Doctors and dentists working in the Slovenian public healthcare service staged a day-long token strike on 9 January to get the government to honour its commitments on pay and health system reform.

The strike aimed at getting the government back at the negotiating table to continue talks on better working conditions, including pay and a separate pay pillar for healthcare within the public sector.

During the strike, doctors only attended to emergencies, and vulnerable groups of patients, including those aged up to 18 and over 65, cancer patients and those in hospitals.

For most health services, the same regime applied as on public holidays. Some non-urgent appointments scheduled for the day of strike had been rebooked.

"Doctors are in distress just like patients. We are overworked, tired, we neglect our families," Damjan Polh, the head of the doctors' and dentists' trade union Fides, said as doctors met at UKC Ljubljana, the country's largest hospital.

Under an agreement that Fides signed with the government in 2023, a separate pay pillar for healthcare was to be created in the single pay system for the public sector. Absent that, separate pay negotiations with Fides were to be held.

The changes are part of a broader reform of the public sector system, which was supposed to enter into force in January 2024 but which the government delayed, citing the massive floods in August 2023 as the reason.

Now, there are some groups of public sector employees that had reached deals with the government that want it to keep its side of the bargain, but the government has been insisting on reforming the public sector pay system as a whole. There has been also little progress on separate health reform.

Talks to start after all

The government initially failed to engage in talks after Fides announced the strike in mid-December but on the eve of the action it formed a team to negotiate with the union. Talks are to start on 10 January.

Fides leader Polh was sceptical, saying the team was the same with which the union parted ways in December, because it had no mandate to negotiate.

However, Health Minister Valentina Prevolnik Rupel was confident that agreement could be reached soon, calling the strike unnecessary.

She said the government wanted to approach the talks constructively to avoid escalation, as Fides has threatened to start an open-ended general strike on 15 January unless its demands are met.

Asked whether a deal could be reached on time, as Prime Minister Robert Golob has recently said the government would not agree to "partial agreements", the minister agreed with Golob.

Doctors want better pay, working conditions

The union insists on having their pay scale tackled independently of the general pay system in the public sector; they want this new system to come into effect on 1 July 2024 at the latest.

They also want for annexes to the collective bargaining agreement to set out the doctor's career path and eliminate disparities in pay emerging after junior doctors received a more substantial rise than their senior counterparts in 2023.

Fides proposes a new post of a senior doctor or consultant dentist with a monthly salary of €5,890 gross and scrapping the provision in the collective agreement under which the new work norms for doctors must be approved by the Health Ministry's health council.

The Medical Chamber cited OECD showing major shortages of doctors in Slovenia, which is the reason why the chamber believes an effort should be made to keep health professionals in the public system.

The chamber's president Bojana Beović said there was a lot of dissatisfaction among doctors, so many were leaving the public system.

"Objectively speaking, we older doctors now have more reasons to be dissatisfied because we have been completely overlooked in the bonuses or salary changes. But younger doctors are actually more dissatisfied, because they know they will be working in this system for decades to come," she said.

Govt points to pay rises already made

Data provided by the government show that pay in healthcare increased twice last year, and is to be further adjusted to 80% of last year's inflation in June like for the rest of the public sector.

The pay rise in the first eight months of 2023 for doctors and dentists reached nearly 17% compared to the same period in 2022, while an average monthly gross pay in the private sector increased by only 7.4%. Doctors received an average €680 more a month.

The government also noted that the pay celling of the 57th pay bracket for public sector employees was lifted, as a result of which over 36% of 7,251 doctors and dentists are in the 59th pay bracket with €4,475 gross base pay. Before this change, only office holders qualified for pay brackets above the 57th.

In response to the doctors' strike, a rally of patients was organised in Prešeren Square by the Voice of the People, a coalition of NGOs and individuals created during the anti-government protests in the previous term.

They say the only goal of the doctors' strike is to extract them from the single public sector pay system and raise the salaries of senior doctors, despite what they say was a record-high increase in doctors' average pay by €1,000 all the while waiting lists for procedures only got longer.