Anaesthetists launch wage campaign

In September 2004, anaesthetists at Latvia’s largest hospital launched a campaign for increased pay, threatening to cut their working hours drastically if their demands are not met. The campaign has been joined by anaesthetists from across the country.

In early September 2004, doctors working as anaesthetists at the Gailezers hospital (Klīniskā slimnīca Gaiļezers), Latvia’s largest, announced that they intend to stop working long hours. They currently often work for 24 hours at a time, for pay that is equivalent to the average national wage (EUR 300 per month). The anaesthetists believe that such working hours are unacceptable, with tired doctors risking not just their own health but also that of patients, and that their wages are inadequate in terms of both the amount of time worked and the level of complexity and responsibility required in the work. The anaesthetists have announced they will start working roughly eight-hour days from 13 October 2004 unless their wages are set in accordance with their workload, which they argue means increasing their pay fourfold. They will decline to perform planned (non-emergency) operations, but will still provide emergency services and perform acute operations and care for children and oncology patients.

The doctors’ protest has been prompted by a protracted inability to resolve funding problems for healthcare. Critics claim that as elections approach, politicians always say that they will make addressing the healthcare system a priority, but once in power they quickly forget these promises. It appears to be quietly accepted that doctors will find their own solution to their wage problems. Therefore, payment for medical services is widely practiced in Latvia, but the low standard of living means that these services are not available to a large proportion of the population. The public healthcare system is supported by illegal payments (ie undeclared, 'under the table' wages), without which it arguably could not exist at all. Naturally, this illegal funding is not reflected in official statistics. Due to these circumstances, the scale of the healthcare sector has fallen to a critically low 2.5% of Latvia’s GDP.

The Gailezers hospital director, Edvīns Platkājis, has announced that the hospital does not have the resources to increase anaesthetists' wages. However, in early September 2004, the Minister of Health, Rinalds Muciņš, said that the doctors’ action will force 'a serious evaluation of the rational and effective placement and usage of human and technical resources in Riga hospitals'. The Minister considers that the anaesthetists’ demands are justified, but that their desired wage increase is too high.

Immediately after the announcement of the Gailezers anaesthetists’ protest, a meeting of the board of the Association of Anaesthesiologists and Reanimatologists of the Republic of Latvia (Latvijas Republikas Anesteziologu un Reanimatologu asociācija, LARA) supported their decision.

Attempts to find a possible solution continued throughout September. The government links improved healthcare funding with the need to finish the protracted reorganisation and improvement of hospitals. However it is widely perceived that this will not resolve the problem unless greater funding is promised. In response to the anaesthetists’ demands, the Minister of Health suggested increasing patients' payments as a solution to the healthcare funding crisis. The doctors consider that this is unacceptable because the amount of additional funding needed for healthcare is so great that patient payments will reduce access to medical services even more. Already the health indicators for the Latvia population are the worst of any EU country, and for several illnesses these can be considered as critical. Anaesthetists from other Latvian hospitals have gradually joined the demands made by their colleagues at Gailezers.

The public appears to have reacted with understanding toward the doctors’ protest, because 'under the table' payments for healthcare services is not pleasant for either doctors or patients, and everybody wants accessible and high-quality healthcare services.

After the draft 2005 government budget was published, containing no provisions for improving healthcare funding, the anaesthetists announced that they would not back down from their demands. At a national meeting of anaesthetists on 24 September 2004, doctors from other hospitals joined their Gailezers colleagues. The Minister of Health promised personally to seek additional funds for doctors’ wages.

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