Doctors Set to Resist Hospital Sell-offs
Doctors Trade Union Association (LOZ) has warned of mass resignations if the government does not alter its plans to turn hospitals into joint-stock companies.
Chairman of LOZ (which represent over 10% of Slovak physicians) Marian Kollár announced at a press conference on Wednesday that the expected dialogue could result in mass resignations as early as this autumn.
The union has been conducting an internal survey within hospitals to discover which doctors would be willing to take tougher action. A total of 1,500 doctors have apparently given their approval, i.e. 75% of the membership.
Kollár noted that, “If there is no will for dialogue, we’ll decide on further steps after completing the declaration… we’re big optimists considering our colleagues’ current interest in the situation,” In teaching hospitals, an estimate of 60-80% of medical staff are prepared to take action.
A demand for higher doctor salaries as the principal grievance was refuted by Kollár. Instead he cites the planned privatisation of hospitals as the chief concern. “The transformation of hospitals is the final nail in the coffin of the health care system,” he stressed.
LOZ member Roman Prochazka attacked the proposed privatisations, alluding to the financial interests of a “certain wealthy financial group”. The group he is probably referring to is Penta.
Penta is a Central European private equity group established in 1994. Apart from ProCare, a private healthcare centre operator, Penta is also involved in the Slovak healthcare industry via the insurance company Dovera, and also Falck Zachranna (provider of emergency medical services), Alpha Medical Ventures (operator of a chain of medical laboratories), Dr Max (a chain of pharmacies), and Sanitas, a pharmaceutical distributor.
“They have a health-insurance company. They control health care distribution companies. They control pharmacies. They have private clinics, and the only thing that they lack at the end of the chain is hospitals. When they have the whole circle under their management, they’ll be able to regulate cash flows as they want,” said Prochazka. “What is being divided up in other sectors is being silently united elsewhere,” he added.
Such policies should come as a surprise to no-one. They have been adopted in many different parts of the world over the last 30-40 years., from British railways to Bolivian water. They follow a consistent pattern of what is called neo-liberalism (also known as the Washington Consensus or “El Modelo” in Latin America), named presumably to denote the second great phase of world market driven social and economic policy based on neoclassical theories of economics.
The policy menu is familiar enough, such as encouraging flexible labour markets, lifting price controls, social spending cuts or austerity, balanced budgets and of course privatisation of public assets and utilities. The rationale simply stated is that unfettered market forces will maximise efficiency and growth and that a “trickle down effect” would ensure that everyone was better off.
The underlying theme has been one of eroding state responsibility for its citizens well being and a greater onus on personal responsibility. The unpopularity of these policies and the devastation wrought on the most vulnerable in society, especially in the global South, has been well understood and documented.
The Health Ministry’s response to these concerns was to chastise LOZ for addressing its criticism via the media, and not with representatives in a direct debate as other doctors’ organisations do. Perhaps this would allow the government to make their pitch to medical staff more discreetly. As Health Ministry spokesperson Katarina Zollerova has already pointed out the higher salaries of doctors working in hospitals that were transformed six years ago. She added that “The transformation of hospitals into joint-stock companies, which has been approved by Parliament, is an important step towards raising doctors’ salaries.”
What it will mean for the Slovak public health system, and for those who depend on it most, can only be guessed.