WHILE private hospitals and clinics are considering the HIO’s (Health Insurance Organisation) proposal for a 6 per cent cut in the prices agreed for offering treatment to Gesy patients, the state health services Okypy, which runs the public hospitals, has said it would be submitting pay incentive proposals to its specialist doctors. The doctors’ unions at public hospitals have been threatening dynamic measures if they do not receive these proposals by early next week.
These pay negotiations had started last year but stopped because of the coronavirus. But even when the two sides were talking there was a big gulf separating what the doctors were demanding and what Okypy was willing to pay them. The pay rises are intended to stop the outflow of public hospital specialists, who, apparently, can earn more by setting up a private practice and working with Gesy. Many hospital departments had doctor shortages, but Okypy has hired over 100 in order solve the problem.
Nobody knows what pay incentives would be offered, but Okypy would be wise not to be very generous, because the taxpayer would be picking up the bill. At a time when private hospital, which receive no assistance from the state, are being asked to take a hit in order to help Gesy, it would be provocative for the state to be giving big pay incentives to its own doctors, the majority of whom enjoy all the benefits of public employees – guaranteed pay rises, retirement bonus, paid holidays, big pension, job security. They cannot all leave the hospitals, because as the number of private specialists increases, the earnings, which come from a fixed amount, would fall.
Perhaps Okypy should consider letting specialists go and keep hiring younger ones; it could use the services of the experienced specialists at hospital clinics a couple of days a week for an agreed fee, as happens in the UK. This would be part of a process of hiring its permanent staff on individual contracts, which was the original plan, and eventually get rid of all those that have the status of public employees and enjoy union-protected work privileges. This is an opportunity to end the restrictive union practices for public hospitals, make them more flexible, competitive and efficient.
Part of the problem though is that the health ministry does not want a confrontation with the hospital doctors’ unions and is encouraging Okypy to offer higher pay. Okypy is currently in the process of hiring experienced nurses, offering public sector pay rates that are 50 per cent higher than average paid by private hospitals. In other words, the state-subsidised hospitals will create nursing shortages at private hospitals by paying union-set rates rather than market wages. While the state will be pushing up wages of medical staff, it still expects private hospitals, to take a cut in the rates of in-patient care for the good of Gesy. By the same logic, government doctors should be told there would be no increased pay offer, for the good of Gesy and the public hospitals.