Czechs fret over Slovak doctors

QUESTIONS remain over who will treat patients in Czech hospitals if thousands of protesting doctors there fail to reach an agreement with the government and leave hospitals en masse come March. This has recently become a topic across the border in Slovakia after rumours began circulating that Czech hospitals might try recruiting Slovak doctors to fill in.

QUESTIONS remain over who will treat patients in Czech hospitals if thousands of protesting doctors there fail to reach an agreement with the government and leave hospitals en masse come March. This has recently become a topic across the border in Slovakia after rumours began circulating that Czech hospitals might try recruiting Slovak doctors to fill in.

Slovak doctors are promising not to act as strike-breakers, but at the same time say conditions in the Czech health-care system are far better than they get in Slovakia.

The situation across Slovakia’s western border, which is growing serious as the notice period for almost 4,000 Czech doctors’ resignations approaches, has posed questions about the potential for an exodus of doctors from Slovakia too.

Thank you, we're leaving

In the Czech Republic, the doctors’ trade unions have threatened a walkout since the middle of 2010, seeking a hike in pay to guarantee them between one and a half and three times the national average salary, depending upon experience. About 3,800 of the country's 20,000 hospital doctors handed in their resignations at the turn of the year. These come with a two-month resignation period, meaning the practical implications of the “Thank You, We’re Leaving” campaign would be felt by early March, The Prague Post reported.

According to The Prague Post, in the third quarter of 2010 the national average salary was Kč23,655 (almost €1,000) per month, according to the Czech Statistical Office. Doctors earn between Kč45,000 and Kč50,000 on average but say these figures are based on them working massive amounts of overtime.

The campaign could result in several hospitals in the Czech Republic having to close down, especially those missing doctors in key departments like intensive care, surgery, internal medicine and radiology, according to the idnes.cz news portal.

Slovaks support their colleagues

Czech doctors have found a sympathetic ear among their Slovak colleagues. The Slovak Medical Chamber (SLK) has written an open letter to the Czech prime minister saying that the chamber has appealed to Slovak specialists not to take jobs in Czech hospitals freed up by their departing Czech counterparts.

“Like in the Czech Republic, in Slovakia we too experience similar feelings of frustration at the declining social status of a doctor imprisoned in a politicised and barely transparent health-care system,” the letter reads.

Katarína Zollerová, the spokesperson of the Slovak Health Ministry, told The Slovak Spectator that at the moment the ministry does not have any specific information about any large number of Slovak doctors intending to leave for the Czech Republic.

“According to our information, the selected hospitals in the vicinity of the border have not recorded any resignations in this connection,” Zollerová said.

But the Sme daily reported that doctors from some hospitals located close to the Czech border have received offers to help out at least part-time. For doctors living in those regions, working in the Czech Republic is no problem as they would not need to move and could just commute.

Ladislav Pásztor, the president of the Private Physicians’ Association of Slovakia, remarked that Slovak doctors will not leave in large numbers, simply because there are none actually able or willing to do so.

“Young doctors up to 30 years old either don’t have their internship completed, and therefore can’t leave yet, or have already left,” Pásztor told The Slovak Spectator. “Then we’ve got a huge gap, as there are very few doctors aged between 30 and 50. And doctors older than 50 are not that willing to try something new anymore.”

Young doctors already missing

The fact is that salaries offered by Czech hospitals already serve as a strong incentive for Slovak doctors to consider leaving the Slovak health-care system for better money abroad. According to Milan Dragula, the president of the SLK, monthly salaries are on average €600 higher there for young doctors. Pásztor said that in the Czech health-care system salaries are two to three times higher than in Slovakia.

However, experts agree that it is not only money that serves as an incentive, but also better conditions for professional growth, working conditions and the social status of doctors.

“In Slovakia a doctor is still seen as a class enemy that anyone can kick as they like without punishment,” Pásztor said.

Better salaries and better conditions for one’s career development are an attraction for Slovak doctors in other countries too. According to Dragula, Slovak doctors get offers from hospitals in Germany, the UK, France, Austria, the Nordic countries, and also Arab countries. In the case of the Czech Republic, a further advantage is its proximity and the fact that there is no language barrier between Slovak doctors and Czech patients.

According to data from the Health Ministry, there are over 15,500 medical doctors and 2,550 dentists working in Slovakia at the moment. Representatives of doctors say the situation is critical.

“We already have problems with a lack of doctors now, as many, mainly younger doctors, have left for abroad,” Dragula said, adding that the consequent problem in Slovakia is that the remaining doctors are relatively elderly, with almost 60 percent of all doctors working in health-care facilities in Slovakia over 55 years old.

Some observers have suggested that gaps could be filled by graduates from Ukraine or other countries to the east of Slovakia. But Pásztor dismisses that option.

“Who would come to Slovakia if [doctors] in Romania already earn almost as much?” he asked. “Even if they came, they would do their internship – which is then valid in the whole of the EU – and move on.”

Pásztor therefore claims that the Slovak health-care system should only rely on educating its own doctors, and then motivate them not to leave.

“The minister has been leading a dialogue with doctors since he took up his post and he will do everything in order for the prepared changes to have a positive effect on the motivation of doctors and nurses,” Zollerová said. These changes should, according to her, include the transformation of hospitals, introduction of fair rewards for hospitals for their results on the basis of diagnosis-related groups (DRG), and significant savings via the drugs policy.

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