Catastrophes typically strike without warning, leaving the authorities and health care workers unprepared. Not this time in the Czech Republic. Weeks ahead of time, special military medical teams are being readied for action. Army medical staff will be on hand with five helicopter ambulances, 10 passenger helicopters, and 100 ground ambulances. Hospitals say they will cancel vacations for doctors and temporarily shut some wards. What are they preparing for? Neither earthquakes, volcanic eruptions, nor hurricanes are especially common in these parts. Destructive floods occur nearly every spring and summer, but are not usually predicted so far in advance.
In fact the coming disaster is a man-made one, and the army doctors are being readied because civilian ones may become very scarce come 1 March, the date the resignations of 3,800 doctors become effective. No one seems to really believe that all those doctors – about one in five employed in public hospitals and clinics – are serious about quitting their jobs. Doctors regularly threaten to go on strike, or march through Prague, or hold their breath until they turn blue, over what they say are shamefully low salaries and brutal working conditions. A few months ago the doctors, backed by their professional association, announced their retirements come 1 March. Dubbed “Thanks, We’re Leaving,” the initiative was meant to galvanize the government into finally, finally paying heed to their grievances, and at the same time to shock the public out of its blithe assumption that doctors are highly paid whiners.
Quite typically, the doctors say their real take-home hourly pay is much less than the government says. But even if the health minister’s figures check out – they assume that hospital doctors work the EU-regulated amount of overtime – doctors on average are only adequately paid, and young doctors badly under-paid. But doctors claim that many work 50, 80, even 100 hours a month of mandatory overtime. And without that overtime and other salary adjustments, their base salaries truly are pathetic. The starting salary of a doctor with six years’ experience is about 800 euros a month, well under the Czech average. A doctor with 20 years’ experience can expect to earn, before overtime, around 1,100 euros. Quite enough for a single person to live in moderate comfort, at least in the smaller towns where housing is comparatively cheap. Not enough for a married person with a family, not by a long shot.
I side with those who expect to see most of those 3,800 doctors still on the job next month. They may be desperate, or just cynical, but their threat to leave at a time when other public workers are taking pay cuts seems to be working. Yesterday the government said it can find 60 million euros to raise doctors’ pay; the medical association is asking for 80 million. I just hope that when this has blown over, doctors will publicly announce that seeing as their official pay is now adequate no “gifts” from patients will be accepted in future.