MANY doctors are making good on their threat to terminate their employment contracts with Slovak hospitals. On September 29 as many as 2,411 doctors from hospitals across Slovakia submitted notices to their employers terminating their employment contracts, and additional notices are expected to come in subsequent days. It is the doctors’ way of protesting against what they call the dismal condition of Slovakia’s health-care system and of airing their frustrations with the prescriptions offered by the Health Ministry. Marián Kollár, chairman of the Medical Trade Unions Association (LOZ), warned that if no agreement is reached with the ministry, medical treatment in hospitals could collapse in December after the two-month notice period has run its course.
“Dear Minister, dear Prime Minister, this is not a game any more,” Kollár stated, as quoted by the SITA newswire. “Unless the ministry and the government take a responsible stance in solving the problems and the requirements of doctors, such a large number of notices will cause a collapse in the health-care system in Slovakia – with all its consequences.”
LOZ has rallied the doctors around four demands; a halt in the ministry’s plans to transform public hospitals into joint-stock companies is often stated as the most urgent. The other demands are for hospitals to follow the Labour Code with respect to hours of work and other working conditions, to increase government funding for health care, and to gradually raise the salaries of health-care employees.
Health Minister Ivan Uhliarik responded by accusing the medical trade unions of taking patients as hostages while nonetheless assuring patients that they need not worry about being left without proper health care.
“This is their [the doctors’] right but I do not agree with this,” Uhliarik stated, as quoted by the TASR newswire.
Ministry’s spokesperson Katarína Zollerová told TASR that the ministry respects the legitimate demands of doctors for more funds for the health-care sector, but stressed that the ministry must first make order from the current situation and look for ways to use the available finances more effectively, and that only after that is done can the question of more money be discussed.
Uhliarik is scheduled to meet representatives of the medical trade unions on October 5, and will hold earlier discussions with the directors of hospitals on October 4.
“I believe that we will find common ground so that patients do not need to be put in danger,” Uhliarik said, adding that the demands of the doctors can be summed up into one – more funds going into hospitals and into salaries.
But Uhliarik views the demand to halt the transformation of hospitals into joint-stock companies as impossible to agree with because the law requiring it has already been adopted by parliament.
While the minister said that a plan has been prepared to cope with a mass exodus of doctors from their hospitals in December he did not share any details about it on September 29.
“We are prepared for the alternative to secure health care without 2,411 doctors, which is 13 percent of all doctors in Slovakia and about one-third of all hospital doctors,” Uhliarik stated. Media have reported that one possibility is combining medical departments or using other hospitals, and that the ministry will be analysing the specialisations of the doctors who have submitted employment termination notices.
LOZ, apparently inspired by Czech doctors who earlier this year threatened mass resignations in their country, began to solicit commitments from doctors on August 25 that they would sign termination notices of their employment contracts; 3,827 doctors from 51 hospitals declared their willingness to do so from among the 6,000 doctors who work in Slovak hospitals.
The Slovak Medical Chamber and the Slovak Trade Union of Healthcare and Social Services are supporting LOZ’s campaign.
Doctors clustered under LOZ appeared to remain resolute in delivering their notices even after Slovakia’s cabinet adopted documents on September 27 outlining what the cabinet called effective and prudent operation of hospitals that are to be transformed into joint-stock companies. LOZ has stated that it opposes the ministry’s transformation steps and views it as a route towards privatisation of the hospitals.
On September 27 the cabinet approved revised documents for the transformation, including a founding document and a sample statute for a joint-stock company. Prime Minister Iveta Radičová stated after the cabinet meeting that changing the legal status of the hospitals has nothing in common with privatisation.
“The transformation does not create, anticipate or enable privatisation,” Radičová stated, as quoted by the SITA newswire, emphasising that the sample statute clearly provides that a joint-stock hospital will have 100-percent state ownership.
The original draft statute governing medical facilities operating as joint-stock companies specified that state ownership must not fall below 51 percent but the final document adopted by the cabinet specifies that the 100-percent state ownership of the joint-stock hospital can be changed only through an increase of its share capital and only with the explicit agreement of the cabinet.
According to Radičová and Uhliarik, transforming the hospitals into joint-stock companies will stop waste and ineffective use of public funds.
“Endless indebtedness is the road to perdition and this is also the case with hospitals,” Uhliarik stated, as quoted by SITA. “The condition of some state hospitals is bad. This is because of debt and ineffective financial management. And we want to change this.”
The response of doctors to the changes adopted by the cabinet was less than positive, with Kollár saying the changes were not enough. “We are waiting not for cosmetic adjustments but for a halt in the transformation of the hospitals,” Kollár told the public-service television broadcaster STV.
Richard Raši, the previous health minister and now mayor of Košice, told the broadcaster that the changes approved by the cabinet would not prevent a private [financial] group from obtaining complete control over a hospital.
3. Oct 2011 at 0:00 | Jana Liptáková