Dialog or Resignation: Doctors Issue Ultimatum to the Government

In a bold move, over four thousand doctors in the Czech Republic have threatened to resign or cease taking on overtime shifts starting December 1st. Their protest is a response to the government’s attempt to push through an amendment to the labor code that would temporarily legalize working shifts beyond regular working hours, a practice currently carried out illegally. Doctors vehemently reject the idea of making this a norm.

If these injunctions are realized, it could severely impact the availability of healthcare services. Doctors place the blame squarely on politicians who have ignored this issue for years. The amendment is scheduled for review by the Parliament next week after passing through the Senate. Should it be approved, the Czech Medical Chamber plans to seek intervention from the President and the Constitutional Court.

“If the law is passed, we have no choice but to turn to the President. We are also considering approaching the Constitutional Court because there is discrimination against a certain group of citizens. Why shouldn’t doctors have the same rights as other workers?” said Milan Kubek, the President of the Czech Medical Chamber, in an interview with Právo.

In an extreme scenario, they may even seek assistance from the European Court of Justice, as they believe the proposal violates European directives, a stance previously contested by the Minister of Labor, Marian Jurečka.

Doctors know that the situation cannot be resolved in three months, so they demand at least a guarantee that further overtime will not be legalized. They also want to negotiate changes to the system, with a commitment beyond mere promises, as has happened in the past.

“Doctors are just people. The safety of patients is our top priority. However, if we don’t get the conditions that will allow us to stay in this system for another 20 to 30 years, we willingly say no,” stated Jan Přáda, the head of the Young Doctors Section at the Czech Medical Chamber. They are coordinating their initiative with labor unions and urge politicians to engage in dialogue, although time is running out.

Health Minister Vlastimil Válek, through his spokesperson Ondřej Jakob, conveyed that “negotiations are not opposed.”

Without overtime, a gross income of 38,000 Politicians who introduced the amendment argued that without it, the healthcare system would collapse, as it heavily relies on overtime work. However, even the modification may not avert the crisis. If four thousand doctors were to stop taking overnight, weekend, and holiday shifts, 2,400 shifts would remain uncovered in December, warns the chamber. If the remaining doctors had to shoulder the burden, it could trigger a chain reaction.

Doctors want to prevent the further legalization of overtime, establish sustainable working conditions in the long term, secure better financial compensation, and ensure greater compliance with the labor code.

A survey among 1,450 doctors revealed that only 18 percent balance work and family life. Nearly 70 percent consider the healthcare system unsatisfactory.

Although the law allows doctors a maximum of 35 overtime hours per month, the average is 77. Minister Válek told Právo that if anyone feels the labor code is being violated in the hospital where they work, they should report it.

Doctors argue that it’s a tolerated practice, and the system holds them hostage. Although the law states it’s a voluntary agreement between the hospital and the doctor, refusing shifts can lead to the employer not supporting their mandatory education. Overtime also significantly increases doctors’ income. A medical school graduate would earn 38,980 monthly gross, equivalent to 179 net per hour if restricted to the basic salary. An accredited doctor would earn 50,510 gross.

According to doctors, the legalization of overtime will also adversely affect pregnant women. Even now, the law prohibits them from working overtime, but this still happens. “A pregnant woman’s services are included in the basis for maternity pay. Without those services, it’s charity. I had the same experience,” wrote Jan H. in response to the chamber’s survey.

“It doesn’t look good when a pregnant doctor treats you at night when she should rest and take care of herself. Yes, the system forces us into this. If someone doesn’t write a medical certificate for you or declare a high-risk pregnancy, you keep working as long as you can,” she added.

Yet, women make up 70 percent of medical school graduates in the Czech Republic, and the healthcare system relies on them. According to doctors, addressing this situation cannot be done hospital-by-hospital; it requires systemic change. According to Přáda, Progressive facilities are few and far between, and the chamber cannot interfere with their organization.