After Wednesday’s meeting between protesting doctors and representatives of the Ministry of Health, reaching an agreement seems a little more likely than before. This is good news. Bad linguists could look for a connection between this fact and the fact that the Minister of War did not personally participate in the meeting this time, but that would be short-sighted sarcasm. In the end, no one other than the head of the department can “cover up” the deal anyway.
What is certain is that, according to the joint press conference, the negotiators of the disgruntled doctors and Minister of War Válk were able to agree on several things – first of all, the protection of young doctors without certification from the bullying of their superiors, who can sometimes push their subordinates into overtime under the threat of complicating their postgraduate education.
The agreement is said to have also prevailed over the topic of excessive overtime work, and the ministry promised to put pressure on the organization of work in hospitals so that overtime work is needed less. This is still very vague, but the ministry and the doctors pretend to understand each other.
In short, the last thing on which there is still no agreement, or at least a hint of harmony, is remuneration.
And since it is true that if everything is not agreed, nothing is agreed, so the fate of the provision of health care from December once again depends on the outcome of the argument about money. Perhaps this is the position in which Vlastimil Válek wanted to get his opponents in the negotiations. If it is possible to agree on everything except money, then it is quite easy to subtly bring down the other party by saying that they are not interested in anything but money from the beginning anyway.
It must be admitted, however, that Jan Přáda, the chairman of the Section of Young Doctors and recently also the vice-president of the Czech Medical Chamber, manipulated himself into this position to a certain extent.
What stood at the very beginning of the Do not be a raccoon protest – i.e. the organization of work, less overtime, better education conditions – is essentially on the way to an agreement. From the repeal of the section of the Labor Code on 832 overtime hours to the debate on education and working conditions.
But then Práda could not resist and took the trade unions into his hands. Their support is double-edged. On the one hand, they have reach and influence, means of communication and experience, but on the other hand, they pushed their age-old dreams into a joint document for Přád, including very complicated ideas, such as retirement (it is not clear for whom and for what) or the possibility of early retirement without reducing the pension (apparently for anyone who has ever walked past a hospital).
So, where more trade unionists than Přád’s doctors already speak in the negotiations, it is now rubbing off. At the last meeting, there was no talk of retirement, but Dagmar Žitníková, the chairwoman of the Health and Social Care Trade Union, brushed off her old idea of introducing uniform salary tables across the board in all hospitals, regardless of the founder and legal form.
Žitníková passes it off as a quick solution that could avert the onset of the protest in December. It’s already absurd.
It would be a huge and very risky legislative procedure. A number of regional hospitals have the legal form of joint-stock companies (owned by the region). The idea that the state strictly dictates the level of wages in – some? – stock companies and private corporations, is, without exaggeration, creepy. That the state hastily “expropriates” today’s regional joint-stock companies in order to become contributory organizations again, or even nationalizes private hospitals so that it can determine wages in them, is not a better idea.
Moreover, it is somewhat bizarre to demand such steps from a government that sees itself somewhere to the right of the political center. The chances of getting wider government support for the widespread introduction of salary scales in non-governmental organizations are quite slim. And even if by chance, the chance of implementing such a measure before the beginning of December is zero.
So on one side stands the ministerial – not very specific – proposal of a kind of “guarantee of a non-exceeding amount of salary”. And on the other hand, trade unionist dreams of flat tables across the healthcare sector.
Here, the path to a compromise will be even more difficult, but if health care in December is to look at least approximately as it does now, it will be necessary to find some agreement. There is likely to be a rapid inflation of rate tables to the extent permitted by next year’s reimbursement ordinance and the promise of future negotiations on a special law on health workers’ compensation.
Let’s not be mistaken – money and salaries belong in the overtime debate, because the higher price of doctors’ work represents an economic incentive for hospitals to make changes in the organization of work. But the current debate about overtime should not be misused to try to fulfill union dreams of “glazing” pay across the health care industry.