The communist regime had been suppressing the intelligentsia for forty years in our country. Salaries of university graduates were often lower than those of workmen. For instance whereas lawyers after the so-called velvet revolution put through a conspicuous rise of their incomes, doctors took care of patients´ benefits. They were enthusiastic that after years of isolation they could use new equipment and modern drugs. It took them several years to understand that until they voiced vigorously their pay demand, they would become a laughing stock of politicians for ever.
In 1995 we set up the Trade Union of Doctors (LOK) because neither the Medical Chamber nor the Trade Unions integrating all employees of medical and social services defended doctors´ interests. In the very first year of its existence, LOK organized three strikes of doctors with the aim of increasing substantially their salaries.
From the beginning the situation has been complicated by the lack of unity among doctors, especially by a widening gap between better paid private doctors – mostly general practitioners on one side and low-paid hospital staff on the other.
In 1998 we succeeded in disposing of the old Medical Chamber management that collaborated with the government and Mr Rath, the founder of LOK, became the Chamber´s new president.
Our organization got stronger and stronger and after merging with the Union of Czech Doctors (SČL) to create the LOK-SČL we have become the only trade union to represent doctors-employees. Besides LOK-SČL, there are two more organizations active in the medical sector: the Union of Nurses, and the Trade Union of Medical and Social Service Workers, which is the largest body in terms of the number of employees. The latter is the successor of the communist trade unions from which it inherited large assets. However today it associates just a small number of doctors, who among the assistant and administrative staff only make a minor part of the membership.
In the Czech Republic Trade Unions´ reputation is rather tarnished due to collaboration with the late communist regime, so most of the employees are not their members. LOK-SČL has 5,500 members, associating one third of all the doctors working in hospitals. Our organizations are active in 60 % of hospitals, which we see as a great success in our conditions.
As the representative of doctors-employees we are a partner of the government at negotiations about legal standards and regulations concerning doctors. We collaborate closely with the Czech Medical Chamber, a number of its officials being our members. On the contrary, post communist trade unions, which cannot put up with the loss of monopoly, belong mostly to our opponents.
More or less successful, we have managed to push through increase in doctors´ salaries step by step. Whereas in 1995 doctors´ incomes were 180 % of the average in our country, they amounted to 210 % in 2004. But these incomes were only reached thanks to a number of overtime hours. The EU Directive on the working hours is not observed, nor are verdicts of the European Court. Approximately one half of the hours spent in hospital stand-by duties are not considered as work and doctors get paid much less for it.
Entering the European Union has not come up to our expectations, we are afraid. So, lots of our colleagues are going abroad, mostly to Germany or Great Britain, to get a better paid job. At hospitals they are replaced mostly by doctors from Slovakia because of the absence of language barrier. They are willing to work for lower pay, which makes our situation worse. These colleagues do not want to become members of trade unions for fear of being dismissed by the management. This problem, like many others in our country, stems from a lower law awareness of our citizens and poor work of courts where people often demand justice for years.
In 2000 we got a statute of observers and in 2002 we became a full member of FEMS. At present we are offering assistance to medical organization of other countries. We are ready to play an active role in creating a unified trade union of European doctors. Taking into account the present status of the enlarged European Union, where the Member States are much different from one another, we see the formation of such a body as a necessary step towards improving economic and working conditions of doctors.
MUDr. Milan KUBEK
Chairman of LOK-SČL
Vicepresident of FEMS.