Pay controversy in healthcare sector

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In September 2004, the SANITAS Federation of healthcare workers' trade unions resumed a series of protests initiated earlier in the year, claiming that the Romanian government had failed to address all the points of a protocol on improving pay and conditions signed in July 2004. Their demands, relating mainly to pay increases and other benefits, have received support from other union organisations and professional associations.

In spring 2004, employees in the healthcare sector warned that following 7 April (World Health Day) they would launch protests over pay. To this end, the SANITAS Federation (Federaţia Sanitas), issued a list of 10 trade union claims, focusing on:

  • the pay system;
  • the provision of meal vouchers;
  • free-of-charge healthcare services and medications for employees in the sector, their first-degree relatives and pensioners;
  • the status of medical assistants;
  • overdue annual bonuses dating from 2003;
  • a revision of the number of staff in healthcare units (which had previously been reduced, leading, in the unions' view, to numerous operational deficiencies);
  • redundancy pay in the event of collective redundancies; and
  • the resumption of negotiations on the sector-level collective agreement for healthcare.

Set up in 1990, the SANITAS Federation now has approximately 100,000 members across Romania. It is affiliated at national level to the National Confederation of Free Trade Unions of Romania Brotherhood (Confederaţia Naţională a Sindicatelor Libere din România Frăţia, CNSLR Frăţia) and at international level to the Public Services International (PSI) (since 1990).

On 29 July 2004, after negotiations between the Ministry of Health (Ministerul Sănătăţii, MS), and the SANITAS Federation, a protocol was signed which outlined the means and terms for meeting the unions' various demands.

In July 2004, the minister of health promised to promote a new law on the pay of personnel in the healthcare sector, also suggesting a pay rise of up to 40%, depending on performance and type of healthcare unit. According to the Institute of National Statistics (Institutului Naţional de Statistică, INS), in July 2004 net average monthly earnings in the healthcare and social security sector amounted to approximately ROL 4.9 million (EUR 120), representing 83% of the national average wage.

Negotiations continued and resolved seven of the unions' 10 demands satisfactorily. Three demands could not be met, as the terms agreed in the initial protocol had been exceeded. As a result, on 7 September 2004 members of the SANITAS Federation organised a protest meeting outside the Ministry of Health building. The demonstration involved 500 union members, from Bucharest and five counties, who demanded the resolution of the three remaining demands:

  • finalisation of the pay law for employees in the healthcare sector and the award of an 80% pay rise;
  • free-of-charge healthcare services and medications for employees, their first-degree relatives and pensioners; and
  • provision of meal vouchers.

Following resumption of discussions with the executive, the SANITAS Federation agreed to postpone the resolution of the first two demands until the budgetary year 2005, but requested that the distribution of meal vouchers begin immediately.

Both the Federation of Unions of Administrative Personnel in Healthcare Units and Health Clubs (Federaţia sindicatelor cadrelor TESA din unităţile sanitare şi balneare) and the Medical Products Suppliers Association (Asociaţia Furnizorilor de Produse Medicale, AFPM) - a professional association affiliated to the European Diagnostic Manufacturers Association (EDMA) - made public their solidarity with the SANITAS Federation. At the same time, on 14 September 2004 the five nationally representative trade union organisations (RO0307101F) - Cartel ALFA, the National Trade Unions Bloc (Blocul Naţional Sindical, BNS), CNSLR Frăţia, the Confederation of Democratic Trade Unions in Romania (Confederaţia Sindicatelor Democratice din România, CSDR) and Meridian- submitted an open letter to the Prime Minister, requesting:

  • an inspection of social security fund management and a public presentation of the results; and
  • concrete measures to make the tripartite management of the National House of Health Insurance (Casa Naţională de Asigurări de Sănătate, CNAS- a tripartite national body administering health system funds) more effective.

If the Prime Minister rejects dialogue, trade unions will withdraw their representatives from the executive board of CNAS.

The congress of the SANITAS Federation was held on 16-18 September. On this occasion, the health minister promised that in the following two weeks specialists at the Ministry would seek a legal solution and financing sources for meal vouchers.

Simultaneously, negotiations are being held over the conclusion of a new sectoral collective agreement for healthcare, due to be completed by 30 September 2004. So far 140 articles have been finalised.

The senior vice-president of the SANITAS Federation, Adrian Bârnea, has declared that union members are adamant about resuming the industrial conflict and will even resort to a general strike if their demands are not resolved by October 2004.

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