Labour mobility and employee bargaining power in healthcare – Regional overview

In Hungary, the wages of government workers were frozen and in some cases reduced between 2008 and 2012. Within this very diverse set of employees, resident physicians were the only group capable of taking successful collective action and achieving wage increases that were extended to the entire health-care sector. However, the 2011 mass resignation campaign organized by the Hungarian Association of Resident Physicians was not unique in the Visegrád region. 1 Similar protest events took place in Poland, Slovakia and the Czech Republic. Most importantly, in all these cases (including Hungary) the protest organizers took advantage of the issue of medical emigration and the resulting labour shortages. After the 2004 EU-enlargement, the westward migration of healthcare professionals from these countries intensified, causing further deterioration in health service coverage and quality. On the other hand, large-scale emigration increased the bargaining power of employees who remained in their home countries. Trade unions and professional associations used the issue of emigration to justify their wage demands and claimed that the only way to stop the exodus of professionals was to raise salaries at home. Furthermore , knowing how easy it is to find a job abroad, trade unions and professional associations of doctors launched mass resignation campaigns to back up their claims. Results were similar across the region: in all four countries, significant wage increases were achieved for all healthcare workers, but above all for doctors. Besides, in all cases, contentious action – most importantly in the form of resignation campaigns-proved to be more effective than collective bargaining. Protesters addressed their claims not to employer associations but directly to the central government. Similarly, in most instances the results were underwritten by statutory laws or government orders rather than by collective agreements. This was the case even in Slovakia and the Czech Republic where industry-level collective bargaining is stronger than in Hun-gary. Nevertheless, there were serious crosscountry differences with regard to the timing of the events, the main actors involved and their relationship. The most pronounced conflicts between the government and trade unions and amongst trade unions could be observed in Slovakia, while disputes in Hungary were resolved in a relatively peaceful manner. Within the region, Poland experienced the first major wave of emigration-related healthcare protest in 2007. The bargaining dispute lasted for almost a year and revolved around doctors' call for a starting monthly salary of 5000 zlotys (approximately 1300 euros at 2007 …