Came upon a link to a letter sent by the medical workers' union to its members. It sets out, in clear language, what exactly it is that the doctors and nurses are asking for. Figure it's worth translating for anyone who's following the events.
For what it's worth, the taxation issue warrants further discussion, but otherwise I personally find these demands to be reasonable.
The Purposes and Demands of the Healthcare Workers' Strike
The purpose is to slow down the outflow of healthcare workers from Estonia and stop the disintegration of the healthcare system.
To achieve the purpose:
A. We demand a collective agreement that:
* Extends to all healthcare workers, irrespective of whether they are financed from the Health Insurance Fund or from the state budget;
* Sets out the maximum work amount that can be demanded within a 1.0 workload position. For doctors, the number of in- and outpatients treated per year. For nurses and caretakers, the number of patients in a department per employee;
* Implements a 40-hour paid work week for a resident physician;
* Ensures defacto accounting and compensation of overtime, additional pay for night work, the coverage of supplementary training costs, additional vacation time;
* Implements minimum hourly wage rates - the first phase demands are, before tax, 8.60 for doctors, 5.50 for nurses, 3.00 for caretakers. The wage increase must be palpable and guaranteed for the next 3 years, to slow down the outflow of healthcare workers.
We will accept an honest offer that considers all financial possibilities. Note: we are talking about raising minimum rates, not an equal percentage increase for everyone.
B. We want agreements for the introduction of changes to the healthcare system and funding increases. For conditions that cannot be immediately implemented starting from 2013, we will agree to a longer-term schedule, but a specific plan of action along with implementation deadlines must be agreed upon and binding to the parties.
* The hospital network's development plan must specifically define the volume and kind of specialist medical care (in what specialist fields) that will unequivocally remain in general hospitals, and must also define how the state will ensure the preservation of this volume. This will give young upcoming physicians a sense of stability. The decisions must be made at the state level, not left up to the hospital owners.
* To improve the availability of medical care:
a) Change the maximum limit of outpatient queues for specialist doctor care back to 4 weeks (this was changed to 6 weeks in 2009).
b) Restore dental care compensation for patients.
c) Provide family doctor care to uninsured persons, financing it from the state budget.
These changes will also reduce the unnecessary additional workload of doctors and costs to the state, as easier illnesses that are left untreated become more difficult and chronic, and the treatment becomes more expensive.
* To increase the 2013 budget of the Health Insurance Fund:
a) Cover the capital costs of hospitals from the state budget (as per the Health Services Organisation Act)
b) Use the undistributed profit of the Health Insurance Fund to the maximum extent permitted by law
* To increase the income base of healthcare, we recommend the adoption of the 2010 WHO proposals "Possibilities for ensuring the financial sustainability of the Estonian health system", for example raising capital taxes, application of social tax to dividends, state-paid social tax on pensions. The choice must be made by the politicians.
We are prepared to negotiate and compromise on all topics. We will be able to end the strike as soon as the agreements are signed.
For what it's worth, the taxation issue warrants further discussion, but otherwise I personally find these demands to be reasonable.
The Purposes and Demands of the Healthcare Workers' Strike
The purpose is to slow down the outflow of healthcare workers from Estonia and stop the disintegration of the healthcare system.
To achieve the purpose:
A. We demand a collective agreement that:
* Extends to all healthcare workers, irrespective of whether they are financed from the Health Insurance Fund or from the state budget;
* Sets out the maximum work amount that can be demanded within a 1.0 workload position. For doctors, the number of in- and outpatients treated per year. For nurses and caretakers, the number of patients in a department per employee;
* Implements a 40-hour paid work week for a resident physician;
* Ensures defacto accounting and compensation of overtime, additional pay for night work, the coverage of supplementary training costs, additional vacation time;
* Implements minimum hourly wage rates - the first phase demands are, before tax, 8.60 for doctors, 5.50 for nurses, 3.00 for caretakers. The wage increase must be palpable and guaranteed for the next 3 years, to slow down the outflow of healthcare workers.
We will accept an honest offer that considers all financial possibilities. Note: we are talking about raising minimum rates, not an equal percentage increase for everyone.
B. We want agreements for the introduction of changes to the healthcare system and funding increases. For conditions that cannot be immediately implemented starting from 2013, we will agree to a longer-term schedule, but a specific plan of action along with implementation deadlines must be agreed upon and binding to the parties.
* The hospital network's development plan must specifically define the volume and kind of specialist medical care (in what specialist fields) that will unequivocally remain in general hospitals, and must also define how the state will ensure the preservation of this volume. This will give young upcoming physicians a sense of stability. The decisions must be made at the state level, not left up to the hospital owners.
* To improve the availability of medical care:
a) Change the maximum limit of outpatient queues for specialist doctor care back to 4 weeks (this was changed to 6 weeks in 2009).
b) Restore dental care compensation for patients.
c) Provide family doctor care to uninsured persons, financing it from the state budget.
These changes will also reduce the unnecessary additional workload of doctors and costs to the state, as easier illnesses that are left untreated become more difficult and chronic, and the treatment becomes more expensive.
* To increase the 2013 budget of the Health Insurance Fund:
a) Cover the capital costs of hospitals from the state budget (as per the Health Services Organisation Act)
b) Use the undistributed profit of the Health Insurance Fund to the maximum extent permitted by law
* To increase the income base of healthcare, we recommend the adoption of the 2010 WHO proposals "Possibilities for ensuring the financial sustainability of the Estonian health system", for example raising capital taxes, application of social tax to dividends, state-paid social tax on pensions. The choice must be made by the politicians.
We are prepared to negotiate and compromise on all topics. We will be able to end the strike as soon as the agreements are signed.
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