Several hundred nurses and midwives, who handed in their notices by the end of November, will start leaving their posts in hospitals across the country in February. The reason for their protest is mostly the law on salary conditions which the parliament adopted in November 2015, but also due to their working conditions.
The Health Ministry assures patients that the hospitals will manage the situation even after February, but some associations point to the critical state, especially in facilities where a considerable number of nurses want to leave.
Though Prime Minister Robert Fico respects the right of every person to protest, he is rather critical of the way nurses show their disagreement.
“I would not leave the patients,” Prime Minister Robert Fico told the press on January 19.
Ministry calms the public
The Health Ministry data suggest 691 nurses still insisted on their resignations on January 19, while 570 withdrew them by that date. The Slovak Chamber of Nurses and Midwives (SKSaPA) offers rather different numbers. It claimed on January 19 that 854 nurses and midwives still insist on their notices.
Both the ministry and SKSaPA data show that the most nurses plan to leave hospitals in Prešov (more than 300) and Žilina (more than 180).
Hospitals where nurses handed in notices:
- Dolný Kubín
- Považská Bystrica
Patients, however, do not have to be afraid of not being treated in hospitals, Health Minister Viliam Čislák said on January 17 during a political talk show O 5 Minút 12 (Five to Twelve), broadcast by public-service RTVS.
According to him, the hospitals hire new employees with necessary education. In hospitals where the situation will be the most serious, the patients may be moved to other facilities, he admitted, but added that the hospitals are close and “the roads are safe”.
“We will manage everything,” Čislák said, as quoted by RTVS.
Monika Kavecká, head of the Trade Unions of Nurses and Midwives, however, doubted some of the claims, saying there are some risks. She informed about cases when small children had to be transported from Prešov to Košice. One child was even sent to Martin because they could not treat him in Košice, she told RTVS.
The Health Ministry informed later that the transport was standard, and even the Association to Protest the Rights of Patients (AOPP), which reviewed the case, did not confirm any wrongdoing.
Patients’ health in danger
Iveta Lazorová, head of the SKSaPA, however, says that the situation in hospitals where a high number of nurses handed in their notices is very serious. The Organisation for Economic Cooperation and Development (OECD) suggests that there is a lack of about 12,000 nurses and midwives in Slovakia, while more than 1,200 nurses will retire this year. The number of nurses who start working in health care each year is only 300.
The AOPP is also concerned about the current state in hospitals. Several facilities have already reported problems with securing health-care treatment, and many of them will have to work in crisis operation after the nurses leave. The association also warned of the consequences of postponing treatment and planned surgeries, as well as transporting patients to other hospitals.
“It is important that the current situation has the least possible impact on patients,” said AOPP head Katarína Kafková.
Dušan Zachar, analyst with the Institute for Economic and Social Reforms (INEKO) think tank, says that if a critical number of nurses from important wards insist on their notices, the situation in some towns and their surroundings may be complicated for patients.
“Moving the patients, either within the hospital between the wards or between various facilities, represents worse comfort for patients, worse conditions for their treatment, and worse accessibility and quality of provided health care,” Zachar told The Slovak Spectator.
Petition against notices
Meanwhile, nearly 180 nurses from Prešov hospital, whose notice period ends in January, went on sick leave, which resulted in closing some wards and moving the patients to the other ones. The hospital representatives questioned the high number of sick leaves and initiated inspections which are carried out by state insurer Sociálna Poisťovňa.
Also nurses who did not hand in their notices responded to the current state. They launched a petition with which they condemn the form of protest of their colleagues who went on sick leave and ask for keeping the hospital in its current shape. It has already been signed by more than 830 employees of the hospital, the TASR newswire reported.
The petition was initiated by Ľubica Staroňová, head of the Prešov branch of nurses’ trade union. She claimed that nurses who have resigned are not able to properly voice their requirements, and that they let “some leaders who do not work in Prešov hospital” speak instead. She also said that no concerns about nurses getting lower salaries have been confirmed, as reported by TASR.
The ministry, meanwhile, claimed it wants to take legal steps against nurses’ representatives since they publish “many lies” in media. It mostly dislikes the information about a child’s transport to the hospital in Martin, the alleged abuse of controls Sociálna Poisťovňa carries out in regard to sick leaves, and also the purported decrease in salaries in Žilina hospital, as reported by TASR.
PM should interfere
The nurses and midwives insist on three main requirements: that the law on salary conditions adopted in November 2015 must apply to all medical workers, the coefficients for calculating the basic salary must increase, and that the basic salary should increase every three years of practice.
Though they have been present during negotiations with the Health Ministry for the past 3.5 years, the current law does not contain any suggestion SKSaPA representatives have proposed, Lazorová told The Slovak Spectator.
Thus, SKSaPA and the representatives of trade unions submitted a letter to Prime Minister Robert Fico on January 19, calling on him to address the problem. Instead of trying to solve the situation, Čislák “offended the top representatives of nurses and midwives and deceived the nurses”, she added.
Though they wanted to discuss the situation with Čislák, he has not shown any interest in finding an agreement since December 1, according to Lazorová.
Fico, however, said that they allocated €55 million to secure higher salaries of nurses for this year. He also supported the Health Ministry, saying it is very active in negotiations and does not ignore anyone.
Zachar opines that medical employees, including doctors and nurses, should not have separate laws which determine their salaries. They should receive their income based on the quality of work they are doing, with regard to the economic possibilities of the medical facilities they work for, he added.
“The minimal salary conditions in the health sector, as well as automatic salary valorisation based on number of years worked, deform the motivation of partakers and raise obstacles for effective use of funds to cure patients,” Zachar said, adding that every fair public discussion about salary hikes should reflect the work done by employees.