Doctors in Slovenia went on strike on 15 January 2024. By 20 February 2024, the strike was still ongoing, making it the longest doctors’ strike in Slovenia so far. FIDES, the doctors’ and dentists’ trade union, argues that the strike is due to the government not respecting previous agreements on adjusting salaries and the current remuneration model.
As previously reported, there are two issues in the background:
- increases in registered nurses salaries in 2022 sparked strong demands from doctors to follow suit and
- an ambitious government plan to reform the public employee salary system.
In this context, an agreement was signed between FIDES and the government in January 2023 [1], including a separate pillar for healthcare workers within the new public employee salary system. The agreement foresaw that the government would formally file a bill in legislative procedure by 30 June 2023 and the new salary/remuneration model would be implemented by 1 January 2024.
As of 20 February 2024, the government has not introduced the bill for Parliamentary procedure. Meanwhile, the process has suffered two important hindrances. The main driver of the public employee salary reform, the Minister of Public Administration, stepped down for unrelated reasons in the summer of 2023, and the damage caused by severe flooding in Slovenia in August 2023 significantly changed expected budget spending for the next few years. Notably, both events took place after the 30 June deadline.
In December 2023, the government reached an agreement with other trade unions in the public sector on some salary increases for all workers, and to suspend any strike until September 2024. This gives the government additional time to negotiate the new public employee salary system. The agreement also precluded the government from agreeing on and implementing salary changes with individual trade unions in the public sector before September 2024 [2]. Some trade unions, including FIDES, never agreed to this, with FIDES urging the government to respect its obligations from January 2023. In reaction, the doctors are striking.
The impact of the doctors’ strike is difficult to quantify. Though waiting times for a large number of outpatient and inpatient healthcare services are long, preliminary data indicate that waiting lists since the beginning of the strike have not significantly changed. This may be because regulation requires doctors to provide care to pregnant women, children and older persons as well as all services, the omission of which might lead to serious irreversible consequences to a patient’s health.
Meanwhile, escalating the protest, about 30% of hospital doctors [3] recalled their consent to work beyond the 48 hours/week set in EU and national regulations. This will take effect for the most part on 1 March 2024. Though again the impact is difficult to predict, when a similar action was taken by doctors in 2010, the subsequent shortage of available personnel led to significant disruptions for non-urgent healthcare services [4].
The substance of FIDES’ requests is two-fold:
- to address “salary imbalances”, linked to the expectation that there is a relation between the salary of nurses, other healthcare workers and doctors, as well as between the salaries of more junior and more senior doctors, which has been disrupted by recent reforms and
- to address the lack of clarity around the remuneration model in the new pillar for healthcare workers within the public employees’ salary system.