Salary and working time of health care employees to be kept confidential between employee and employer
The Employment Contracts Act entering into force on 1st July 2009 will, inter alia, introduce changes in the working time regulations of health care employees. Pursuant to the currently valid Working and Rest Time Act, reduced working time has been established for those employees who perform work underground, work that poses a health hazard, or work of a special nature. As of 1st July, working time is governed solely by the Employment Contracts Act, pursuant to which mandatory reduced working time will not be applicable to any of the aforementioned specialities. Arising from the aforementioned, reduced working time will also not be applicable to anaesthesiologists, anaesthesia/intensive care nurses and surgery nurses, employees of pathology departments, medical employees of intensive care departments (35 hours per week at present) and employees in the field of radiology (30 hours per week at present).
The general working time limit that has been applied to the aforementioned health care occupations dates back to the time when health care technology was not sufficiently developed, in order to be considered harmless to one’s health. Today, modern technology has made it possible to bring the risk factors of hospital working environments in line with the established limits, and, therefore, these working time limits are not duly justified.
Upon calculation of the hourly fee of health care employees, the Health Insurance Fund is guided by the agreements on the minimum wage for health care employees, which currently stands at 112 EEK for doctors and 60 EEK for nurses per hour (approximately 19,400 EEK and 10,400 EEK per month). Not all health care employees receive a minimum wage and the actual wage is agreed upon between the employee and employer. Therefore, not the minimum wage itself but rather the wage that is 30% higher than the minimum wage in the case of doctors and 20% higher in the case of nurses will be calculated into prices, in order to guarantee a flexible remuneration policy. As a result, the average calculated monthly salary is approximately 25,300 EEK for doctors and 12,500 EEK for nurses.
Although hospitals are not obliged to pay higher hourly rates to the employees in line with reduced working time arising from legislation, the Health Insurance Fund has, upon the price calculation of health care services, presupposed so far that a reduced working time will be implemented in the aforementioned specialities. With regard to price formation, it means that 1 minute of a cardio surgeon’s time is worth less that 1 minute of time for an anaesthesiologist or a radiologist. In simpler terms, this difference means that in order to receive an average salary, a cardio surgeon must work 40 hours per week, whereas this corresponds to 35 hours for an anaesthesiologist and 30 hours for a radiologist. As the standards for reduced working time will become invalid, pursuant to the Employment Contracts Act to be entered into force, the Health Insurance Fund will not have any reason from now on to be guided by the requirements for reduced working time in the case of the wage structure of certain specialities. The working time and salary of each single doctor and nurse until now have been and will continue to be established upon agreement between employee and employer. In addition to the speciality, the employer should certainly take into consideration the qualifications, working experience and results of a specialist, and then calculate his/her salary on the basis of these criteria.
The Health Insurance Fund is of the opinion that today’s price formation is sufficiently flexible and provides plenty of opportunities for organising the remuneration policy inside medical institutions in such a manner that the specialists with higher qualifications and who are engaged in more complicated work (regardless of speciality) would receive a higher salary than the average.
Due to the changes in the reference prices of health care services arising from the entry into force of the new Employment Contracts Act, it will be possible to save 50 million EEK in the health insurance budget in 2009, which constitutes under 1% of the total budget for specialised medical care. It is also important to note that regardless of the price reductions arising from the Employment Contracts Act, the reference prices of health care services will still increase to the extent of 100 million EEK as of the 1st July 2009. The Health Insurance Fund wants to purchase supplementary treatment on account of the funds that will become available due to changes in prices, and, therefore, these changes will not cause a reduction in the contractual volumes of hospitals. It means to people that the availability of treatment will improve to some extent.