Slovak doctors’ avoid prison, Fico’s government avoids mass resignations, for now


Health Minister Kamil Šaško and the Medical Trade Union Association (LOZ) struck a deal on Friday, preventing Slovak healthcare from spiralling into crisis on 1 January with mass resignations by doctors.

Doctors will not resign, but the government has until February to show progress on the negotiated points or risk a return to the crisis.

Since Wednesday, the negotiations have been conducted behind closed doors, and neither the Minister nor the head of LOZ, Peter Visolajský, had given an update on the progress of the talks.

In a joint press conference on Friday, Minister Šaško and Visolajský announced a breakthrough, shook hands, and exchanged a signed 30-page agreement, ensuring doctors’ resignations withdrawal and stable healthcare provision on 1 January.

“I am genuinely pleased that four days before Christmas, together with Mr Visolajský, we can announce good news for everyone who wishes for better healthcare and peace in Slovak society,” the Minister stated during the press conference.

LOZ leader Visolajský thanked the doctors who submitted their resignations, handled the pressure, and also stood by nurses, psychologists, and speech therapists from having their salary growth reduced.

“It was a difficult negotiation,” Visolajský stated at the joint press conference. He said the agreement is a compromise, with both sides making concessions.

The agreement also includes amendments to employment contracts for doctors who have submitted resignations, ensuring that if the parliament does not pass the six pre-agreed laws by the end of February, the resignations will take effect on 28 February.

The next parliamentary session is scheduled for 4 February.

Wage compromise 

Doctors will receive a salary increase as agreed in the 2022 memorandum. Instead of the 6.4 per cent, lowered by the budget consolidation measures, the salary boost remains at 9.7 per cent.

However, this applies only to those with at least a half-time position in the hospital and who do not work elsewhere, such as in a private practice or an outpatient clinic. 

Minister Šaško said that the money for faster salary growth will have to be found within the Health Ministry and its budget.

As a result, the deficit will not increase, and there should be no need for additional healthcare funding. According to the Minister, it will amount to millions of euros, but he did not disclose the exact figure.

Since the president has already approved and signed budget consolidation measures, the cancellation of the reduction in doctors’ salary growth will need to be approved by parliament, likely through a fast-tracked legislative process.

No state of emergency

The government has pledged to present an amendment to the law that will repeal the changes related to the extraordinary situation established during last week’s final parliamentary vote before the holiday recess.

The mechanism would have effectively paused/frozen the doctors’ notice periods, forcing them to work under the threat of a prison sentence. This was a fallback plan by the government in case there was no agreement by 31 December.

Hospital location, study duration

The government will cancel the resolution that the new hospital in Bratislava will be in the Ružinov district, which Šaško’s predecessor, Zuzana Dolinková, pushed for.

The Minister promised to present the location of the new state hospital by the first quarter of 2025, with construction beginning during this government’s term.

In addition, a reassessment of the length of specialisation training is planned, as it currently exceeds the duration found in certain other countries.

A committee will be formed to evaluate the duration of several specialisations. As stated in the agreement, the goal is to adjust the length at least to the level of Czechia.

Hospital financing and audit

“In 2025, a thorough, in-depth audit will be conducted, covering personnel, processes, and materials, with the aim of improving the management of state hospitals,” Minister Šaško stated. 

The audit will review the effectiveness of employment contracts, adherence to working hours, operational indicators, and the procurement of medications and medical equipment.

Contracts between hospitals and health insurance companies will be standardised. These contracts will be binding and include provisions such as prohibiting insurance companies from paying hospitals less than their economically justified costs.

This was a strong demand by the LOZ to ensure slower accumulation of hospital debt, uniformity, fairness, and consistency between all parties involved.

Additionally, an intervention to turn the majority of hospitals under the Health Ministry or regional management from contributory organisations into joint-stock companies has been put to bed, with the government rejecting this transformation during the current term.

Conflict of interest

Minister Šaško overcame PM Robert Fico’s inaction and refusal to meet with the unions. The opposition parties criticised the PM for not stepping into the negotiations and avoiding the issue.

In 2022, Fico, then in the opposition, repeatedly asked, “Where is the Prime Minister?” while the government, led by Eduard Heger, was negotiating with the medical unions.

This week, he distanced himself, arguing that he is in a deep conflict of interest because the doctors saved his life after the assassination attempt in May. “I would prefer not to engage in discussions with people who saved my life. I am too subjective and too emotional,” the PM said.

The PM was not present at the press conference announcing the agreement, but Visolajský said Fico shook his hand after reaching the compromise.

In two previous negotiated agreements with the unions, a prime minister signed the agreement. However, Minister Šaško stated that he signed the deal on behalf of the government, not the PM.

Response

“It is important that people receive healthcare and that a collapse does not occur. However, let us remember one crucial message from this crisis. Prime Minister Fico left the people of Slovakia abandoned in their most difficult moment,” Progressive Slovakia (Renew) leader Michal Šimečka said on Friday.

He continued, “For months, he ignored the healthcare problem and the doctors’ demands. First, it wasn’t a topic for the prime minister, then he travelled the world, and finally, he felt too subjective and emotional.”

Christian Democrats (KDH/EPP) leader Milan Majerský welcomed the compromise, which will finally end the traumatisation of Slovak citizens, who have been hostages of the long inability to reach an agreement.

“The government bought time with the agreement until the end of February, by which time it must pass several laws – and we will be closely monitoring this. At the same time, we expect the minister to present a plan for further changes to improve healthcare, including outpatient care and emergency medical services,” František Majerský, KDH MP, stated.

[Edited by Vasiliki Angouridi, Brian Maguire]



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