http://www.cesm.org/
Situation in Spain
FEMS Report - Spring 2011 Growing support for medical unions
In Spain, we have been immersed in union elections since the end of the past year and the good news is that the results achieved until now, have given to the medical unions more support than ever.
The support given has been such that Metges de Catalunya that represents over 24,000 doctors has become the principal union. For the first time, medical unions have supplanted the large general unions (CCOO and UGT) despite the fact that “all” workers in the sector can vote for them.
Considering that doctors only represent 15 to 17% of the workforce, this represents a significant achievement.
In other regional health services, the CESM has garnered significant support, whereas the support of the Government to the biggest unions has been declined, although the Government tends to treat them in a “special” way. The population and the medical profession accuse the biggest unions of looking out for their own interests with little regard for the economic crisis affecting the country as a whole.
Considering that last year doctor’s salaries were cut an average of 7.5% and have been frozen since then, doctors have not forgotten that only the professional unions protested against this discrimination, as the salary cut was greater for them than for the rest of public employees (where the average cut is of 5%).
Our positive results in the union elections, reinforces our prime objective: demand independent negotiations with the public administrations.
Although doctors did not want elections, the regulations do require them, but the results show that doctors prefer to represent themselves through professional unions. The goal is to hold direct negotiations with employers, including, of course, the public administrations.
On the other hand and regarding to our last report, there is little to report other than timid advances in the following issues:
- Employment stability through offers of public employment.
- The courts have agreed with our contention that retirement at the age of 65 should be voluntary or at least be justified.
- We have managed to re-address a situation in which no less than 45% of candidates for the latest specialisation test (MIR), were non-EU doctors.
- We continue demanding the creation of a public register of doctors (which, incredibly, does not yet exist).
- The union of all medical organisations (professional, academic and scientific organisations and CESM as the medical union) continues apace thanks to the Medical Profession Forum.
September 2010
The financial-economic crisis in Spain is more acute than in other European countries due to the failure of the Spanish government to recognise the reality of the situation when it occurred. This has resulted in significant consequences for the Spanish health care system. Doctors within the public sector (80%) have suffered a 7.5% cut in salaries, while the finances of the National Health System are in deficit. The total debt of the System is unknown given that regions or Autonomous Communities are reluctant to reveal their health care debt load, although the problem is certainly significant.
Our organisation, CESM, has called for an evaluation of the total debt of the National Health System, in order to establish the basis for a solution. These calls for transparency have thus far gone unheeded and the situation is increasingly unsustainable and uncertain. Plans have been presented to raise taxes, establish a copayment system, increase doctor’s workloads, remove doctors from health care management, etc.
In addition to the financial situation, there are other important tissues:
- Have nurses assume the functions of doctors, writing prescribing medication, some types of surgery, etc.
- Fix a quota of non-EU doctors accessing the training system for specialisations. Exams are held annually and in the latest some 40% had studied Medicine outside the EU.
- Establish a registry and official demographic study of doctors in Spain.