands, the workers have called for the five additional weekly hours they will be required to work to be paid as overtime hours.

In the cases of Viana and Oporto, the new companies taking over some municipal services will have public capital, and employees will be given the option to become a company employee or remain a municipal employees. The management of the new companies has guaranteed that workers will be allowed to have muncipal employee status if they so desire. The unions will be kept informed as the process develops. Because of the changeover, a number of demonstrations were staged in January in Oporto.

Commentary

Health services have come under increasing pressure from citizens, anxious to see significant improvements in the healthcare system. A healthcare system as fragile as Portugal's requires forms of management that will maximise the efficient use of public resources and clearly define the priorities that will affect those resources. Privatisation of some public services has taken place in a few sectors. From the range of possible solutions, the health system has chosen to adopt private management or obtaining certain health services from private organisations. Other sectors, such as some municipalities, have opted for the transfer of certain activities to the private sector. (Maria Luisa Cristovam, UAL)

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