Central Europe Review - A Meek Protest

	Vol 1, No 16 11 October 1999

H E A L T H:
A Meek Protest
Czech doctors' latest round of protests have failed again

Jan Culik

On Wednesday 6 October, Czech doctors went on strike for better pay and conditions, demanding that the government enter into a debate with them about the state of the Czech health service. The strike was very mild, so much so that most patients were not even affected by the fact that it was taking place. The Czech doctors are bound by their moral considerations and refrain from taking any action which would harm their patients. This is why the government is not taking their demands seriously. Several times during the past three years, the doctors have attempted to draw the attention of the government to their plight, but it seems that last week's strike has been as unsuccessful as all the previous ones.

Ivan David, the Czech Health Secretary, said that the doctors' submission to the government was "an extreme example of social imbecility." He added that there was no point in him entering into a debate with the doctors about the state of the health service because all decision-making in the Czech health service has been de-centralised and he has no power to do anything. The Prime Minister, Milos Zeman, accused the doctors' trade union organisation Lekarsky odborovy klub of blackmailing the government and refused to deal with them.

The doctors' letter to the government, dated 6 October 1999, which the Health Secretary calls "an extreme example of social imbecility" says the following:

The Czech health service only works due to the selfless efforts of its employees who are forced to subsidise a bad system at the expense of their incomes. The Health Secretary does not communicate with the doctors and, under his leadership, the Department of Health has failed to draft a single law in a form suitable to be approved by Parliament.

In its election manifesto, the Czech social democratic party promised to improve the pay of the people in the health service "by tens of per cent within two years." However, the January 1999 pay adjustment has not even allowed the health service workers to catch up with inflation. The average pay in the health service is still a mere 94 per cent of the national average.

The health service workers demand the start of an immediate dialogue between them and the government about changes in the financing of the health service which would make it possible for them to be better paid.

The health service demands that the doctors' pay should be three times the national average and the pay of middle-ranking health personnel should be 1.3 times higher than the average pay in the Czech Republic. In the European Union the income of doctors ranges between 2.5 and 5 times the national average.

It is a fact that the doctors' pay in the Czech Republic is low, just as is the pay of many other university educated people. Doctors often testify to occasions when they treat a bricklayer or any other manual worker during a night shift in hospital. When the manual workers find out how much the doctor gets to be paid for his work, they admit they would not bother to crawl out of bed for such little money.

"When I left the Motol Hospital in Prague last year at the age of 34, where I worked as an internist, after nine years of medical practice and ten years of study, my monthly net pay was USD 318. This included extra pay for long work shifts," said Michal Sojka, the editor of the Czech doctors' professional journal, writing in Britske listy on Friday 8 October .

Czech doctors often work overnight shifts, so that their work load is between 100 and 200 hours per week. They frequently work without interruption from Friday morning (6 am) until Monday afternoon (5 pm). Critics say that during these long shifts, the doctors do not do anything anyway, "just watch television." For such periods of inactivity, doctors receive USD 0.44 per hour for their work. In district hospitals in the country, doctors are often forced to operate on patients after a full night shift without being able to have any rest.

The doctors' low pay has serious implications. As Sojka states, "If a doctor is paid little, that means that he can be used for doing menial work, allocated elsewhere to clerical staff. If a doctor is paid as little as a secretary, surely he can be expected to spend his day sitting at a typewriter, writing bureaucratic reports."

Jan Culik, 11 October 1999

The author is the publisher of the Czech Internet daily Britske listy.

Other Articles by Jan Culik in CER

Pricking Havel's Bottom, 4 October 1999

More Moribund Manouevring (Further TV Nova Tales), 27 September 1999

Mixed Czech Nuts, 20 September 1999

Nova TV: The saga continues, 13 September 1999

UK: Central Europeans Keep Out!, 30 August 1999

Czech Public TV: The yellow-bellies, 23 August 1999

Zelezny Pulls the Plug on Czech TV Nova, 16 August 1999

Czech Media and Civil Society: A survey, 16 August 1999

Czech Revival: No Pulse 99, 9 August 1999