Assessing healthcare reforms and challenges for trade union work in the health sector in Ukraine

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Myrhorod (Ukraine) 28/29 January 2014 / Brussels 14 March 2013

The Health Workers’ Union of Ukraine on 28-29 January 2014 organised the seminar “Main issues of legal and social protection of the health workers under the conditions of the healthcare reform in Ukraine” in Myrhorod, region of Poltava, Ukraine.

Participants discussed different facets and problems of the on-going healthcare reform in the Ukraine. They highlighted the deficiencies of the legal framework, the impact of inadequate financing of the healthcare system, the violation of workers' legal rights to pay and working conditions and pension policies for healthcare workers.

Please read the seminar report in EN and RU.

In her contribution Lidija Gavrilenko refers to the practice of setting the basic rate of the salary lower than the legal minimum wage. This practice can be explained as follows:

• There is a legal minimum wage for all which defines the lower wage floor, currently 1,218 UAH.

• The Resolution of the Cabinet of Ministers of Ukraine № 1298 of 30.08.2002 (“About payment of labour based on Unified Rate Schedule and coefficients on employees compensation of organisations, institutions and the organisations of separate sectors of public sector”), however, has set first class wage rates (currently 852 UAH and currently for workers on wage rates 1 to 5) that are lower than minimum wage.

• Despite this resolution every worker in the Ukraine is still entitled to the legal minimum wage. It's only as of wage rate 6 (with a wage level of currently 1,235 UAH) that workers receive a wage actually higher than the minimum wage.

• This practice has been challenged before the Constitutional Court of Ukraine. However, it ruled that all provisions comply with the statutory requirements.

• Salaries for public health service workers are fixed according to the basic rate of the Unified Rate Schedule. Wage rates are then defined via a multiplication of the wage rate of class 1, i.e. the basic wage, with Unified Rate Schedule coefficients.

One of the main objectives of the Health Workers’ Union of Ukraine is to push and convince the Ukrainian government to set wage rate 1 on the level of minimum wage (i.e. 1,218 UAH). They don’t accept the current practice of setting the first class wage rate at about 30% lower than the legal minimum wage (852 UAH - corresponding to about 64 € - compared to 1,218 UAH - corresponding to about 92 €).

To give colleagues/readers outside the Ukraine an idea of the level of pay of health workers we list below the salaries of doctors (of first qualification grade), of nurses (of first qualification grade) and of assistant nurses. They are calculated based on the amounts fixed for the Unified Rate Schedule as of 1 January 2014.

• Doctors (or first grade qualification) are categorised at wage level 12 of the Unified Rate Schedule. Given the mechanism of lowering of the whole wage grid by about 30% described above they actually earn 1,806 UAH (137 €) whereas the would/should earn 2,582 UAH (196 €) were the wage rates set in relation to the legal minimum wage and starting from it.

• Nurses (or first grade qualification) are categorised at wage level 9. They actually earn 1,474 UAH (112 €) whereas they would/should earn 2,107 UAH (160 €). As for the other health professions and workers in the public sector under this schedule this means an underpay of about 30%!

• Assistant nurses are categorised at wage level 3. They actually earn 1,218 UAH (92 €), the legal minimum wage, whereas they would/should earn 1,437 UAH (109 €).

N.B.: The amounts are calculated based on the exchange rate Euro-Ukrainian Grwina-Euro as of 14 March 2014, i.e. 1:13.19

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