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Minister of Health Vlastimil Válek performed political acrobatics not seen for a long time. He promised that he would quickly cancel the disputed section, which as of October had newly enacted the possibility to agree on double the amount of overtime work. This can without much debate be described as the success of the coercive action, which takes place under the alternating names Doctors are only people and Don’t be a raccoon.
In addition to this “main” protest, a partial rebellion entered the atmosphere of the Czech healthcare system at the Na Bulovce University Hospital, where the development is even more dynamic – and unfortunately significantly less clear. Therefore, let’s devote today’s Visit not so much to the overtime itself, but rather to the wave of medical dissatisfaction, which is taking on very interesting dimensions.
Not just the young. The doctors’ anger is much broader
According to the latest reports from representatives of the Young Doctors Section of the Czech Medical Chamber, around 4,900 doctors have resigned from their employers for voluntary overtime work.
At the outset, it must be said that this is a very respectable number. When, 13 years ago, the great protest action We are leaving reached its peak, to which Jan Přáda and spol. to some extent reports, the then organizers from the Medical Trade Union Club collected approximately 3,800 statements. It should be added here that at that time resignations from work were given straight away, not “only” from overtime work, so the comparison is certainly not perfect.
Even so, almost five thousand doctors refusing to work overtime since December is a really solid success for the organizers of the Don’t be a raccoon event, which shows that their event has an undeniable social “pressure”. And not only social, but also political.
Let us remind you that at the beginning of October, the amended Labor Code came into force, which also includes section 93a on additional agreed overtime work in the healthcare sector. This allows the employer to agree with the employee on up to 832 hours of overtime work per year and became the trigger for the current protest.
And even before this section came into effect, Minister of War Válek promised in a Sunday television discussion that he would advocate for its urgent cancellation. We learned from the minister that he always had reservations about the amendment and that “the risks really were as great as we feared”.
One of the proponents of the amendment proposal with paragraph 93a, Lidovecky MP Vít Kaňkovský, in turn stated that he had misjudged the situation in the healthcare sector.
“I didn’t guess that doctors take it as a symbol. A symbol that if the current situation is legalized, nothing will change again. Neither I nor my colleagues who submitted the amendment guessed that. I have to say that I regret it in retrospect,” Kaňkovský told Deník N.
These head-scratching political turns are not the result of some sudden epiphany. They are undoubtedly the result of pressure from the medical community. Politicians downplayed her protest by saying that if doctors don’t like the conditions in the healthcare sector, they can resign and go work elsewhere, or that everyone can negotiate better conditions, but the doctors keep whining.
It should also be remembered that the inclusion of section 93a in the Labor Code passed both parliamentary chambers quite smoothly with the support of a wide range of political parties.
The fact that the section became an unwanted orphan practically overnight, with which no one suddenly wants anything to do, is probably also due to the fact that what at first appeared to be a protest by a few disgruntled young doctors eventually managed to resonate across the healthcare sector. At least in some places, even older or more experienced doctors joined in submitting overtime notices.
“In our hospital, 374 drs, of which 260 L3s, including senior doctors, have given their consent to overtime overtime,” wrote on the social network X anesthesiologist from the Faculty Hospital in Králové Hradec David Doležal.
Tomáš Vacek, head of the internal hospital in Jablonec, on the same network he wrote, that if the doctors’ protest were to go according to plan, there would be big changes in the hospital not only in the availability of care: “It is necessary to choose between maintaining the complete operation of a large inpatient department and maintaining the complete operation of the specialist outpatient clinics. You can’t do both together. Beds are preferable, and even that will come at the price of compromises. The big ones.”
The section of young doctors of the CLK is still cautious about the offered political concessions and does not intend to call off the protest. He points out that the repeal of section 93a is only one of the requirements. Others are more rigorous checks on compliance with the labor code in hospitals, the elimination of systemic discrimination against women and, last but not least, an increase in collective wages so that doctors are not dependent on overtime work for their livelihood. The meeting with Minister of War Válek should take place on October 20, it remains to be seen.
In the shadow of a wider protest, a “partial” rebellion is taking place at the Na Bulovce Hospital. Here, doctors from the ARO department are protesting against the allegedly non-transparent dismissal of the headmaster Jakub Bala and his replacement by the Ústí anesthesiologist Josef Škola.
How does this protest relate to the “raccoons” action? The answer to this is not entirely clear. It is certain that the thirty doctors from Bulovka used the same form of protest against the director of the hospital, Jan Kvaček – that is, they tried to terminate voluntary overtime from October (not from December, as is the case with young doctors), thereby paralyzing the functioning of the ARO department, as well as the emergency department and a large part of the operatives in the whole hospital.
With this form of protest, on the one hand, they partially subscribed to the dissatisfaction of the “raccoons”, but they used it to achieve another goal – they tried to reverse a specific personnel decision of the hospital management.
Director Kvaček reacted very harshly – he accused the protesting doctors of irresponsibility and tried to order them to work on a continuous shift, which according to his legal opinion he could, but according to the doctors he could not. After a few days, however, he also suspended the new mayor and promised a new selection process.
According to Vizita’s information, the current situation in the hospital is quite confusing. Most doctors go to work and take care of patients as before, but disgust with Kvaček’s authoritative and uncommunicative approach is growing.
In any case, the outcome of the Bulovka doctors’ protest is uncertain and the situation is changing every moment. In retrospect, it seems too spontaneous and not very well thought out and prepared. But it can also surprise.
However, it can be seen as part of a kind of general anger among doctors (primarily hospital doctors) towards the system as a whole and the general treatment of their highly qualified workforce. And since the situation in Bulovka will probably have to be resolved in the coming days or weeks, the local rebellion could be perceived as a kind of “pilot project” of the Don’t be a Raccoon campaign. Among other things, it can indicate what possibilities the hospital management has to fight overtime dismissals, as well as how effective this method of coercion on the part of doctors can be.
In any case, a wave of dissatisfaction is spreading through the healthcare industry, which is far from limited to doctors from the ranks of millennials. The threat of reducing the availability of care is real, and politicians and hospital managers will have no choice but to respond to it in some way. If this anger became the engine of systemic changes in the organization of medical work, the “raccoons” would deserve metal.
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