When this government was discussing the organisation of the public hospitals in Gesy, it had originally come up with the idea that hospital workers such as nurses and doctors would cease to have the status of public employees. This was because each hospital would eventually become an autonomous entity that would, in theory, be self-sufficient.
The idea, inevitably, sparked a big reaction from the powerful doctors’ and nursing unions and rather than confront them, the government surrendered to them, saying that whoever chose to could keep the public employee status at the new entities. Of course, they all kept this status with the result that Okypy (the state medical services), which is charge of all the public hospitals, not being able to manage them or implement its decisions.
Not only was Okypy obliged to increase the pay of all the hospital doctors, because their union insisted their income should be closer to personal doctors, but it also accepted the numbers of doctors and nurses for each clinic dictated by the unions. In effect, the new hospitals under Okypy operated in exactly the same way as the previous version under the health ministry, with unions calling the shots and keeping all restrictive practices in place.
Now, Okypy has decided that hospitals should be open to patients in the afternoons in order to tackle long waiting times and to better utilise its expensive medical equipment that lay idle after 3pm. The doctors’ union Pasyki is opposed to this change, because, like all public sector unions, good service to the people that pay their big wages is not on the agenda. Why would it be when, the absurd arrangement of hospitals working civil service hours has been in place for decades and no politician dares challenge it?
To get round the problem, Okypy is prepared to offer pay incentives to doctors to work in the afternoons, further increasing its operating costs. Pasyki opposes the idea, probably as a negotiating tactic to secure bigger pay increases. At this rate, public hospitals will never become self-sufficient. Their costs will keep spiraling as they try to cope with the restrictive practices imposed, as a matter of routine, by unions accustomed to calling the shots. We will end up with public hospitals, with such high operating costs they will threaten the future of Gesy and put a huge strain on public finances.
Is this what we want? ‘Public employee’ doctors will drive Gesy, which they see as nothing more than a cash cow, into the ground. They must be stopped if we want Gesy to survive.