National Report Slovak Republic
Authors: Marián Kollár, M.D., Pavel Oravec, M.D.
Report on the Slovak Health Care Situation
(October 2010 - April 2011)
Discontent with conditions of health care system still rises in Slovakia. No government after 1989 has complexly solved the situation in this field. Instead of the real change, problems are shifting to health care workers.
The new difficulties have arisen after the formation of new government. The payment of the state for economically inactive inhabitants declined from 4.78 % to 4.32% from the base salary. It caused additional cut of financial sources in system which had been deficiently fixed before. Moreover, further decreasing is not excluded. Simultaneously, the government is preparing transformation of all public hospitals left, including University Hospitals, into stock companies with neither special discussion nor analyse of expediency of this approach. As we can assume, the target for this transformation is to privatize gainful selected elements of health service by financial groups which partly control lucrative segments of health care nowadays. Interests of doctors', nurses’, and patients’ are on the last place.
Commencing salary of a young doctor is approximately 700€ pre-tax which is less than average wage in national economy that was 769€ in 2010. Full qualified doctors earn on average 1160€ /base pay/ which is 1.51 times more than average salary.
In many hospitals, the limit of overtime in not respected. There are doctors who continuously spend 32 hours or more at work.
The Labour Union of Physicians (LOZ) has been warning the necessity of systematic changeovers in the health department for a very long time. It is necessary that payments to the hospitals reflect their real charges including account of work of medical staff. The aim of LOZ is to achieve that wages of doctors would be minimum of 1.5-3 times of average salary in national economy according to the level of education and work experience. Also, it is necessary to respect the law adjustment about length of work, material and personal capability of place of employment. We do not hesitate to use any necessary tools to achieve our goals, e.g. strikes or any other supporting activities and we take inspiration from our Czech colleagues.
Report on the health care situation in Slovakia -spring 2010.
Parliamentary election in Slovakia will be in few weeks, on June 12-th, 2010. According to preliminary prognosis greater changes in the political orientation are not expected. Corruption on the highest political level, nontransparent tenders, misuse of dotations from European Union and mafia-friendly environment are the greatest problems in the country. These are the main reasons why „money are missing“ and still insufficient part of GNP is coming to the health care sector. Salaries are practically frozen (there was 2,5% increase last year and this increase was only partially copying the inflation in the country).
University and state hospitals are in growing debts, especially younger doctors are leaving the country, which creates more night duties and overtime hours for hospital doctors with fatigue, mistakes, burnout sy, etc. Of course, Slovak doctors are not happy with this situation, but in the atmosphere of global crisis, closing of smaller hospitals, migration of unemployed people there is a little chance in the firm reaction like for example strike, or strict maintaining of the law by the hospital employees according to the working conditions (e.g. not exceeding maximal working hours per week or fulfilling of minimal personal normatives of doctors and sisters in hospital departments).
We believe, that in this difficult situation, only serious and strong pressure from EU authorities could force our „competent“ politicians to change something in their mind and especially in redistribution of (their pocket) money...
Slovakia, Bratislava, 1st May 2010
Dr. Marian Kollar, chairman of the Slovak Labour Union of Physicians (LUP)
Dr. Kamil Kvalteni, Vice-chairman of the Slovak Labour Union of Physicians (LUP)