OVERTIME IN HEALTH CARE OR DOCTORS' PROTESTS

5.1.2024

In recent weeks, the topic of health care and overtime for doctors has been coming from all sides. How does it look for doctors with overtime and what are the current developments in the healthcare field? Let's take a look together at what the current situation is.

On Thursday, 30 November 2023, the Chamber of Deputies already approved in the first reading a bill amending both Act No. 262/2006 Coll., the Labour Code (hereinafter referred to as the "Labour Code") and Act No. 281/2023 Coll., which itself contains amendments to the Labour Code. The bill responds to the current major amendment to the Labour Code, which, among other things, reintroduced Section 93a of the Labour Code regulating so-called additional agreed overtime work in the healthcare sector.

So-called additional agreed overtime work in the healthcare sector

The original amendment in September allowed the doubling of voluntary overtime to 832 hours per year. In response, some physicians terminated this voluntary overtime in protest of the increase. However, this provision will not have much longevity because it is due to be repealed as early as 1 January 2024 instead of 1 January 2029.

Current situation in the health sector

Thus, the latest amendment reduces voluntary overtime to a maximum of 416 hours per year, but allows work to be performed continuously for 24 hours. It should be stressed that this latest amendment therefore restores the original situation.

The proposed legislation (new § 83a of the Labour Code) is thus intended to allow the performance of work for up to 24 hours during 26 consecutive hours only for selected health care employees in continuous operation․ This period of continuous work would be a combination of a shift, the maximum duration of which is 12 hours according to § 83 of the Labour Code, and related overtime work.

The application of this maximum duration of working time is subject to agreement in a collective agreement or a provision in an internal regulation in the case of an employer without a trade union and a written agreement between the employer and the employee.

However, the young doctors are still advocating for adjustments to the length of rest periods and additional payments for 24-hour working hours, and in particular for adequate compensatory time off before or after 24-hour services and adequate financial remuneration for 24-hour services through special allowances.

They also point out that overtime premiums are often cancelled out by compensatory time off, and that this puts part-time workers in particular at a disadvantage. They are therefore asking for special pay for 24 hours' service, regardless of the level of time worked and without the possibility of using compensatory time off in lieu of additional pay.

Apart from this, the key change is also the tightening of the conditions for the length of rest (see Section 92 of the Labour Code). From 1 January 2024, the amendment to the Labour Code will require employers to provide employees with an additional 35 hours of rest per week in addition to the daily rest period. As regards health care, the law allows the rest period to be reduced from 35 hours to 24 hours, but the weekly rest period must be supplemented accordingly in the following two weeks. The possibility for this reduction is provided for in section 90(2) of the Labour Code, but there is no explicit exception for a 24-hour shift, making the requirement very difficult for practitioners. Thus, experts agree that this requirement is very difficult to implement, if not unrealistic, in the Czech healthcare system.

Then, in early December, an agreement was signed by the doctors with the Prime Minister, the Ministry of Health and the public health insurance company promising to increase salaries and wages for doctors and other health workers, support the training of health workers and a commitment by the Ministry to continue with further steps. The increase will take place as of 1 January 2024, with a total of CZK 9.8 billion to be provided for the increase, of which CZK 3 billion will be provided by the General Health Insurance Fund through reimbursement supplements with hospitals, with the remainder coming from higher reimbursements from insurance companies.

The ministry has also committed to drafting proposals for further changes to reduce the amount of overtime for doctors and other health and non-health workers. They have also committed to improving their working conditions. This agreement, too, however, has been the subject of much criticism. Although such an agreement is obviously a step in a good direction, it lacks any specifics and is instead full of only general statements and commitments. It remains to be seen, therefore, whether other promised changes, in addition to the increase in salaries for doctors and other healthcare workers, will occur over time.