Hospital workers strike over pay and overtime

Following a series of unsuccessful protests, healthcare workers in a number of Slovak hospitals staged a strike in early April 2006. By 19 April, employees of 21 hospitals joined the strike, as their demands for higher wages and better working conditions had not been addressed. Although the healthcare sector trade union has succeeded in stipulating a wage increase within the collective agreement for 2006, the demands of the strikers have not been met. Despite this, the protesting doctors terminated the strike on 21 April 2006. However, they continue to protest by using other forms of strike action.

Failure to secure higher wage demands (SK0604029I) led to a decision by healthcare workers to take strike action to help resolve the conflict. In the afternoon of 6 April 2006, doctors and nurses in Bratislava, Banská Bystrica and Prešov Faculty Hospitals went on strike. The action marked the first official strike in the Slovakian healthcare sector, and was called for an unlimited period of time by employees who are members of the Medical Trade Unions Association (Lekárske odborové združenie, LOZ). The strike was not organised in accordance with the act on collective bargaining, because the law only allows industrial action to take place in connection with collective bargaining, for example, when conciliation procedures for concluding a collective agreement have failed. However, the healthcare workers acknowledged their right to strike as set out in the Slovakian Constitution. A representative of the Ministry of Healthcare (Ministerstvo zdravotníctva Slovenskej republiky, MZ SR), Karol Farkašovský, said he did not consider strike as the best solution for solving the wage issues. In his opinion, wage negotiations should continue until all possibilities to settle the conflict are explored.

Progress of strike

Since the daily tasks of healthcare workers in hospitals are vital for the health and well-being of hospital patients, these workers are not permitted by law to stop their work completely during a strike. According to the President of LOZ, Marian Kollár, doctors and nurses should work during a strike as they do at weekends: that means providing only essential medical care. Therefore, the delivery of other less urgent medical services is postponed. Although doctors agreed to provide acute medical care during the period of strike action without claiming wages, it seems that the Director of the Bratislava Faculty Hospital, Valerián Poticný, banned doctors taking part in the recent strike from performing their duties and suspended head doctors and nurses participating in the strike from their functions.

The Office for Healthcare Service Supervision (Úrad pre dohlad nad zdravotnou starostlivostou, UDZS) is the state authority responsible for controlling the quality of healthcare services. During the strike, the office asked hospital patients to inform them of incidences of when their health was at risk due to the strike action. Moreover, the strike could be called off by the courts if the health of patients was endangered due to doctors joining the strike. As a result, the directors of some of the hospitals asked the courts to intervene and stop the strike. Only the court in Bratislava responded, issuing a precautionary warning to the trade union in Bratislava Faculty Hospital to end the strike. However, employees at the hospital continued to strike because, according to their representative, the court decision did not apply to them. Simultaneously, the President of the Slovak Republic, Ivan Gašparovic, received a letter from employees of the Nitra Faculty Hospital in which they asked for his support of the healthcare workers’ demands. The President stated that healthcare workers have the legal right to strike and that those workers who decide to join the strike cannot be punished for it.

Although the sectoral Slovakian Trade Unions of Healthcare and Social Welfare (Slovenský odborový zväz zdravotníctva a sociálnych služieb, SOZ ZaSS) issued a strike alert to hospitals on 27 February 2006, its members did not participate in the strike. SOZ ZaSS negotiated for higher wages with both the Association of Slovak Hospitals (Asociácia nemocníc Slovenska, ANS) and the Association of Faculty Hospitals (Asociácia fakultných nemocníc, AFN); the latter was established during the protest actions as another employer organisation in hospitals. However, the President of SOZ ZaSS, Andrej Kucinský, declared that if they could not reach agreement on a wage increase before 20 April, SOZ ZaSS would also call for strike action on the basis of the act on collective bargaining.

Demands of healthcare workers

On 12 April 2006, approximately 1,000 healthcare workers met in Bratislava at a protest meeting where they announced that, in addition to a wage increase, they are also lobbying for the improvement of working conditions for doctors and nurses (such as a reduction in the high amount of overtime), which should reflect an improvement in the health services available for patients. Representatives of the Confederation of Trade Unions (Konfederácia odborových zväzov Slovenskej republiky, KOZ SR), some well-known artists and members of the public came to support the workers at the protest meeting. The protesting healthcare workers warned that if the government did not handle their demands before 20 April 2006, they would use more severe forms of protest action. It was clear to the strikers that this problem could not be solved solely through negotiations with the hospital management, who have limited financial sources as set out in the state budget. However, government representatives considered this struggle as a labour conflict and were therefore reluctant to get involved.

On 19 April, the healthcare workers organised a protest meeting in front of the parliament buildings in Bratislava. On the workers’ behalf, several politicians tried to add the issue of a wage increase for healthcare workers to the agenda of the parliament session (the last session of the election period), but without success. The strikers announced that, from 21 April, they would end the strike; however, if the Slovakian government continued to neglect their demands, they would refuse to provide emergency services from 2 May 2006.

Other hospitals joined the strike and, by 19 April, healthcare workers in 21 hospitals were on strike in Slovakia (some of the workers supported the hospitals on strike only symbolically). On the same day, SOZ ZaSS representatives signed a new sectoral collective agreement with the AFN. According to this collective agreement, employees’ wages in faculty hospitals in Slovakia will increase on average by 20% in 2006. However, the solution is seen as a compromise because the collective agreement stipulates that wages will increase by 10% from 1 May 2006 and by another 10% only from 1 December 2006. Recently, SOZ ZaSS also concluded a new sectoral collective agreement with ANS, mostly for the smaller hospitals in its association, on wage increases; it subsequently announced that it was going to recall the strike alert issued in February.

Representatives of the strikers branded the new sectoral collective agreements unfair because they do not solve their wage demands; therefore, they refused to end the strike. Doctors in hospitals continue to strike by applying ‘work-to-rule’ tactics. The doctors, who had already used the Labour Code annual limit for overtime work (150 hours) that the employer can order the employee to take on without his or her approval, refused to provide emergency services in hospitals from 2 May 2006. An end to the conflict is not yet in sight.

Note: material for this article has been drawn from articles published in the SME newspaper on 7 and 12 April 2006, available online at http://sme.sk/.

Ludovít Cziria, Institute for Labour and Family Research

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