Pressure mounts for wage increase in healthcare sector

Healthcare workers have been asking for a wage increase for some time. At the beginning of 2006, doctors went on strike in an effort to get their wages increased. The current government is dealing with the healthcare workers’ demands for a wage increase, and hoping to introduce the increase in 1 January 2007. While some trade unionists are hoping for a 30% rise in wage, this has been refuted by the Minister of Health, as it would put a significant burden on the state budgetary resources. At the same time, the biggest sector representative trade union organisation wants to change from the current remuneration system to a system which guarantees minimum wages in individual healthcare professions.

Demands of healthcare workers

For the past couple of years, Slovakian healthcare workers have been asking for a wage increase as their wages are below average compared with other professions. The remuneration of healthcare workers had significantly changed in 2004, when legislative changes relating to public services entered into effect. With these changes, the former government wanted to achieve a higher flexibility in the remuneration of healthcare workers in order to improve their performance by means of pay-based motivation. These changes impacted also on the remuneration of nurses, who in the summer of 2005 organised several protest meetings to improve their wage situation and employment conditions (SK0509101N).

In early April 2006, doctors, mainly from university hospitals and members of the Medical Trade Unions Association (Lekárske odborové združenie, LOZ), also protested against their low wages and asked for a 25% wage increase on average. After long-standing and unsuccessful negotiations with the management of state-owned hospitals, the hospital doctors went on strike. At that time, another trade union organisation – the Slovakian Trade Unions of Healthcare and Social Welfare (Slovenský odborový zväz zdravotníctva a sociálnych služieb, SOZ ZaSS) – managed to negotiate a wage increase in a new sectoral collective agreement (SK0605029I). Although the pay increase was lower than what the doctors on strike were demanding, they nonetheless decided to terminate the strike.

Radical wage increase expected

Healthcare workers are hopeful that their requirements for a wage increase will now be met. A significant wage increase could also be a tool for preventing doctors and nurses from leaving Slovakia to work abroad. Recently, the President of LOZ, Marián Kollár, who led the striking doctors in their protest action, declared that the wage increase of healthcare workers would be as much as 30%. However, it seems this may not be the case. The Minister of Health, Ivan Valentovic, refuted such definite promises and declared that the government was still debating the wage increase for healthcare workers, with the 30% wage increase being only one option out of all those under consideration. The Ministry of Health (Ministerstvo zdravotníctva Slovenskej republiky, MZ SR) intends to increase the wage of healthcare workers from 1 January 2007. However, according to analysts from the Health Policy Institute, such general wage increases would require an increase of resources from the state budget of approximately SKK 6 billion (about €174 million as at 2 January 2007).

According to the representatives of SOZ ZaSS, their priority – besides the wage increase – is to change the current wage system. to the union advocates setting up minimum guaranteed monthly wages for individual categories of healthcare professions. In its opinion, this does not mean reverting to the former uniform tariff wages of healthcare workers. This new system would allow for further differentiation of healthcare workers’ wages according to their performance and quality of work. If the trade unions manage to enforce their proposal, it would imply not only that the minimum wage levels of healthcare workers are guaranteed, but that they will also increase. For example, the monthly wage of a doctor, who has obtained the highest qualifications and skills level in the profession, could reach approximately three times the amount of the average monthly wage in the national economy.

Commentary

Since the average wages in the Slovak economy are increasing quite rapidly (SK0610029I), such a development could trigger a significant increase of wages across the entire healthcare sector. Adopting the proposal put forward by SOZ ZaSS would requires a lot of state budget resources for the healthcare sector. Healthcare workers would certainly welcome such significant wage increases, although it is questionable whether this would prevent them from leaving the country for better-paid jobs abroad. Social partners in the sectoral tripartite body, which has been effectively operating in the healthcare sector for many years, will discuss the ministry’s proposal regarding changes in the remuneration system for healthcare workers.

Ludovít Cziria, Institute for Labour and Family Research