Joint campaign to save hospitals from closure

Hospitals, trade unions, patients and people with disabilities have organised a joint campaign to preserve the current hospital network in the Czech Republic. The protesters say 198 hospitals are under threat of closure after health insurance companies announced they were withdrawing from their contracts with all hospitals at the end of the year. Insurers are negotiating with some hospitals, but say they will only agree contracts with those that meet strict new criteria.

Background

Health insurance companies in the Czech Republic are in talks with the country’s hospitals over new contracts to replace agreements that expire on 31 December 2012. If no insurance contracts are in place, some hospitals may be forced to close.

Negotiations currently under way have led to promises that around 55 hospitals will be covered by new contracts. That leaves 198 hospitals still to conclude agreements and therefore at serious risk of being closed down.

Health insurance companies argue that there is a need to reduce bed numbers and to close underutilised wards. They have also said they will agree contracts only with hospitals that meet strict criteria on quality and equipment.

Hospitals and unions launch protest

Hospital management, trade unions and patients are against hospital closures. Although the Association of Bohemian and Moravian Hospitals (AČMN) admits there’s a need to improve the efficiency of the hospital network, it says it must be done differently. According to the AČMN, health insurance companies will not generate savings from closures of hospitals and the reduction of beds. It claims relying on larger hospitals could even cost more.

Unions say uncertainty over the granting of new contracts has made things very difficult for hospitals and their employees. The President of the Trade Union of Health Service and Social Care in the Czech Republic (OSZSP), Dagmar Žitníková, said ‘hospitals and their employees live in enormous insecurity’. In response to the crisis, AČMN, OSZSP, the Association of Regional Hospitals, the Czech Association of Patients (Svaz pacientů), and the Czech Doctors’ Trade Union (LOK-SČL) have released a joint declaration called ‘Last chance to stop the prepared cancellation of hospitals’. They have also organised a petition entitled ‘Citizens, protect your hospitals!’

Healthcare tripartite meeting abandoned

The potential hospital closures were expected to be discussed on 1 October 2012 by the Czech Republic’s healthcare tripartite consultation body. This is made up of representatives from the Ministry of Health of the Czech Republic (MZ ČR), the employers – the health insurance companies and hospitals – and trade union leaders.

However, the meeting was cancelled when the employers’ representative, the Union of Employer Associations of the Czech Republic (UZS), refused to take part. The union said the MZ ČR did not send information about the talks in time.

The employers were represented at the meeting by members from the AČMN, which is also a member of the UZS. There were also representatives there from the Association of Health Insurance Funds Czech Republic (SZP ČR) and the Open Association of Health Insurance Companies.

The AČMN accused the SZP ČR and the Open Association of Health Insurance Companies of inciting the UZS to boycott the healthcare tripartite meeting, and also disagreed with UZS’s decision not to send a representative to the talks.

Stanislav Fiala, an AČMN lawyer, argued that hospital representatives had been ready to attend the meeting, and wanted to discuss the closures of hospitals, saying...

We believe that the late delivery of [information] was a ‘red herring’, so that the tripartite meeting could not discuss this issue and could not talk about the fact that hospitals are lacking next year’s contracts, and that care of insured persons is not therefore secure from 1 January 2013.

Crisis committee

On 8 October 2012, hospital closure protesters met and received support from a number of other trade unions, including the Trade Union of Workers in Transport, Road Management and Car Maintenance of Bohemia and Moravia (DOSIA), the Trade Union of Transport (OSD), the Engine Drivers’ Federation of the Czech Republic (FS ČR), the Union of Workers in Services and Transport (SOSAD) and the Czech-Moravian Confederation of Trade Unions (ČMKOS).

At the meeting it was agreed that a crisis committee should be formed. The committee would look at how the crisis had come about, evaluate measures taken by the MZ ČR and health insurance companies, and propose its own measures to deal with the issues. It would also act as a coordinator for the organisations involved in the protest.

Commentary

For the time being, the Ministry of Health says it does not plan to address the situation. According to the Deputy Minister of Health for Health Insurance, Petr Nosek, hospitals and trade unions should exert pressure on health insurance companies, not on the ministry.

The ministry sees the struggle for survival of hospitals as a part of the campaigning taking place ahead of planned regional and senate elections. Vlastimil Sršeň, a ministry spokesman, said...

We regard the great pressure of trade unions on the tripartite meeting… as their active involvement in the pre-election campaign, which is also indicated by the media campaign and the petition for keeping hospitals in regions.

Hospitals and trade unions, however, take the view that the ministry does not want to be engaged in the whole matter until the elections are safely over.

Soňa Veverková, Research Institute for Labour and Social Affairs