http://www.fides-si.org/
F I D E S Report – May 2011
The amendment of the Public Sector Salary System Act reached its conclusion in the autumn of 2010 with the signing of the Agreement between the Ministry of Health and FIDES, which ensured the managements of medical centres that the payment of overtime, night, Sunday and public holiday work would not change (would not decrease!). However, the agreement itself did not guarantee success, which is why we devoted the majority of our winter activities to providing information on the content of the signed Agreement to the members and management of medical centres; especially to the management of centres, which »did not want to understand« the Agreement. We even had to use the threat of a medical strike. Only the pressure of the trade unions thus brought certain directors of medical centres »to their senses« to the extent that they began cooperating with the doctors in the centres. We therefore contributed to the resolution of the issue of overtime payment.
On the national level, a health care reform is being drafted. This is one of the reforms, which the Government would like to adopt, while all planned reforms are intended to contribute to fast recovery from the current economic crisis (such as, for example, pension scheme reform, amendment of labour legislation, Act on Activities in the Non-economic Sector, etc.). While implementing numerous changes, the Government completely lost its ability to lead dialogue with its social partners during the drafting of the laws and is entering non-harmonised acts into the legislative procedure. Due to the lack of social dialogue, trade unions took advantage of the opportunity and were granted calls for referendums. These referendums primarily reflect public dissatisfaction with the Government (based on a public opinion poll, the support for government is lower than 15%!). With the rejection of proposed laws put to the referendums, the reforms are sliding further away and the crisis is deepening. This Government has another year and a half in office, but we are all well aware that such position is not of benefit to the State. Early elections are also up in the air.
FIDES has planned a few priority tasks which could only be realised in cooperation with the Ministry of Health. These mainly concern the implementation of the standards and norms regarding work of medical doctors. Their implementation itself would give answers to many current issues, such as: lack of medical doctors, long waiting periods for individual examinations and procedures, quality of services, and similar. We also evaluate that a complete amendment of the collective labour agreement for medical doctors and dentists, together with different salary arrangement for doctors, would be necessary. The system, implemented with the Public Sector Salary System Act, is progressively showing its weakness, especially in the area of remuneration of more successful doctors and the chances for promotion. Due to the saving measures concerning public sector salaries, remuneration and promotion are frozen.
Let me conclude with a far-reaching event, celebrated at the end of March 2011. All three medical organisations, the Medical Chamber of Slovenia, Slovenian Medical Association and trade union of medical works, FIDES, have marked the move into our new common home Domus Medica with a formal ceremony.
Damjan Polh, Vice President of FIDES
FIDES Report
October 2010
The summer months are traditionally quiet months in politics; however, exactly the opposite occurred. As a consequence of the economic crisis and the resulting drop in GNP, FIDES, with other trade unions of the public sector, was involved in negotiations with the Government on reducing expenses in the public sector. The negotiations were unsuccessful and the Government sent to the Parliament an amendment of the Public Sector Salary System Act, which was uncoordinated with the trade unions. This text hurt particularly medical doctors, especially those on call (nights, Sundays, Public holiday overtime), since the Act decreases their allowances for work under less favourable working time by half and, in addition, introduces on call positions (paid less than the wage grade of the doctor available on call). It is well known that there are not enough medical doctors in Slovenia and, consequently, on the basis of a consent given to the employer, numerous doctors work considerably more than legally prescribed, i.e. regulated by the European Directive on working hours.
Of course the amendment was quickly passed and all reasonable expert arguments from our side that this is not the way to save money (when there is a lack of doctors who work overtime just for the healthcare system to function!) were in vain. As medical professionals we were outraged and FIDES searched for a solution to the given situation. It offered colleagues an opportunity to claim their rights by withdrawing their consent and working only as much as prescribed by law, i.e. in the same way as all other public sector employees. This was supposed to be the answer to the reproaches we hear all the time: medical doctors are exclusively profiteers; they care only about the money, etc.
We began warning the Government about the consequences of a unilaterally passed amendment (beginning of July) and about the possible withdrawal of consents. We began reminding medical doctors about their rights, which they can exercise and, against expectations, by the end of July most of the doctors working on call withdrew their consents. With this we timely and clearly demonstrated to the Government and the employers that by 1 September doctors would no longer work over the legally prescribed 40 hours per week.
Serious warnings landed on deaf ears, all those responsible promised nothing will change with 1 September. They actually believed that such a mass withdrawal is not possible!? As the fatal date neared, they became more and more concerned. The President of the Republic of Slovenia with his reputation got involved in the resolving of the issue, which encouraged those responsible in the Government and the Ministry to seriously approach the solving of the problem. Despite the fact that it was clear to all that problems will occur with providing medical services to patients (at which point there was already talk of providing only emergency continuous 24 hour care and of postponement of non-urgent examinations and procedures), no agreement was reached and on 1 September medical doctors began working in accordance with the Act.
The healthcare system showed its wide cracks within a few days. Surgical operations were postponed one after another, patients were re-booked for later dates. Experts began warning about the grave consequences of such behaviour (accident and emergency medicine, oncology, transplantations, cardiovascular patients, etc). Pressures, which we as doctors underwent from the management of institutions and via the media, were immense. It was not easy working in such a climate.
Finally, actual negotiations between FIDES and the Government were instated and in the end (following a few long and tiring meetings) an agreement was adopted, in accordance with which we were returned what was taken from us with the amendment of the Act. With this the conditions were created for medical doctors to return their consents and with their overtime work to return the national healthcare to its »normal« framework.
Unfortunately, another delay occurred in talks with the Government on systemic solutions of saving in the public sector. In negotiations on pay freeze and freeze of other rights (suspended promotions, rewards, etc) the Government again adopted unilateral decisions since it was not able to find a common language with the trade unions. The trade unions now announced a general strike of the public sector at the end of the month, which will last until the fulfilment of strike demands. A hot autumn is in sight.
Health Care and Health Insurance Act has been temporarily withdrawn from the parliamentary procedure and will probably be under discussion again only in the coming year. There will be no lack of work for FIDES, since we will have to carefully monitor the execution of just signed agreement and continue with the implementation of standards and norms for the work of medical doctors.
Damjan Polh, Vice President of FIDES