Health and social care wages return to pre-crisis levels

For many years, the health and social care sectors in Latvia have been under threat, facing problems caused by the implementation of austerity measures. Since the beginning of the economic crisis, trade unions have been engaged in active discussions with the government about how to improve the quality and quantity of health and social care services and an agreement to return salaries in social care and rehabilitation institutions to pre-crisis levels was reached on 5 April 2013.

Cuts threaten health and social care services

Reforms and austerity measures in the health and social care sectors have affected the quantity and quality of services. Cost-cutting reforms have reduced the number of service providers and state-funded services because organisations cannot afford to pay employees’ salaries. Consequently, the accessibility and quality of services has deteriorated, and the number of medical specialists available is inadequate. For example, because fewer emergency personnel are on duty at night, the number of timely responses to requests for an ambulance in rural areas has decreased to 79.6%. Also, as a result of emigration, health and social care institutions are short of mid-level medical personnel. Figures from the Ministry of Finance show that, in 2012, social care centres employed 3,056 employees, with an average monthly salary of €402, the lowest average monthly remuneration in the sector.

Liene Cipule, Parliamentary Secretary of the Ministry of Health, has said that the problems are particularly prominent in social care centres, where health and social care are closely related. In her view, the austerity measures taken in these centres were unacceptable.

Even before the crisis, these institutions were inadequately funded. They also had various organisational problems caused by previous reforms, such as the separation of social care services from healthcare services, which hindered the establishment of a satisfactory service delivery system.

The decision to cut funding, which has led to a cut in salaries, and the failure to adequately evaluate the needs of the sector has had a knock-on effect on clients’ well-being in social care centres. This matter has become a priority for the Ministry of Welfare, and for the Ombudsman of Latvia. The Latvian Parliament’s deputies and non-governmental organisations have also been vocal about the problems in social care centres.

Trade union response

Trade unions have taken a holistic approach to evaluating the problems in the health and social care sectors. Inadequate funding and low salaries that disproportionate to the scale of the work done by employees are common to both sectors. The trade unions are discussing these matters with the Ministry of Health, which is responsible for healthcare, and the Ministry of Welfare, which is responsible for social care (LV1211019I, LV1208029I, LV1202019I).

In 2005, the Trade Union of Health and Social Care Employees of Latvia (LVSADA) concluded a general agreement that established general principles for calculating doctors’ salaries. However, these principles have rarely been observed, and so acute are the current problems in the two sectors that trade unions have been fighting not just for improved working conditions, but for the very existence of health and social care services. The LVSADA, in cooperation with other healthcare trade unions, regularly meets with the ministers for health and welfare but the recommendations they make are rarely taken up by the ministries. Despite unions making two approaches to the European Ombudsman about improvements needed in the sectors, their viewpoint has, thus far, been ignored.

Ministry for Welfare relents

A year-long discussion on wages in the social care sector was concluded on 5 April 2013 between the LVSADA, the Latvian Nursing and Health Care Personnel Trade Union (LAADA) and the Trade Union of Employees of State Institutions, Self-governments and the Finance Sector (LVIPUFDA). The Ministry for Welfare agreed to significantly increase the monthly salaries of employees in social care and rehabilitation institutions to either equal or, in some cases, exceed pre-crisis levels. The average monthly wage in these jobs in 2008 was €515, dropping to €422 in 2009).

Commentary

Press releases emphasise that the agreement marks a trend towards development of the sector, which is good news for both service providers and recipients of care. Nevertheless, although the agreement restores salaries to their previous levels, it does not envision an increase in real terms. This agreement cannot, therefore, be seen as resolving the problem of the typically low salaries within the sector.

Raita Karnite, EPC Ltd.

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