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Slovakia’s doctors prepare to strike over plans to privatise hospitals

BMJ 2011; 343 doi: http://dx.doi.org/10.1136/bmj.d8200 (Published 16 December 2011) Cite this as: BMJ 2011;343:d8200
  1. Jane Feinmann
  1. 1London

Doctors in Slovakia say they are going on strike for a second time in a month in a bid to force the government to scrap plans to turn the country’s state run hospitals into joint stock companies funded by private health insurance. The move, according to the Slovakian Medical Trade Unions’ Association, LOZ, will lead to the privatisation of hospitals and the end of accessible, quality healthcare.

The strike warning, made at a press conference on 12 December, came as around 1200 Slovakian doctors—including many of the country’s surgeons and anaesthetists—were preparing to return to work after participating in a mass resignation from the country’s health service from 1 December. The action, condemned by the government as “traumatising patients,” forced at least 16 Slovakian hospitals to work in a state of emergency for over a week because of critical shortages of specialised staff that, according to a report in the Economist, left thousands of patients untreated.

The mass resignations were carried out in a dispute that involved disagreements over pay as well as the privatisation issue. Now the government has pushed legislation through the Slovakian parliament, providing a new pay structure for the country’s 7400 doctors and dentists who currently have an average monthly income of €1000 (£840; $1300).

New working contracts that are now being issued to doctors guarantee a pay increase of around €300 effective from January—with the promise of paying doctors up to 1.9 times the average salary by July 2012 and, up to 2.3 times as much by January 2013. It has also promised to introduce a plan for doctors to have days off if they exceed a certain overtime limit.

The health ministry is insisting that these contracts reflect the doctors’ demands. A spokesperson said: “LOZ should now stop traumatising patients and focus on remedying the current poor level of trust between patients and doctors.”

LOZ, however, claims that the move towards privatisation has merely been postponed rather than halted. It has issued a warning that further industrial action is now likely in a campaign that it insists has always been about far more than doctors’ pay.

“The transformation of hospitals into joint-stock companies must be halted so that there are no lingering doubts on this issue,” Marian Kollar, president of LOZ, told a press conference on 12 December. “We’re vigilant and if they [government and parliament] don’t meet their commitments immediately and in full, we’re ready to act again,” Dr Kollar said, according to a report by the Slovakian news agency, TASR.

Many doctors are concerned that with the Slovakian health service already debt ridden, there is a high risk of insolvency when the hospitals become joint stock companies, funded by private medical insurance. There is particular concern that the large financial group, Penta, that already owns companies, utilities, and a growing number of pharmacies in Slovakia, has expressed an interest in buying Slovakian hospitals when they go bust.

A further cause for concern is that in September 2011 a series of cables from the US embassy in Bratislava, published by Wikileaks, suggested that the financial group was using bribes to get favourable healthcare reforms.

LOZ has been praised by healthcare unions throughout Europe as well as the Paris based European Federation of Salaried Doctors (FEMS) for its anti-corruption stand. In November 2011, FEMS issued a statement warning of the dire consequences of underfunding healthcare systems in “former communist colonies” particularly Slovakia. It said the safety of patients was endangered by twin policies of privatisation and low pay for doctors, triggering high rates of migration of doctors to countries where they are better paid.

Notes

Cite this as: BMJ 2011;343:d8200