Doctors not convinced; strikes remain in place
The final proposal reportedly presented by the Ministry of Health to doctors’ unions yesterday provides for an increase of 917.10 euros per month in the entry-level pay of specialised doctors working in SNS (State run health service) hospitals, writes State news agency Lusa.
This is not the perspective of doctors’ unions which stress the pay increase refers only to doctors “who accept the new regime of total dedication, which implies loss of rights for the doctors and puts patients at risk“.
The unions and the Ministry of Health thus met in a new round of extraordinary negotiations ultimately leading nowhere, with the unions maintaining strikes scheduled for September and November due to a lack of agreement on key issues.
According to the government’s final proposal, salary increases have been revised and “are immediate”, the “entry level salary” of a specialist doctor working in a hospital would rise from 2,863.21 euros/month to 3,780.31 euros/month.
Fully dedicated doctors would have a 35-hour working week, plus five hours, and a 33% pay rise.
Doctors who don’t want to join this regime would have “a salary adjustment” of 6.3% (35-hour week), 3.6% (40-hour week) and 2.7% (42-hour week in exclusive dedication).
Full dedication would become the “normal working regime” in hospitals applicable to all doctors who are part of the Integrated Responsibility Centres and who hold senior positions. Forother doctors, adherence would be voluntary.
For medical interns, who are training to obtain their specialities, the government has proposed salary increases of 3% (general training interns), 4.75% (doctors in the first three years of specific training) and 9.8% (doctors from the fourth year of speciality).
In primary health care, provided in health centres, full dedication would apply to all doctors in the so-called Family Health Units (USF), according to the Ministry of Health’s proposal, which points out that “all USFs will have a remuneration system linked to performance”, which includes a basic salary, supplements and performance incentives.
The Ministry’s final proposal does away with quotas that existed for the transition from model A USFs and Personalised Health Care Units (UCSPs) to model B USFs.
Model A USFs and UCSPs that have applied to become model B USFs can make the transition, with doctors’ pay being linked to performance and increasing by more than 60%.
Says Lusa, according to the Ministry of Health’s proposal, doctors in the current model B USFs will have a 12.7% increase in their basic salary, plus supplements and the amount linked to performance. The supplement awarded for expanding the list of users “will allow 250,000 more Portuguese to have access to a family doctor”.
Doctors who “cannot immediately join a model B USF will be able to individually join the full dedication regime with a 33% pay increase, indexed to the expansion of the user list”.
The Ministry of Health emphasises that all the proposed salary increases are in addition, as of January, to the salary increases (of at least 2% per year until 2026) that “are transversal to the Public Administration”, under the terms of the Multi-Year Agreement for the Enhancement of Public Administration Workers.
Negotiations between the doctors’ unions and the government began in 2022, but there has been no consensus, Lusa admits, possibly because what is ‘announced’ and the reality behind it differs, in doctors’ eyes, so much.
A new extraordinary negotiating meeting, “the last one, has been scheduled for Tuesday”.
Meantime, professional associations, federations and trade unions linked to health in Portugal have said they rate the first year of the country’s current health minister, Manuel Pizarro, as a difficult one, in which his appointment “gave hope” that has since “fizzled out” with his “inability” to convince the prime minister and finance minister to spend more on what is needed.
Carlos Cortes, head of the Portuguese Order of Physicians (Ordem dos Médicos), told Lusa that Pizarro “has failed” – especially in areas such as maternity wards, emergency rooms, the retention of professionals and family doctor coverage – describing this year as “a certain disappointment” compared to the expectations that had been created.
Jorge Roque da Cunha, president of SIM – the independent syndicate of doctors – has recognised that it is not that Manuel Pizarro has not tried; his actions (or lack of them) are the “individual responsibility” of the prime minister, António Costa, and the minister of finance, Fernando Medina.