Healthcare workers threaten strike action over wages

Healthcare reform in Slovakia has resulted in a new management system, including changes in remuneration levels in public healthcare institutions. As a result of the move away from a standard pay increase system, wages have become the subject of collective bargaining at sectoral and company level. However, collective bargaining for 2006 has not yet been concluded because the social partners disagree on the proposed wage increase for employees. If agreement is not reached soon, the trade unions have threatened strike action.

Dissatisfaction over wages

In 2005, healthcare employees in Slovakia expressed their discontent with wage levels (SK0509101N), and they continue to be dissatisfied as the situation has changed little in the meantime. Workers are currently trying to negotiate a better wage increase with their employers than they received last year. The employees mainly affected are the medical staff of public hospitals who are members of the sectoral Slovakian Trade Unions of Healthcare and Social Welfare (Slovenský odborový zväz zdravotníctva a sociálnych služieb, SOZ ZaSS). Within the framework of sectoral collective bargaining with the Association of Hospitals of Slovakia (Asociácia nemocníc Slovenska, ANS), SOZ Zass has requested a wage increase of about 12% for 2006. The trade union group, which represents around 40,000 employees in the healthcare sector, issued a strike alert on 27 February 2006 and, in the event of their wage demands not being met, will consider taking industrial action.

The first protest action against low wages was organised by employees of the Prešov Faculty Hospital in eastern Slovakia. In January of this year, doctors and nurses organised a protest meeting against their low wages and they continued to protest in February. The Prešov region has one of the highest unemployment rates in the country, and average wages of employees are among the country’s lowest. The hospital’s union members demanded a 35% wage increase. Justification for their request was that their real incomes have decreased by about 35% in the last five years, since their wages have not been indexed in line with the inflation rate.

In the course of collective bargaining in the hospital in early March 2006, some progress was made in wage negotiations. The hospital management decided to increase overtime pay by 100% retrospectively from 1 January 2006. According to the hospital director, Peter Bíroš, this is a positive step towards meeting the requests of the trade unions, which was accepted by the nurses and by most of the doctors. However, local trade union representatives continue to insist on a 35% salary increase, which the director considers to be unattainable. The chair of the trade unions in the hospital, Štefan Hudacko, regards the salary increase proposed by the hospital management to be only a partial measure. This partial increase indicates that management has realised the mistake it made by not discussing the new wage directive with the trade unions, while the collective agreement for 2006 has not yet been signed. Nevertheless, it does not solve the problem of low wages among hospital employees.

Wage gap between healthcare and general economy

Healthcare workers have different demands in terms of wage increases in different regions; for example, in Bratislava in western Slovakia – where both income levels and the cost of living are the highest in the country – workers are demanding a 25% wage increase. According to the chair of the Medical Trade Unions Association (Lekárske odborové združenie, LOZ), Marián Kollár, who also represents doctors in the Faculty Hospital in Bratislava, employees in healthcare services earn, on average, just over SKK 13,000 (€348) per month, while the average monthly wage in the general Slovakian economy amounts to SKK 17,000 (€455). Despite this 30% discrepancy, the hospital director, Valerián Potocný, considers that the employees’ request for a 25% salary increase is unrealistic. In his opinion, at present, it is only possible to negotiate a salary increase of up to 10%.

According to the spokesperson of the Ministry of Healthcare (Ministerstvo zdravotníctva), Karol Farkašovský, wages for healthcare workers can be increased only if the financial situation in their hospitals improves. Regarding the wage increase dispute, it should be explained that the recent implementation of healthcare reforms abolished the standard salary scales for remuneration of healthcare workers. As a result, the wages of employees in healthcare services can be increased only if the social partners find an agreement in a sectoral or company collective bargaining. Directors of public hospitals, to whom management must report, have halted the wage increases of employees in order to control hospital finances and avoid running into debt.

National protest

On 15 March 2006, a national protest meeting of healthcare workers took place in Prešov. Between 1,000 and 2,000 people took part in the meeting, calling for higher wages. Andrej Kucinský, chair of the SOZ ZaSS, reiterated the 30% wage gap of SKK 4,000 (€107) between employees in state-owned healthcare institutions, which were transformed to public non-profit organisations, and the general economy. The participants of the protest meeting urged the Slovakian government to tackle the situation in the healthcare sector immediately and to ensure a sufficient amount of financial resources to allow wage increases for the employees. Moreover, the healthcare workers support trade unionists in the negotiation process for the new sectoral collective agreement for 2006–2009. However, the financial resources of the healthcare institutions, including employee wages, have already been set and approved as part of the state budget for 2006.

Proposals for reducing staff numbers

According to available information, collective bargaining on wage increases in public healthcare institutions is continuing since a suitable agreement has not yet been reached. The situation in the Prešov Faculty Hospital has angered employees, and some doctors announced that, if no agreement on their pay increase was reached by 1 April, they would refuse to carry out their duties in emergency services. On the other hand, hospital management argues that it does not have enough financial resources to meet the requested pay increase. According to the hospital director, dismissals of employees in allegedly over-staffed departments are being considered, and it is estimated that up to 50 doctors and 250 nurses will be let go.

The situation is not much better in the city of Bratislava, where healthcare employees have higher salaries, but are still looking for their 25% wage increase. According to a director of the Faculty Hospital in Bratislava, financial resources are insufficient to allow for such an increase, and one of the possible solutions is to downsize. According to information published in the SME newspaper, the first deputy directors of the four hospitals that are part of the Faculty Hospital are said to have prepared proposals for a downsizing strategy, namely reducing the number of employees in these hospitals. However, Pavel Traubner, Dean of the Faculty of Medicine (Lekárska fakulta) in Bratislava, which has a contract with the Faculty Hospital, declared that management must discuss all fundamental changes, including downsizing, with the faculty in advance.

Potential healthcare strike throughout Slovakia

If disputes over wage increases are not resolved soon, impending strike action of healthcare workers is likely to go ahead throughout Slovakia during April 2006. In the four hospitals in Bratislava mentioned above, the trade unions have set up strike committees. Other hospitals in Slovakia are currently also on strike alert.

Note: material for this article has been drawn from articles published in the SME newspaper in February and March 2006, available online at

Ludovít Cziria, Institute for Labour and Family Research

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