Dopis evropskom udruženju ljekara zaposlenih u javnom sektoru
The European Federation of Salaried Doctors
Monday, February 29th, 2016.
Dear Madam or Sir,
I am writing to you on behalf of the Trade union of Montenegrin Physicians. Our trade union organization was founded in 2013 and represents around 800 doctors or more than half of all doctors in the state. The basic goal of our organization is improvement of the social and economic position of doctors in Montenegro.
Firstly we would like to inform you about the present state in the Montenegrin health. Our country has 620,000 citizens and is situated in southeast Europe. Montenegro is a candidate for the EU membership, as well as NATO. The basic doctor salary in Montenegro for the 174 hour monthly work is 390 euros for residents, 550 euros for specialists and 650 euros for subspecialists. For the sake of comparison, a physician working in the Montenegrin public health care system can earn the same as an average taxi driver or hair dresser, and significantly less than government or municipality officials. In total, the salary of a specialist (with all bonuses: attendances, night shifts, additional and overtime work) amounts to 1.3 average salaries in Montenegro, whereas in other countries of the region, for the same work specialists make 2 in Serbia and Macedonia, 2.8 in Croatia or even 3 average salaries in Slovenia.
Furthermore, our country is far from being a leader in the density of physicians, which means that we have considerably bigger workload than our colleagues from other countries. Thereby, the total number of physicians per 1000 population in Montenegro is 2.1, in Croatia 3, in Bulgaria 3.9, in Germany and Spain 4.9 (source: www.worldbank.com). The reason for this is not poverty, but poor allocation of budgetary resources. Namely, the total health expenditure per capita in Montenegro amounts to 55% of the national average salary (265 euros), in Serbia 70% (260 euros), in Croatia 95% (720 euros), and in Slovenia 115% (1200 euros). For all the reasons above our health system according to the Euro health consumer index is the lowest among 35 European countries, which the Montenegrin public mostly blames on the physicians.
The reason we addressed you is the difficult position of our trade union activity in Montenegro. If we had your assurances of goodwill or if you could consider us as a potential member in your federation after the model of Croatia, we believe that with joint efforts we could significantly contribute to improving the current state. Your help would be very important particularly with regard to the present legislative solutions which continuously jeopardise the position of our members in Montenegro. With this regard, our Government has in the last few years initiated a set of laws which additionally aggravate the position of doctors of medicine, all under the excuse of the alignment with the EU acquis. Exactly those legal solutions are the source of key problems of our trade union. Here are several examples:
1. The Union of Montenegrin Physicians is being ignored in the matters of creating the branch collective agreement for health.
Namely, our Government does not allow the Union of Montenegrin Physicians to participate in the social dialogue since our trade union is not representative at the branch level. In order to become representative our Union would need to include at least 15% of the total number of employees in health (which also includes nonmedical workers, pharmacists, dentists, as well as the employees in private health institutions) which is practically impossible. In fact, the health care institutions in Montenegro employ 9359 workers (source: Statistical office of Montenegro) whereas there are altogether 1348 physicians or 14.4 % in the branch (source: the 2013 Annual Statistical Bulletin of the Institute for Public Health of Montenegro). Hence, even if each and every doctor became a member of our trade union organization we would not meet the criteria for representation.
On the other hand, to make things more absurd, the nonmedical workers who make 30% of the employees in the health institutions (lawyers, economists, accountants, hygiene workers, security, drivers etc.), can theoretically form even 2 representative health trade unions (they currently have one headed by dr. Ljiljana Krivokapic), while the middle medical staff could form 3 representative trade unions (they currently also have one headed by dr. Vladimir Pavićevic)! It turns out that the only trade union that does not have the luxury of being representative is the one representing the key actors of health care – doctors of medicine!
The moment we write this to you, the Government of Montenegro, behind closed doors and without consultations with our trade union, negotiates with the two representative publically subsidized trade unions, about the salaries of our members. On the top of everything, earlier this month the Parliament adopted a law according to which salaries of public officials will multiply whereas for us they planned the increase of 5%.
2. Limited possibilities of additional work in private health institutions.
The other legal act we would like mention is the Law on Health Care of Montenegro. This Law proposed by the Ministry of Health of Montenegro, almost completely prohibits doctors from working extra jobs in private health institutions, thus officially condemning doctors to poverty. Namely, a doctor of medicine is allowed to work a part time job only with the recommendation of the Head of institutions of their employment and with the consent of the Ministry of Health which is granted without objectively defined criteria! This means that a doctor of medicine can work in his or her free time as a taxi driver, waiter or waitress, but not as a physician.
3. Inability to strike.
That was not enough for the national and “European” legislation. In 2015, with the new Law on Strike the Government prohibited us from exercising the right to strike. Reason – again, we are not representative. This means that the government favours certain trade union organisations and controls even the right to expressing dissatisfaction of employees.
4. The Chamber of Physicians, protection of physician’s rights.
In the end, we would like refer to the Chamber of Physicians, a body which everywhere else in the world takes care of physician’s rights, but not in Montenegro. This is the organisation to which all of our members pay regular mandatory fees. Our Chamber of Physicians is a closed organisation with non-transparent work which serves everybody except its members. So far, this organisation, as far as we know, did not participate in the preparation of any legislative act related to health, and they almost completely remained mute to the increasingly worse standard and deprivation of physicians in Montenegro. To make things worse, although the Statute of the Chamber of Physicians of Montenegro stipulates that the members of its Assembly are elected through public or secret voting, no elections have been announced or held for the Assembly since its establishment. We would like to know if it is possible in any European country that the elections of any kind of assembly are not held. Besides, although the mandate of thus (non)elected Chamber expired on 28 January 2015, today the Chamber still functions in the same composition. The head of this organisation is a retired physician – Dr Djoko Jocic who has been on this position since the foundation of the Chamber in 1995!
Imagine a state with the worst health care system in Europe, where doctors of medicine have no right to strike, part time job, nor the right to negotiate on the collective agreements for the branch in which they play the key role. Imagine a state in which physicians have lower salaries than chauffeurs and hairdressers. That state is called Montenegro and for that reason we need your support.
Respectfully,
Dr Milena Popovic Samardzic
President of the Trade Union of Montenegrin Physicians
Leave a reply
