Health care workers’ labour rights: compulsory labour and unfulfilled promises

Photo: Nemanja Jovanović / Kamerades

As the coronavirus epidemic once again accelerates in Serbia a number of questions emerge, and the media and public focus once again on healthcare workers. What conditions are their working under in these (new) circumstances?

Already at the end of March, the Ministry of Health issued an order prompting health institutions to urgently offer full-time labour contracts to the doctors, nurses and technicians who were at the time engaged on suppressing and preventing the spread of coronavirus. However, in April it became clear that some health care institutions haven’t implemented this order, as evidenced by data from a survey conducted and published by the Balkan Investigative Reporting Network – BIRN.

Those who had gotten the chance to become permanently employed were chosen in a non-transparent manner and without clear criteria. Many health workers were left without the promised contracts, despite the fact that the public was lead to believe that over 2,500 new permanently engaged employees will be hired in health care.

Since then, the situation has changed insofar that the public attention on this issue has decreased due to the easing of the coronavirus-related restrictions and the return of life to normal. However, already in the first days after the elections – whose holding provoked a what has in the meantime proven to be justified concern with regard to health risks – conditions in health institutions have again come under public scrutiny due to the “second peak of the first epidemic wave”.

Doctors, nurses and technicians, as well as non-medical staff in health care institutions, currently suffer enormous pressure, as the president of the Confederation of Free Trade Unions (KSS), Ivica Cvetanović, stated for Mašina:

With the lifting of the state of emergency a general notion was created that everything was over, so the elections and sports matches were organized. We have called for the measures to be phased out. The “results” are obvious: only two days ago, as much as 5% of the total numbers of those tested were infected, and our health care system is very difficult to maintain in these conditions. I don’t know how to thank these people enough for everything they do.

The issue of compulsory labour

A conclusion of the Serbian Crisis Staff, by which compulsory labour was practically introduced in legally regular circumstances, recently caught special public attention. According to it, health care workers, health associates and other employees in health institutions can be sent to perform compulsory labour in any public health institution or temporary hospital which lacks the required number of staff, based on the verbal order of the manager.

Rade Panić, president of the Serbian Trade Union of Doctors and Pharmacists, told us that due to the bad epidemiological situation in Novi Pazar and Kragujevac, “some colleagues went there to help” yesterday. Panić also stated that he wasn’t informed on whether the Prime Minister signed a Decree on compulsory labour, which he says could be applied only if states of war or emergency were declared.

According to the valid Law on Defense, “Compulsory labor is introduced during the states of war and emergency and shall apply to the state bodies, the bodies of autonomous provinces, local government units, companies, other legal entities and entrepreneurs. Compulsory labor implies execution of defence jobs and tasks in accordance with the Defense Plan of the Republic of Serbia”.

Panić stated that there was no other situation in which this could be introduced (just) like that.

We have waited for seven days for the colleagues to be transferred because there was no valid regulation to lean on. I’m not even sure that this Government in its technical convocation is allowed to make such a decision at all.

And the law clearly states that such a Decree is not valid. According to the Labor Law:

“An employee may be transferred to another work location: 2) If the distance between the place in which the employee works and place to which his/her workplace is transferred is less than 50 km, if there is a regular transportation line that enables timely commuting to and from work and if reimbursement of cost of the fare in public transport is provided”.

Mario Reljanović, a research associate at the Institute of Comparative Law, writes that “first of all, it should be said that what follows is a text copied almost word for word from the Decision on Declaration of the State of Emergency.” The Decision, which, of course, ceased to be valid when the state of emergency was lifted. We are now moving towards the introduction of measures that have been valid during the state of emergency, but without the reintroduction of the state of emergency itself. Of course, that can’t be right.”

Health workers are to be orally informed about the transfers decided upon in order to allow compulsory labour, as stated in the above mentioned conclusion. According to Panić this proves that the authorities are “appealing to the conscience of medical workers who are basically expected to agree to go to a different medical institution without any documents or valid legal acts to back it up, because they are aware that their colleagues need help”. Panić ads that it is necessary for the state to do its part of the job and make things legal.

The Trade Union of Nurses and Technicians of Serbia sent an open letter to the Government of the Republic of Serbia, in which they state that the decision of the Crisis Staff on oral assignment, which lacks a legal basis – given that the Labor Law does not recognize it as a category – is “unacceptable and illegal”. Namely, legally it cannot be implemented without submitting an annex to the employment contract, supplied with a written explanation of the reasons for the annex to be added to the contract, the deadline within which the employee should decide on the annex, and information regarding legal consequences of not signing such an annex.

In addition, this Trade union warned that the decision to terminate an employee who decides to go against such an oral order is also unacceptable and illegal. Namely, according to the Labor Law, it is necessary to follow the legal procedure for termination of employment step by step.

If such a dismissal would happen to an employee, they would have a right to initiate a court dispute, which, according to the Union, they would certainly win. The cost of such a dispute would then be borne by the health institution, i.e. by the taxpayers – in other words, all of us.

What are the working conditions in healthcare institutions?

According to the president of KSS, Ivica Cvetanović, what saved us at the beginning of the epidemic was primary protection:

We inherited the primary protection from the previous system, thanks to which we did well at the beginning. There is no primary protection in Europe. In the meantime it has become much more difficult with regards to primary protection, because the pressure on it is great.

In a conversation with a journalist from Mašina, Rade Panić also stated that 15 doctors and dentists have died so far, “most of them because they didn’t have adequate equipment”. “At the beginning of the epidemic it was forbidden to wear protective gear, which was either lacking or we had to buy it ourselves, and many directors put pressure on employees not to wear it so that patients would not be afraid and would not panic”.

Panic also mentions that, although the representatives of the Crisis Staff stated that health care institutions have enough protective equipment in store at the moment, the question remains of how large the equipment supplies are, since “this is just the beginning of what lays ahead”.

Panić comments on the announced employing of medical staff and doctors, calling it “mere advertisements and political marketing”:

You have to be a member of the party to get a job. Healthcare institutions have a need to employ 15% of the resident doctors and medical staff, but you cannot get a contract due to the law on maximum employment in public institutions. So in order for you to get a permanent job as a member of the necessary staff, some of those who receive salaries and don’t even come to work would have to be fired.

Panic adds that the first request of his union, was that all of his 2300 colleagues who are currently registered as unemployed at the National Employment Bureau get permanent job positions. He further mentions those who reacted to the Government’s appeal at the beginning of the pandemic and had returned to Serbia from abroad, but did not get the promised jobs. As he says, the Ministry, the Government and the National Health Insurance Fund in the end failed to step up and do right – to employ all those stuck at the Employment Bureau, all the medical specialists, people who paid for their education out of their own pocket, and have volunteered and worked for years on end without a single dinar of pay.

Translation from Serbian: Iskra Krstić

This article was originally published in Serbian on Jun 30, 2020.

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