The Ministry of Health wants to change the work rules for health workers, the framework statute that governs their profession, and which has been in force for more than 20 years. The Government sat down this Wednesday with workers’ representatives to advance the negotiation of a bill that aims to change (among others) two well-established realities in Spanish healthcare: and the compatibility of doctors to work in healthcare. public and private.
Although nothing is finalized yet, the latter has generated a great response among the medical community and its representatives. The minister, Mónica García, intends that the heads of service and management positions of public hospitals be obliged to work exclusively for public health and cannot make their positions compatible with functions in the private sector. “No one imagines that someone can work at Coca-Cola and Pepsi at the same time,” he told the media on Monday in reference to this initiative.
García assured that this incompatibility would not extend to other professionals who did not occupy management positions. However, a draft that was leaked last Friday also provided that, in the first five years of profession, doctors who have gone through the MIR (the four or five year residency that converts medical graduates into specialists) will also They had exclusivity in the public.
After the meeting with the sector, the minister, who appeared at a press conference, admitted that this is one of the proposals on the table, but that it is not that of her department: “The one of the ministry, which is being debated , is exclusive dedication to management and responsibility positions. I have explained it, motivated it, and outside of our scope it is totally understandable.”
García has defended his proposal as necessary “to dignify the health system” and has committed to continue negotiating with workers’ representatives to achieve an agreement that “benefits professionals, citizens and patients.”
Tempers were heated at the meeting. Doctors and their representatives have been very opposed to the exclusivity of working only in public healthcare. “The emphasis that the minister places on the mixed, public and private practice of medicine responds to an ideological prejudice and distorts reality, perhaps with the intention of discrediting the demands of a medical group obsessed with obtaining ‘obscene benefits.’ [citando palabras de García]. Because the truth is that the vast majority of Spanish doctors practice exclusively in public healthcare. Doctors with public exclusivity represent practically 100% of the workforce in most of Spain and those provinces in which this percentage drops below 70% are exceptional.
At the end of the table, the State Confederation of Medical Unions (CESM, the majority in the profession) maintains its rejection of this proposal and demands a specific statute for physicians, “that includes the special conditions of training and responsibility” of this staff.
The , another of the ministry’s promises, has not satisfied the unions, as it is written. What it does is eliminate the ordinary day prior to on-call, so that professionals would work 17 hours, instead of an entire day. The workers’ representatives consider that, as they interpret the draft, this would force the professionals to return the hours another day, “probably in the afternoon doubling shifts”, something that García also denied at the press conference: “One of The ministry’s commitments are not to exceed 17 hours [de trabajo continuado]and that the hours of rest do not have to be recoverable in any case.” The minister has attributed this confusion to a possible ambiguity in the wording that will be corrected.
The majority union among nurses (Satse) has recognized after the meeting labor and professional advances for nurses and physiotherapists, but has warned that “there is still much to improve, clarify and specify.” García believes that there is a consensus when it comes to recognizing each professional for the credits taken in their careers, something that has not been done since the implementation of the Bologna Plan, which began to consider these two degrees as a degree, while the professional category continued to correspond to a diploma, which restricts career development and reduces their salaries.
The Independent Trade Union Center and Civil Servants (CSIF), the most representative union in public administrations, for its part, has urged the Ministry of Health to prioritize an adequate reclassification of all categories of healthcare, especially middle and senior technicians (Technicians laboratory, TCAEs, among others).
This Wednesday’s contact will not be the last. Health, which has tried to maintain discretion to be able to make progress on the points of friction, will continue negotiating. The Secretary of State, Javier Padilla, had already warned on his Telegram account that there are still a few weeks before we can see a closed and negotiated text – although there will still be an information and public hearing phase – that “serves to reclassify, advance in management professionalization, eliminate 24-hour shifts” and “facilitate stabilization by reducing temporality.”
