The FIDES Report for the FEMS Assembly, October 2024

Doctors and dentists in Slovenia have been on strike since January 15, but we face a government that refuses to meet our demands. Negotiations are at a standstill, blocked entirely by the government's unwillingness to compromise. Mediation efforts have failed as well, since the government side lacks the mandate to move forward.

Instead of tackling the real issues in public healthcare, the government has chosen to make this an ideological battle against doctors, moving toward a state-regulated healthcare system that would control both the public and private sectors. Their response to our strike was first to issue a decree, and then amend the Law on Medical Services, effectively banning the strike. We’ve challenged this law in the Constitutional Court, but after months of waiting, including the summer recess, we still have no word from the court.

As it stands, we’re left with a formal strike and limited opportunities to negotiate with the government’s team. We’re trying to find common ground to resolve what we can, but dissatisfaction among healthcare workers continues to grow. Many doctors and healthcare workers are leaving the public system—migrating to the private sector, going abroad, or even leaving healthcare entirely. This exodus leaves immense gaps, and those of us remaining are struggling to keep the system afloat. Clinics and departments are closing, and we are seeing a significant loss of specialists, whose expertise is irreplaceable.

The public healthcare crisis is becoming deeper and more critical every day.

In response to this crisis, the government has prepared an amendment to the Health Care Activities Act and submitted it for public discussion. The problem is that this law was created without the input of healthcare professionals and is therefore difficult to implement. Its essence lies in completely separating public and private healthcare, prohibiting public sector doctors from working privately, and vice versa. It forces public doctors into additional work through public sector contracts, abolishes protections for older doctors by forcing them into overtime and night shifts, and expands the group of those who must provide continuous healthcare. It also introduces state-regulated pricing for private healthcare services, which only further highlights the government's desire to control both sectors.

To summarize, the government is attempting to impose a state-regulated healthcare system using coercion, rather than improving working conditions. This has only further alienated healthcare professionals. What’s more, the government has admitted that they haven’t even analyzed the impact these changes will have on healthcare. According to our legal team, the bill is constitutionally questionable in several areas, and we expect even more doctors to leave the public healthcare system as a result.

Alongside this chaos, the government is also preparing a public sector salary reform, which includes healthcare workers. Despite the fact that the government signed an agreement with FIDES at the beginning of its term, promising that healthcare would be treated differently in the salary reform, we are now witnessing negotiations between the government and public sector unions that continue to ignore the specific needs ofhealthcare. This will prolong the unsustainable wage rigidity we’ve been facing, and worsen conditions even further.

Looking ahead, we are facing a turbulent autumn. Despite strong opposition from the medical profession, it is likely that the coalition government will push both reform bills through parliament, with the support of other public sector unions. There is a real danger that the general collective agreement will overshadow our specific occupational agreement, and FIDES does not intend to support such solutions. In short, the government is sacrificing the public healthcare system to buy temporary social peace, at the expense of too many patients who will face longer waiting times and a lack of top specialists in the public healthcare system.