Young doctors in the Czech Republic have challenged the existing system, which forces them to work overtime without adequate pay and rest with the government, after weeks of negotiations, finally bowing to pressure and preparing new legislation.
The doctors, led by the Young Doctors Section of the Czech Medical Chamber, planned to strike as of December 2023 by refusing to undertake any overtime. This would cause significant issues within the Czech system as it relies on the extra, unpaid hours put in by medical staff.
So far, almost 6,000 doctors said they would participate, with nurses and other healthcare workers considering joining their ranks, representatives of young doctors and health and medical unions warned.
But the main issue is not overtime, but rather a legislated rest period, which is currently not included in Czech law.
“I sincerely hope there will be no terminations [refusals to work overtime] on 1 December. If we did not reach an agreement, it would really lead to a reduction in health care, at least the scheduled one,” said Jan Přáda, a representative of the Czech Medical Chamber’s Young Doctors Section.
According to him, not only young doctors want to protest against the system and demonstratively end with overtime, “but also experienced ones.”
Czech minister: The gap in Czech law will be fixed
In the Czech Labour Code, the maximum time at the workplace was set at 16 hours, but doctors also go on 24-hour shifts without any appropriate legal regulation.
EU legislation allows 24-hour shifts, but they must be covered by national legislation and followed by adequate rest periods, something not provided for in Czech law.
The Czech Ministry of Labour and Social Affairs is now promising change. “We will add an amendment allowing 24-hour service, which would consist of shift work and overtime work,” Czech Labour Minister Marian Jurečka (KDU-ČSL, EPP) said after meeting with representatives of Czech doctors on 20 October.
“This was preceded by negotiations and consultations with the European Commission on whether such legislation was possible. Of course, this is also followed by modifications that relate to clearly defined conditions for further rest so that there is a clear guarantee of the rest that must follow,” Jurečka added.
Based on talks with Czech doctors, the Labour Ministry and the Health Ministry prepared a new proposal, which was shared with young doctors’ organisations. However, the latter are not yet satisfied.
“The amendment to the Act as proposed was unacceptable from the point of view of the Czech Medical Chamber’s Young Doctors Section. It created a legal framework for 24-hour work without compensating health workers for this difference from the work of other groups of employees,” young doctors informed on Thursday (26 October). Negotiations will, therefore, continue.
Meanwhile, health workers continue to insist on overtime terminations. The conditions for withdrawing the process remain – a maximum of 416 hours of overtime per year, the legal possibility of 24 shifts with subsequent rests and an increase in the basic doctor’s salary to 1.5 times the average wage.
The Czech government promises to increase the salaries of health workers and solve the problems with working hours, but no specific legislation has yet been approved.
Unattractive working conditions as a pan-European problem
Doctors’ strikes are nothing new in Europe. For example, a doctor’s strike in emergency services in November 2022 in the Madrid region demanded a substantial wage increase. Doctors have also protested in France and Portugal.
The poor working conditions of doctors were also highlighted in a World Health Organisation report last year, which warned of the imminent decline of healthcare in Europe. According to Hans Henri P. Kluge, WHO Regional Director for Europe, unattractive working conditions, personnel shortages, and other factors “are blighting health systems”.
The WHO director for Europe also warned that “these threats represent a ticking time bomb which, if not addressed, is likely to lead to poor health outcomes across the board, long waiting times for treatment, many preventable deaths, and potentially even health system collapse”.
[By Aneta Zachová | Edited by Vasiliki Angouridi]