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Uncertainties in health sector remain

The year 2013 did not see the government re-establish a unitary system of public health insurance as it had planned. It did however see an agreement to increase salaries of doctors while a law seeking to raise nurse salaries was found unconstitutional.

The year 2013 did not see the government re-establish a unitary system of public health insurance as it had planned. It did however see an agreement to increase salaries of doctors while a law seeking to raise nurse salaries was found unconstitutional.

Despite the original plans to transform the country’s health insurance system into one with a single health insurer as of May 2013, the Health Ministry still has not presented the new law. At its November 6 session the cabinet acknowledged the ministry’s report, which however does not include any deadlines, the TASR newswire reported.

Health Minister Zvolenská, who survived a no-confidence vote in October over a botched tender over licences for helicopter emergency services, said the law is ready but the date of its official presentation has not been scheduled because the government first wants to solve its financing. The first option is to reach agreement with shareholders of private health insurers. In the event that no agreement is reached, expropriation of the private insurers and the launch of the unitary system had been planned to be introduced by the government as of July 2014, TASR wrote.

Meanwhile, the Federal Court of Justice in Germany in mid September said it will not deal with Slovakia’s request to reassess the decision of the International Court of Arbitration that ruled in December 2012 that Slovakia has to pay €25 million to Achmea, the Dutch owner of the health insurer Union, for what it called a violation of the provisions of the investment treaty between Slovakia and the Netherlands that Achmea had submitted over controversial legislation which prevented privately-owned public health insurers from retaining profits.

The dailies Sme and Hospodárske Noviny wrote in October that the court indirectly upheld the ruling of the arbitration court when it said that it would not deal with the matter since it has already been decided by a court. Yet, Finance Minister Peter Kažimír responded that the case is not as gloomy for Slovakia as local media have painted it, adding that the German court did not decide on the merit of the case, but only issued a draft decision, to which Slovakia can now respond.
After nearly a year the Constitutional Court negated a law authorising increased minimum salaries for nurses in a non-public proceeding held on June 19. The scrapped law had guaranteed wages between €640 to €928 per month depending on professional area of emphasis.

In a response, the unions representing nurses and midwives organised a three-day campout in front of the Government Office. Fico pledged to address the issue in state-controlled health institutions, with nurses working in private hospitals seemingly sidelined from the process. The unions however said that Fico’s offer does not solve the situation since they want all nurses, regardless of the type of hospital they work for, to have their salaries guaranteed by law, according to SITA.

Unlike the nurses, the Health Ministry agreed with doctors on their salary hike in two stages.

As of January 1, 2014 the salary of trainee doctors will increase to 1.25 times Slovakia’s average salary, at least €1,005 per month. Salaries of fully-qualified doctors will rise to 2.1 times the average salary, or €1,668 monthly. As of the following year, fully-qualified doctors should receive 2.3 times the average salary. These two increases will translate into additional state budget expenditures of €30 million a year, TASR wrote in April.

Radka Minarechová contributed to this story


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