Substantial wage increases and a new bargaining situation for the medical profession

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As a result of the 1996 wage settlement, medical physicians employed at Norwegian hospitals gained substantial wage increases. These increases can in part be explained by an increase in basic wages, and in part by prolonging weekly working hours through permitting more overtime and at the same time increasing the financial compensation for overtime. However, the future bargaining situation for the medical profession is unclear since The Norwegian Medical Association has dissociated itself from one of the main organisations, the Federation of Norwegian Professional Associations.

Favourable wage settlement in 1996

Medical physicians employed at municipal or state hospitals have lately received substantial wage increases, while at the same time wage growth has been moderate for other occupational groups. As a result of the 1996 wage settlement, hospital physicians received a sizeable increase in their basic wage. In addition, the Norwegian Medical Association and the largest employer organisation, the Norwegian Association of Local Authorities (KS), signed a new agreement concerning overtime. The agreement entails an increase in overtime remuneration, as well as a commitment from the doctors to increase the total number of working hours by working a certain amount of overtime, as required.

Overall, this has meant sizeable wage increases for all groups of hospital physicians. A new study reports that different groups of physicians at the hospitals owned by the counties/municipalities have experienced an annual wage increase in the range from NOK 70,000 to NOK 130,000 in the past two years. Many physicians employed by state-owned hospitals have received increases that are even higher than this. The overview is based on a report which the consultancy firm Agenda has produced for KS ("Endring av legekostnader i sykehus. Fokus på legeoppgjøret i 1996", Kommunenes Sentralforbund (1997)). Figures from Statistics Norway show that several groups of hospital physicians received a wage increase of just under NOK 5,000 per month for the period from 1 October 1995 until 1 October 1996. In comparison, the average wage increase for municipal employees for the same period was NOK 940 per month.

A new bargaining situation in 1997

The Norwegian Medical Association, which organises the great majority of the Norwegian medical profession, was until 31 December 1996 a member organisation of the Federation of Norwegian Professional Associations (AF). The Norwegian Medical Association was displeased with AF's priorities in wage negotiations and decided therefore, during the spring of 1996, to dissociate itself from AF and continue as an independent employee organisation.

In practical terms, the dissociation means that the organisation may not participate in the negotiations leading up to the main collective agreement covering the state and municipal sector. The dissociation also entails that the organisation is not covered by any basic agreement in the public sector, and is hence without an agreement which, amongst other issues, regulates employees' rights to information, participation and consultation. Approximately 60% of the 12,000-strong membership in employment are employed in the municipal sector, while just under 10% are employed in the state sector. The organisation's bargaining position will additionally be affected if the Norwegian Labour Dispute Act is amended in line with the proposals which a joint committee has recently put forward (NO9706112F). The proposal, which is controversial, will in particular reinforce the position of the main bargaining cartels within the municipal sector, where the majority of the physicians work.

Commentary

The Norwegian Medical Association organises the vast majority of Norwegian medical physicians, and has traditionally been a strong professional organisation with significant influence in health policy issues. In recent years, the organisation has also proved to be a trade union with muscle, which has been able to utilise a favourable bargaining position. In Norway, national employee organisations may conclude wage agreements concerning overtime which exceeds the maximum number of hours stipulated in the 1977 Worker Protection and Working Environment Act. The Norwegian Medical Association has won several cases in the Labour Court regarding special agreements concerning overtime, and this is one of the reasons for the massive pay increases.

The scarce supply of medical physicians, along with the authorities' need to increase the efficiency with which hospitals are run and to reduce patient waiting lists, are the major explanatory factors for why the Norwegian Medical Association succeeded to such an extent in promoting its members' interests at a time when wage increases were moderate for the rest of the working population. Many hospital physicians have taken on secondary employment outside the hospital sector, and an important aim for both the Minister of Health and the owners of the hospitals has been to redirect the hospital physicians' use of resources so that they in total work more for the hospitals. The health authorities would also like to see a reduction in labour turnover amongst the hospital physicians, which meant reducing the income gap between hospital physicians and medical physicians with a private practice. Although there seems to have been political agreement about securing hospital physicians a wage increase which was substantially higher than what the remaining of the working population achieved, claims are made that the settlement gave more favourable terms than the employers had envisaged. The owners of the hospitals claim that the doctors' wage increases have meant a significant financial burden, and have asked for additional funds from the state.

The Norwegian Medical Association's dissociation from AF will have a significant bearing on the organisations' bargaining position in the public sector. There are three bargaining cartels today which negotiate over the main wage agreement for the municipal sector, and the Norwegian Medical Association can not expect to participate in these negotiations. However, any employee organisation, the Norwegian Medical Association included, may reject a recommended settlement proposal and take industrial action. The proposal to introduce statutory provisions which would imply that the right to negotiate and the right to take industrial action would be restricted to the major bargaining cartels, could, if it is passed, make it even more difficult for the Norwegian Medical Association to act as an independent employee organisation. The medical association's strongest hand today, the overtime agreements, may also be effected by this controversial legislative proposal.

A strategy which the independent employee organisations in the public sector may make use of is to conclude various types of cooperation agreements. The Norwegian Medical Association has concluded a cooperation agreement with the Norwegian Union of Municipal Employees, which is the largest employee organisation within the municipal sector. The agreement makes it possible to cooperate on most issues, including wage issues. However, the two organisations are very dissimilar in terms of the type of labour they represent and their income profile. This can make a more lasting cooperation with regard to wages difficult, though at the same time the organisations may avoid the kind of conflicts which are due to professional antagonism which exists between different groups of health personnel. (Kristine Nergaard, FAFO Institute for Applied Social Science)

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