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Diana Voicu

Spain

CESM

National Report Spain
September 2017

The most positive thing about the current situation of doctors in Spain is that the so-called "replacement rate" has been eliminated. It was implemented in 2012, under the pretext of the economic crisis triggered two years earlier, and none of the vacant posts in the National Health System (NHS) were covered. In addition, almost 50% of the practitioners have temporary employment contract. Regional health services, which are responsible for the health management, are beginning to convene public employment offers. Many of them are from the previous years since they were not carried out due to the economic crisis.

At the same time, as we mentioned in the previous report, public employment offers coordinated by the State, is being negotiated. Last month the Government and the main public unions reached an agreement to convert temporary contracts into indefinite contracts in the next three years. It is estimated that this could affect more than 100.000 workers in the health sector. 

CESM has questioned this agreement, since it leaves out a significant proportion of doctors and extends the process over a very long period of time that will probably exceed the dead line of three years. The agreement does not improve the precarious work conditions of Spanish doctors and will not respond, with the necessary urgency, to the demands from the recent judgments of the European Court to improve the quality of fixed-term work by establishing a framework to prevent the abuse arising from the use of successive fixed-term employment contracts. 

FINANCING
Proposal of agreement based on a new financing model for the autonomous communities (regions) in which health spending has more weight. The debate over budget shortfalls is another issue at the Parliament. 

TRAINING
Also the Congress of Deputies has decided to create a commission on medical training. CESM has requested that the NHS finance the medical training carried out during working hours. 

WITHOUT RECOVERING SALARY CUTS
The negative note is that doctors are still not recovering the pay cuts implemented since 2010. The ordinary working hours per week are 37,5 hours, and not 35 hours as the previous years.