HPI

Faculty hospital in Nitra will only do the acute medical interventions after December 1^st. This scenario will be fulfilled if medical trade unions do not reach an agreement with Minister of Health till the end of November. Hospital received 60 notices to date. Planned operations will be performed in the hospital only till November the 30^th. Only acute care will be provided in all surgical departments, Paediatric department, Neurology, Otolaryngology, Urology and department of Anaesthesiology and intensive care. According to Deputy Director of Hospital, they will, however, not close the departments. There will also be some departments, which will continue without restrictions – for example Infection department, Psychiatry and Oncology.

President Ivan Gašparovič gave an ultimatum to more than 2 000 doctors, who have resigned. Either they make an agreement with Minister of Health Ivan Uhliarik until Saturday, or president will ask government to declare state of emergency. Doctors will have to get to work and will receive 70% of their current salary. Emergency may be declared for 30 to 90 days. President warned doctors, that if they withdraw their notices, their position will, according to the offer of the minister and government, get better, but if they do not, they will not get anything.

According to daily SME from 25/11/2011 almost all of the doctors from surgical clinic of Children's Faculty Hospital in Banská Bystrica resigned. Hospital so far, nevertheless, did not postpone any operations of children's patients. Director of hospital will temporary take on seven external doctors – three paediatric surgeons, two general practitioners and two traumatologists. Hospital has allegedly prepared an emergency plan and will ensure the urgent medical care. Hospital is also cooperating with the Roosvelt Hospital and if doctors from both hospitals actually leave, they will reportedly help each other personally.

Constitutional Court of Slovak Republic will have to deal with the emergency posts. Court will consider the constitutionality of certain provisions of the Act on Health Care Providers. Specifically, it will focus on the obligation of General Practitioner (for adults, and for children and adolescents) and Dentists to perform First Aid according to the schedule specified by self-governing region and the possibility of imposing penalties for breaching of this obligation up to € 3 319. System of emergency posts operation was in the past criticized by the Association of Private Doctors whose President welcomed the initiation of the proceeding. Ministry of Health under the leadership of Richard Raši also tried to solve this problem by approving of the change of financing.

According to daily Hospodárske noviny from 25/11/2011 the average gross basic wage of nurses is € 482. Midwives earn € 490. Those are the statistics of National Health Information Centre. According to pay scale of Bratislava University Hospital even administrative staff (officers, technicians or librarians) earns more than them. The new draft Act should guarantee them a minimum wage of € 640. This draft is, however, inconvenient for doctors, who say, that they can come to the situation, when nurse will earn more than a doctor. There is also another discontent group – so called lower health care professionals, ergo laboratorians, technicians, sanitarians, etc. Higher wages for them were also not contested yet.

Minister of Health Ivan Uhliarik ordered directors of hospitals to increase the salary of all doctors next year by an average of € 300. Ministry of Health started to send this command to all state hospitals based on memorandum signed by the Prime Minister Iveta Radičová. According to spokeswomen of Ministry of Health Minister also issued an order for the directors of hospitals to give each doctor today in the morning the amendment to the employment contract, which guarantees them the salary increases.

Part of the so-called Plan B which should deal with the situation in hospitals affected by the notices of doctors after December the 1^st is also the set up of 24-hour hotline for patients. Patients should get to know, if their doctor is working, or if the operation was postponed for a few days. Plan B also deals about where the patients would be transferred if the particular hospital was unable to do some specific operations. The plan also describes how the operations centre will work and how the ambulances and air ambulance services will be directed in the case if some hospitals will have limited run of some departments. According to Minister of Health Ivan Uhliarik the Plan B also considers the future merging of some departments in larger cities.

If doctors take the memorandum submitted by Prime Minister Iveta Radičová, their salaries should be increased twice next year – since January and since April. As is clear from the memorandum, government committed itself to increase salaries for doctors from January to a minimum of 1,05 to 1,6 times the average wage in the national economy. From April the 1^st their salaries should rise again, at least 1,17 to 1,73 times the average wage. The exact amount of salary for an individual doctor should be driven by the attained education and experiences. Adjusting of the salaries should be made through the Act on minimum wage of nurses and midwives. If this change fails, government will increase the salaries by the directive to the directors of public hospitals and the appeal to the other founders.

Patients are passing to the private hospitals and planned operations are being moved. According to the director of private institution Medissimo in Bratislava patients are more than ever consulting the services and the conditions of hospitalization, observes the daily SME. Medissimo does not provide acute care, only the planned operations. Increased interest in the childbirths and gynaecological operations was also registered in the private Sanatorium Koch in Bratislava. According to its director the greatest surge of patients is exactly in these days. Number of patients also increased in private hospital Šaca in Košice. Director of this hospital also made an agreement with the management of hospital in Košice that they will help in the case the doctors will not return.

Minister of Health Ivan Uhliarik addressed his departmental colleagues abroad with the request of providing doctors in the case of emergency situation in Slovak hospitals. Whether this option will be used depends on current development with mass notices of doctors. How many doctors responded to the government̍s offer to increase salaries by an average of € 300 and signed the contract amendment, is not known yet. Minister, however, stressed, that despite the notices about 5 500 doctors should remain in the hospitals. At the end of last week there were about 2 000 notices of their colleagues registered.