Doctors’ strike ends in new collective agreement

In June 2006, the trade union and employer sides agreed on a new collective agreement covering medical doctors at university hospitals. The new collective agreement provides for a standard weekly working time of 42 hours and introduces regulations for on-call services. It also provides for the introduction of new pay scales for medical doctors working in both west and east Germany. The agreement, which will run until the end of 2009, followed the first major strike action taken by medical doctors in post-war Germany.

On 16 June 2006, the Marburger Bund (MB), a trade union representing medical doctors, and the Employers’ Association of German Länder (Tarifgemeinschaft deutscher Länder, TdL) signed a new collective agreement (in German) covering some 22,000 medical doctors at university hospitals. The new collective agreement will cover the period from 1 November 2006 to 31 December 2009. It followed several waves of warning strikes and 12 weeks of strike action involving up to 13,000 doctors.

Provisions of new agreement

Working time

The new collective agreement provides for a standard working week of 42 hours. Medical doctors can individually opt to continue working a 38.5-hour week in west Germany and a 40-hour week in east Germany, with their monthly pay being adjusted accordingly. The agreement also allows for the introduction of 12-hour shifts, with a maximum of eight shifts within a fortnight.

In cases where the regular service is combined with ‘on-call service’ (Bereitschaftsdienst), daily working time can be extended to up to 24 hours, consisting of eight hours’ regular service and 16 hours’ on-call service. Such an arrangement, however, requires the prior examination of alternative working time models and a workload analysis in line with German health and safety legislation. If on-call service is included, the average weekly working time may be extended by agreement to a maximum of 58 hours a week and in exceptional cases to up to 66 hours a week. These working time arrangements require the individual consent of the doctors affected.


The collective agreement also provides for new pay scales for west and east Germany based on a standard weekly working time of 42 hours. Holiday and Christmas bonuses will be integrated into the new scales and will no longer be paid separately. Depending on the expected workload, on-call service will be paid at either 60% or 95% of the individual hourly rate. On-call service on public holidays will entitle the employee to a 25% bonus payment.

Notwithstanding these provisions, opening clauses in the agreement enable employers to enter into collective bargaining at regional level, with the aim of derogating from the agreed pay rates. Cuts of up to 10% can be agreed if this may help to secure employment for doctors. Salaries that are 20% or even 25% above the standard rates can be agreed if this helps hospitals to fill vacancies or discourages doctors from leaving, by compensating for higher regional living costs.

The new pay provisions will run from 1 July 2006 to 31 December 2008, including a general pay increase of 2.9% with effect from 1 January 2008 in west Germany and 1 May 2008 in east Germany.


Since the 1950s, MB had formed a bargaining alliance with the Trade Union of German Employees (Deutsche Angestelltengewerkschaft, DAG), a trade union for white-collar employees. When DAG became part of the merger that formed the United Services Union (Vereinte Dienstleistungsgewerkschaft, ver.di) in 2001 (DE0104220F), this bargaining alliance was continued with ver.di.

However, in September 2005, MB decided to opt out of the alliance because of a disagreement over the new framework collective agreement concluded for the public sector in February 2005 (DE0503203F). MB felt that better terms and conditions could be achieved for doctors through separate negotiations. Ver.di criticised MB for this move and insisted on its right to negotiate for all staff in the healthcare service.

The rift between ver.di and MB became even more pronounced when ver.di signed a new framework collective agreement for the public sector with TdL on 20 May 2006 (DE0606029I). This also included special provisions for doctors, similar to an offer made by TdL that MB had previously rejected. MB continued its dispute, but finally settled with a result close to the previous offer by TdL.

MB claims to have gained 20,000 new members during the dispute and to represent 105,000 doctors out of a total of 146,000 doctors in employment. Ver.di on the other hand highlights that it is a trade union for all staff in the healthcare service. Its strong position in hospitals is mainly visible among nurses and technical staff.

On 26 June 2006, following the collapse of negotiations with the Municipal Employers’ Association (Vereinigung kommunaler Arbeitgeberverbände, VKA), MB called for strike action demanding better pay and working conditions at the municipal hospitals. So far, pay negotiations have not resumed and strike action continues with increasing support from doctors and other medical staff of municipal hospitals throughout Germany.


Industrial relations in the healthcare sector have become more adversarial, largely due to the pressures of privatisation and cost-cutting measures. The dispute at the university hospitals marks the first major strike action by medical doctors in post-war Germany. Nurses and other hospital staff have also engaged in industrial action during the disputes that took place this year in the public service (DE0605019I).

The move by MB to secure a separate collective agreement for medical doctors follows a similar development in the airline industry in 2001 involving the Vereinigung Cockpit (VC) pilots’ trade union, which resulted in a separate collective agreement for pilots (DE0106226F). This latest development at the university hospitals marks the end of a long period of joint collective bargaining on behalf of all staff in the healthcare service.

Heiner Dribbusch, Institute of Economic and Social Research (WSI)

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