The dropout rate in the medical centers of the four medical training universities was about 5 percent, and none of the clinics exceeded 10 percent. This will not cause disruption, even at the organizational level, let alone the system level, in most changes to the schedule. “
Zoltan Berke, president of the Union of Medical Universities (OSZSZ), the umbrella organization of trade unions representing medical universities, told the index. However, he noted, that doesn’t mean that 95 percent of health workers signed the service contract because they found the system great. Their professionalism, loyalty to employer and patients is what has always kept order and what saves it now.
They see their job as their profession, they want to work, which is why most people have to get into a bad situation they don’t want at all.
According to Zoltán Berki, although the Hungarian Medical Chamber was present in negotiations with the government or the General Directorate of the National Hospital (OKFŐ), the arguments and suggestions put forward by the healthcare organizations did not appear to be over, with few exceptions. Will be. The fundamental problem is that Law C of 2020 regarding the employment relationship has not changed.
In two online conferences organized by NSZL, the heads of labor departments of the university department also said that the legislation is full of legal errors and confusion, which has not been improved by subsequent implementing regulations and other related regulations.
OKFŐ instructions tried to reverse the situation in some way, however, decisions of the General Directorate of the Hospital were published to amend contract details even after many doctors and specialists had already signed their contracts. Originally, it would take 30 days to recognize and sign the employment contract, but in most cases, it was unavailable for a few days or less.
There was an evening when we discussed the issue of contracts under the leadership of Semmelweis University, and by the time we were done, another OKFŐ decision had been made. While formal contacts tried to express positive messages about the fundamental change, some workers had no idea behind it.
– That’s the president.
From the president’s point of view, from a general point of view this situation is unfair for healthcare workers, because signing a new employment contract that includes changing the legal status will determine the long-term existence of the workers and their families.
Do they volunteer?
There were three union concerns in the new legal relationship:
- Prohibiting collective bargaining;
- How to transfer the different elements of mobile wages, in particular the duty on demand, into the new agreement between wage-related benefits
- And whether it is possible to solve the issue of voluntary overtime.
Regarding collective agreements, he said that the signing of the new agreements was more smooth as this system was working before and its content could be transferred to the new agreement. This was largely achieved in the clinical centers of the four medical training universities. There is a grace period of a few months on Szeged, but according to Zoltan Berke, that might not be an issue.
In the case of on-demand fees, there was already a problem that the duty to service on demand, as defined in the Labor Law, meant readiness in the workplace with less work. At the same time, it is a feature of healthcare that fewer workers are overburdened than ordinary people.
“The problem is that healthcare providers also organize duties on demand where there is more than 50 percent of work time, whereas if this happens regularly then a shift has to be arranged.
Hospitals cannot do that because they require more doctors, but no more. The new law plans to reward service upon request with a substantial extra burden of 70 percent of the normal wage, which is unacceptable in healthcare or anywhere else. This cannot be compensated even through an increase in the base wage
– NSZSZ head brushes.
It reminded him of how outrageous it was in the unhealthy professions when the level of demandable and voluntary overtime was raised in 2019. Meanwhile, in health care, employees work in the most stressful regular overtime system, and the overtime they volunteer is built up. In some departments, normal operation requires that employees voluntarily take overtime in addition to ‘primary’ overtime. This has been a serious problem with the system for years, and there are actually a lot of people in the new situation who haven’t registered to do so, and many have removed the sentence about it from their agreement.
There was a specialist in the capital who indicated to the index that he would really crack down on the regime when doctors whose basic pay increased would terminate their low-paid voluntary overtime contracts, thus dismantling the on-demand system.
Years ago, the medical room advised doctors not to volunteer for overtime, showing the current government just how scarce workers are in the care system. So far, however, doctors have not reached themselves en masse.
Healthcare immigrants
Zoltan Berkey also spoke about the professionals, their new status does not radically change their status. OSZSZ recommended the state health department, as with general culture workers, receive a 30 percent wage increase in relation to the wage bill due to a change of legal relationship, but the proposal has not been passed. However, they promise that none of them can earn less than before, compared to this, many professionals have left the profession now, and there are relatively fewer of them than doctors.
Among those who did not sign into the employment relationship now, the expert says the proportion of skilled workers is slightly higher.
“They are leaving in groups in many cases, and together they dare to cut off their insecurity.
In many hospitals, large professional communities are forming, not only close-knit, but highly knowledgeable and earnest sympathy, but unfortunately only they get tired and bored over time.
In some institutions, local leadership does not seem to take their problems into account. I am convinced that if the management of the designated institution listened to them and cooperated with them, their emigration would not continue. “
Zoltan Burke drew attention to the fact that many physicians can now obtain part-time contracts under a fixed-term contract, just as a personal shareholder can be hired for a fixed period of time. Very slowly, there may come a time when the doctor will also have to choose between public service and private practice. Now we still have the promise that everyone can get a part-time license. “We will see. There is a promise, no guarantee.”
The president is confident that the new legal relationship has not removed the toxins of the system, which will make the future uncertain. Covertly, even withdrawing gratitude funds can contribute to this.
Problems will arise in the future, as the largest wheelbarrow in the system is that it is not motivated by a top-down payroll scale. Neither the good performance nor the quality. At the same time, the doctor-patient relationship is based on familiarity and trust, so the patient still needs to seek personalized service. And this was partly embodied in gratitude funds, which had momentum. The good news is that the gratitude system will be gradually abolished, but the question is how current changes affect the doctor-patient relationship. No patient has yet asked if this would be beneficial for them in this way.
(Cover Photo: Nurse in the Department of Pulmonary Medicine at the Korányi National Institute of Lung Diseases on February 18, 2021. Photo: Zoltán Balogh / MTI)