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National Report Croatia (HLS), September 2018
The doctors in Croatia – general data and exodus
Lack of the doctors
Working conditions, overtime work and court proceedings
Collective bargaining and representativeness
The biggest problem in Croatia is the lack of doctors, mostly caused by leaving for work abroad in last few years. For the past five years, many doctors have been retired and in the next 10 years many doctors will be retired, too. The doctor's deficit is compensated by running a huge number of overtime hours by the remaining doctors, which largely exceed the legally permitted limits.
THE DOCTORS IN CROATIA – GENERAL DATA AND EXODUS
According to the Croatian Medical Chamber latest data (August 1st, 2018), there are 18.866 doctors in Croatia today (public sector 69%, private sector 31%).
Since Croatia became a member of the European Union in 2013, 662 doctors left and have been employed abroad. In the same period, 30 doctors from other countries were employed in Croatia The main medical specializations of the doctors who leave for other countries are: Anesthesiology, Radiology, Psychiatry, Gynecology and Obstetrition, Urology, ENT, Ortopedic surgery.
The doctors' reasons to leave and work in other countries are: better salary, working hours 40 or less/week (in Croatia is often 60 and more!).
LACK OF DOCTORS
Currently, about 4.000 doctors are missing in the Republic of Croatia, out of which 2.000 in the hospital system. Over the past 10 years, 650 doctors have been retired, of whom 68 are retired in this year. Education and training of specialist doctors in Croatia lasts from ten to fifteen years, and for the next decade it is expected a steady growth of doctor´s population at the age of 65+ with the simultaneous upward trend of leaving young doctors from the country. Over the next 10 years, additional 4000 doctors will be eligible for retirement, which can not be compensated by the number of doctors who complete the medical school (about 300/year).
How do we try to solve the doctor's lack? In recent years, the number of specialists who continue to work after the retirement age has increased, considerably as a result of the lack of young people, but this is not a solution for saving the Croatian health system.
WORKING CONDITIONS, OVERTIME WORK AND COURT PROCEEDINGS
The main reasons of dissatisfaction for (especially) hospital doctors in Croatia are:
- too much overtime work during the week (60 and more);
- excessive/overload work during the regular hours (for lack of a doctor, one doctor performs work instead of 2 or 3 doctors)
- inadequate salary
The Labor Law in Croatia permits maximum 180 hours per year. Because of the lack of doctors in Croatia, the vast majority of hospital doctors spend on average about 300 overtime hours a year, in an effort to keep the healthcare system functional.
Estimated overtime hours have not been calculated in an adequate manner since 2013, with overtime work not counting any additions contracted under the current Collective Labour Agreement. For this reason, numerous court proceedings are ongoing, including thirty of which have been legally valid, so far.
COLLECTIVE BARGAINING AND REPRESENTATIVENESS Another problem is the fact that the Croatian Medical Association is not representative in the negotiations on a collective bargaining agreement. Croatian doctors have been seeking a Professional collective agreement for years, but this government, just as before, does not want to negotiate for Professional collective agreement with the excuse, that it will contribute to the creation of discomfort among other health and public service unions.