The decision by the government to give in to state nurses pay demands was met with resentment from medical professionals, but officials are pointing out that the National Health Scheme (NHS) can now move forward on government terms.
President Nicos Anastasiades put an end to a year-long ugly debate on Tuesday, as he looked on Health Minister George Pamboridis and state nurses union leaders sign an agreement, essentially moving Pasyno and Pasydy state nurses up the professional ladder within the civil service.
The government initially was fighting hard to push for health reform first, namely turning badly-run state hospitals into autonomous organisations, so that state nurses who signed up for the change could be part of what the minister once called ‘meaningful change’.
But the highly combative Pasyno nurses, along with their colleagues from civil servants union Pasydy, had been demanding a pay grade rise before anything else on the basis their members had gone back to school and obtained university degrees.
Political pundits have called the sudden change of course by Anastasiades as a political ploy in a highly charged pre-election season that began remarkably early this year.
The presidential decision caused unrest among other medical professionals in the public health sector, who are now pointing to double standards.
But the government is denying politics had anything to do with the president’s decision.
Government spokesman Nicos Christodoulides said on Tuesday, after the signing ceremony, that health reform and the introduction of a national healthcare scheme remained a high priority both for the administration and the president.
“The health professionals themselves are in fact those who are being called to be a part of one o the most significant efforts in health reform, which cannot go forward without them,” the government spokesman said.
Christodoulides argued that the government has held the position early on that labour issues ought not to be treated within the narrow constraints of union politics or without a broader context.
“(The issues) ought to be put up for discussion in the broader context of needed reforms that have focus on turning state hospitals into autonomous organisations, with the final aim of implementing NHS,” he said.
The agreement, makes clear from the beginning that state hospitals will be administratively and financially independent. This means that each hospital would operate on its own budget and would have to calculate its own costs, from equipment and health products right down to how much would it cost to give an injection or a pill.
State hospitals will also enjoy the “highest possible autonomy” in hiring new staff, promoting or making other personnel decisions, and eventually all staff in each public hospital will have to be included in the organisational chart underneath its own individual upper management.
There will also be new working hours for medical staff, including an evaluation process and a bonus scheme on the basis of individual productivity.
Pasyno flatly rejected similar proposals late last year, saying they would be willing to sign collective contracts as a union, not as individuals and not having their salaries linked to individual productivity. But in the new agreement, which secures a career upgrade for university degree-holding nurses, there is no mention of collective contracts.
New hires will be offered contracts with end dates, which puts to rest a previous practise where temporary employees would be hired on open-ended or date-unspecified contracts. Such a practice ended up costing tax payers a lot of money, as many workers demanded and ended up working permanently in state hospitals without their positions being properly vetted through an evaluation system. Any new nurses hired will be employees of the hospitals, not the government.
Nurses get lower-paid assistants
The agreement also includes a provision calling for new nursing staff at the certified or licenced level, who would essentially take on duties that do not require a university degree. These “health care providers” would essentially become assistants to union degree-holding state nurses, who will now be elevated to what are widely known as registered nurses.
It is expected that state nurses who got the career upgrades will be given new duties commensurate with the university qualifications. But the agreement still leaves the door open for them to choose whether or not they will leave civil service or simply be seconded to public hospitals as civil servants.
The government is pledging with this agreement that the new upgrades will go into effect between 1 January 2019 and 1 January 2023, as the transfer from A5 to A8, as well as A10 and A11 pay scales, will be done in stages and according to civil service criteria.