Demands of Ukrainian healthcare workers

On 8 December, the All-Ukrainian Trade Union Action was held. Two columns of more than 10,000 people walked from Independence Square and metro station Arsenalna to the Cabinet of Ministers of Ukraine and the Verkhovna Rada of Ukraine to urge the government to fulfil their requirements. The Action was attended by over 1,000 members of the Health Workers’ Union of Ukraine that unites more than 1,000,000 Ukrainian healthcare workers.

The healthcare workers entered into a collective labour dispute with the Cabinet of Ministers registered by the end of September by the National Mediation and Conciliation Service.

First, the healthcare workers urged to pay them wage arrears subject to indexation in 2015, and ensure its payment in full this year. According to the Union, that refer to the Ministry of Health data, the wage arrears in the sector amounted to 17.6 million UAH as of 28 November. However, this is not the biggest amount. The regional offices of the Union argued that lack of funds to pay wages until the end of the year is about 395 million UAH.

The healthcare workers also urged the Cabinet of Ministers to enforce their labour rights and avoid sending the healthcare workers’ to unpaid leave, stop cancelling bonuses and supplements (according to the Union, such payments have been limited or reduced in 13 regions), not to transfer doctors to part-time jobs.
All this results from the Cabinet of Ministers’ Decree No. 95 adopted in March 2014. This document abolished the state wage guarantee for the healthcare workers.
In October, the Ministry of Health announced cancellation of this document. ‘In 2014, the Ministry of Finance, without coordination with the Ministry of Health, decided that supplements to the emergency workers, phthisiologists working at the tuberculosis dispensaries, and primary care physicians are optional. However, the Decree has been not cancelled yet.

In addition to return of the social guarantees, the Union insists that the State Budget 2017 contains rates and wages of the healthcare workers set at a level no lower than the average wage in the sector. According to the State Statistics Service, in January-October it was 5,748 UAH, and 3,311 UAH in the healthcare.

In addition, the healthcare workers urged to increase from January 1 the UTS 1st wage rate to the level of the minimum wage that is 3,200 UAH. This should lead to increase the wages of the higher classes tariff rates workers which are 25 in Ukraine.

According to Viktoriia Koval, President of the Health Workers’ Union of Ukraine, after the recent increase of the minimum wage, the gap between the wage of the 1st class tariff rate and the minimum wage is 265 UAH, and has to be compensated to the healthcare workers from the State Budget. However, no compensation is paid to the higher classes tariff rates workers, as their wages are above the minimum wage.

The Ministry of Health said that next year situation in the healthcare would deteriorate due to the minimum wage increase to 3,200 UAH. ‘This will lead to a breach of qualification ratios, eliminate remuneration of the highly qualified specialists, destroy the tariff system of remuneration and narrow the labour rights of the public sector workers,’ said a representative of the Finance and Resources Department at the Ministry of Health. ‘So, the workers whose wages are determined under the UTS 1-5 classes tariff rates (cleaners, watchmen, etc.) receiving supplements to the minimum wage and the highly qualified staff (doctors, nurses, medical assistants, legal advisers economists, accountants, etc.) will receive almost the same wages including bonuses and supplements.’

The Union believes that the Government has to spend more on the healthcare in general. The healthcare workers asked the Cabinet of Ministers to consider the ‘Fundamentals of Ukrainian Healthcare Law’ according to which the budget subsidies for the sector must be at least 10% of national income (aggregate of all incomes of the country, including the businesses and people).

According to the State Statistics Service, last year the gross national income was about 2 trillion UAH, so the healthcare workers demand the annual funding of at least 200 billion UAH. The draft State Budget 2017 is supposed to provide 62 billion UAH for the healthcare. It is less than 200 billion UAH, but 9% more than allocated for the healthcare this year.

The healthcare workers complain that the officials do not respond to their demands. Therefore, there is not any movement on the dispute with the Cabinet of Ministers, because the Cabinet Ministers has not yet been determined who will represent them in the dispute. By law, the Cabinet of Ministers had to do so within five days, but this did not happen. Therefore, even a single meeting was not on the dispute. The Ministry of Health did not say anything when they intend to respond to the demands of the healthcare workers.

In fact, the Government promises to raise the average wages of the healthcare workers by 40% or up to 3,272 UAH of the doctors and 2,618 UAH of the nurses next year. This year, according to the Ministry of Health, the average wage of doctors was 2,391 UAH, and of nurses – 1,913 UAH.

Naturally, such wages cannot satisfy the Ukrainian healthcare workers. In their view ‘If you have studied for at least 6 years, plus 2-3 years of hospital internship, plus 3-4 years of medical college, such wages seem to be frank humiliation and mockery.’
The unsatisfactory financial situation will lead to that Ukraine might lose its healthcare workers, as they will go to the countries with healthcare staff deficit and higher wages. As Viktoriia Koval said ‘There is a trend: everyone invites Ukrainian health workers: Belarusians, Poles and Czechs. The best of the best left a long time ago, then the best of the medium left, and now the best of the worst are leaving.’

Today, given the low wages and inadequate funding, the hospitals have already beginning to felt shortage of staff, especially young and middle, as well as workers in the economic sector.

If this trend continues, there will be a tangible shortage of healthcare staff and the quality of healthcare services will fall heavily in a couple of years in Ukraine.