On 9 October 2013, the Czech Trade Union of Health Services and Social Care declared its readiness to strike over problems in the health and social care systems. Around 30 hospitals, together employing 8,000 people and treating around 1.2 million patients a year are in financial difficulty. Some may become bankrupt but the Ministry of Health has stated that simply giving money to the health sector will increase national debt, and it has accused trade unions of terrifying patients.
Background
The Czech Moravian Confederation of Trade Unions (ČMKOS) has called on the government to immediately address the plight of health and social care services and spas. According to ČMKOS, the situation is more serious than ever. Around 30 hospitals do not have money to pay for medicines, medical supplies or salaries, according to the President of the Trade Union of Health Services and Social Care (OSZSP), Dagmar Žitníková. In addition, some spa resorts have already become bankrupt (CZ1309019I), and several more are on the brink of failure. On 9 October 2013, OSZSP declared that it was ready to take strike action.
Unions believe the current situation has been primarily caused by the payment decree of the former Health Minister, Leoš Heger. Funding for the healthcare sector is allocated on an annual basis, and this year’s payment decree has cut hospitals’ incomes by 5%. Also to blame is the insolvency of the General Health Insurance Company (VZP), which is currently heavily indebted. Dagmar Žitníková explained that
…VZP holds the hospitals afloat, pays them more for their care than other health insurance companies and ensures the most expensive healthcare provision. So, VZP does not have enough cash to cover costs, and thus the hospitals face big financial difficulties.
He said that if the situation does not change, some hospitals will go bankrupt and will have to reduce the number of employees. The potential consequences of this would be huge. The 30 affected hospitals employ about 8,000 people and treat roughly 1.2 million patients a year.
Solutions proposed
The trade unions believe that a partial solution to the problem could be an interest-free loan, which would be granted to the VZP by the government. The Ministry of Health is considering making a CZK 2.5 billion loan (€97.1 million), and this will be discussed further by the government in November.
Trade unions are also calling for a change to the payment decree to help hospitals financially. The crisis committee comprises representatives from the Association of Bohemian and Moravian Hospitals (ACMN), the Association of Regional Hospitals, the Trade Union of Doctors in the Czech Republic (LOK-SCL), the Czech Association of Patients (Svaz pacientů) and the Czech National Disability Council (NRZP). The committee drafted an amendment to the current payment decree and sent it to Health Minister-designate Martin Holcát. However, the Ministry of Health of the Czech Republic (MZCR) is not considering any amendments. Viktorie Plívová, Health Ministry spokesperson, said:
It is not possible to change the payment decree during its validity. The Ministry is currently preparing new rules for the next year. We expect that representatives from hospitals and trade unions will take part in consultations and decision-making on the final form of the decree.
According to Holcát, changes to the payment decree could lead to administrative confusion and would bring little benefit. In the past, however, amendments to the decree have occurred during its term of validity, in 2006 and 2011 and the possibility of some changes being made was generally accepted.
Ministry of Health accuses unions of scaremongering
The Ministry of Health has accused trade unions of scaring patients by predicting that hospitals will collapse. The Ministry of Health has recently approved an increase in insurance payments for those who are state-insured. Negotiations over a loan for the VZP and the repurchase of irrecoverable receivables from health insurance companies are currently underway.
The Deputy Minister for Health, Martin Plíšek, says the Ministry has adopted all necessary measures, and he believes that simply giving more money to the health sector will increase the national debt.
After announcing their readiness to strike, the unions did not specify which other action they might take.
Soňa Veverková, Research Institute for Labour and Social Affairs