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Doctors return to hospitals

SLOVAKS need no longer live in fear of a minor medical emergency turning into a major crisis, after a protracted protest by hospital doctors, which had seen hundreds of them leave their jobs, ended. After days of negotiation the government and doctors’ representatives announced early on the morning of December 3 that they had finally reached a compromise, albeit “without a smile on their faces”, as the prime minister put it.

SLOVAKS need no longer live in fear of a minor medical emergency turning into a major crisis, after a protracted protest by hospital doctors, which had seen hundreds of them leave their jobs, ended. After days of negotiation the government and doctors’ representatives announced early on the morning of December 3 that they had finally reached a compromise, albeit “without a smile on their faces”, as the prime minister put it.

The stalemate became critical after resignation notices filed in protest by over 1,200 doctors in state-run hospitals became effective on December 1.

But it took another four days after the deal was struck for all the doctors to return to their hospitals, as the Medical Trade Unions’ Association (LOZ), which had organised the protest, insisted on a coordinated return to work by the doctors. A state of emergency implemented in more than a dozen Slovak hospitals officially ended on December 8.



The final memorandum



“As of today, including this weekend, doctors can return to their original positions in the hospitals where they filed their resignations,” Health Minister Ivan Uhliarik stated on Saturday, December 3.

The final agreement guarantees hospital doctors a three-phase salary increase which will result in their pay rising to 1.25 to 2.3 times the national average salary by January 2013, depending on individual education and experience. Originally, doctors had demanded an increase to 1.5 to 3.0 times the average salary. The increase, guaranteed by law, will apply to all doctors, including those working in private hospitals.

The government also pledged to “secure the necessary material and financial conditions” for hospitals to be able to sign new contracts with the doctors including the new salary levels stipulated in the agreement.

The deal also guaranteed that all the doctors who left their jobs would be able to return to the same positions they held before the protest.

Furthermore, the government promised to amend the law to completely halt the transformation of hospitals into joint-stock companies, and to ensure that the Labour Code is observed in Slovak hospitals, particularly when it comes to overtime work and the number of patients that one doctor can handle at a time.



A delay for new contracts



However, the agreement did not lead to hospital doctors immediately returning to work, despite Uhliarik’s repeated calls for them to do so and the LOZ’s assurances that it would do everything to encourage them to resume work as soon as possible.

Most of the 1,200-plus protesting doctors had still not signed new contracts by December 5 and the LOZ admitted that it wanted to coordinate their return to work so as to ensure that all of them really would be able to return to their jobs as promised. LOZ called on doctors, via its website, not to accept new contracts directly from hospital directors, but to wait for union coordinators to accept them instead.



Czech army doctors helped



Meanwhile, many Slovak hospitals, including the teaching hospitals in Bratislava, Trnava, Nitra, Prešov and the main hospital in Liptovský Mikuláš, continued to work in crisis mode. The state of emergency did not prevent protesting doctors from staying at home after their resignations became effective on December 1, as many of them claimed to be ill and stayed at home on sick leave.

To cover for the missing doctors, 25 Czech military doctors, mainly surgeons, anaesthesiologists, traumatologists, doctors of internal medicine, psychiatrists and one urologist, were sent to Slovakia and served in the teaching hospitals in Bratislava, Žilina, Nitra, and at the Central Military Hospital in Ružomberok.

While the opposition in the Czech Republic criticised the centre-right government of Petr Nečas for sending the doctors to help in Slovak hospitals, calling them strike-breakers, the LOZ’s Kollár caused uproar in Slovakia by saying, during a televised debate on TV Markíza on December 4, that “this is the first time since 1968 that foreign troops have come to Slovakia”.

The commander of the Czech doctors in Slovakia, Jan Österreicher, rejected the strike-breaking label.

“Technically speaking, there is no strike, only doctors who have terminated their contracts or fallen ill,” Österreicher told the Sme daily, adding that he and his colleagues had only come to help, and to secure health provision for Slovak patients. The mission of the Czech doctors in Slovakia was set for 29 days originally, but it ended on December 7, with the end of the state of emergency in Slovakia. The doctors performed 91 urgent interventions on Slovak patients, the Czech daily Mladá Fronta Dnes informed.



State of emergency ends



The cabinet ended the state of emergency, which lasted nine days, as of December 8.

The LOZ reported on December 7 that the situation in Slovak hospitals was completely back to normal, that they were all running according to their ordinary working regimes, and that the doctors who had returned had already been re-employed by their respective hospitals.

“We thus fulfilled our pledge from the memorandum that we would do everything to return to patients as soon as possible,” Kollár said.

He also stressed the LOZ expected parliament to fulfil the government’s pledges in line with the memorandum and was ready to monitor the approach of MPs from each political party, because “unfortunately already today some MPs [have expressed] doubt [about] the memorandum signed by the cabinet and don’t consider it binding”.

“In some hospitals the return was complicated by the approach of some directors,” Kollár said, explaining why it took several days for doctors to return to their original jobs.

Several dozen doctors will not be coming back to their jobs by choice, Kollár admitted, but wasn’t able to provide exact figures.

Kollár again criticised Minister Uhliarik for mishandling the situation and for not having the plan B that he had claimed to have.

“It wasn’t really prepared and it was only based on the minister’s conviction that the doctors would withdraw their resignations,” Kollár said, adding that the declaration of the state of emergency, a tool which the government ultimately used to try to keep the doctors in the hospitals and thus prevent the whole system from collapsing, “certainly wasn’t part of the plan B”.

The LOZ has said it believes the state of emergency was unconstitutional and earlier filed a complaint with the Constitutional Court. Citizens angered by the protest action filed a total of 11 criminal complaints with the prosecutors’ office, some of them directed against Kollár himself.


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