The Council of Ministers gave the green light this Tuesday to the Draft Law of the Framework Statute for statutory personnel of health services. This reform updates the regulations in force for more than twenty years. Despite the fact that dialogue has been constant to reach a norm that would satisfy all parties, with four years of conversations, the final result has been highly criticized.
Thus, the Collegiate Medical Organization has expressed its "profound" discontent due to the approval "without consensus", while the MIR Association has described it as "insensitive". The CSIF union has requested "political will" to accelerate the processing of the Statute, while CESM has indicated that the Strike Committee will increase the level of street protests.
For the PP, this draft law "is born dead". Among the few voices in favor is that of the Nursing Technicians Union SAE, which has described it as "a significant step forward".
Among the main innovations, a maximum weekly working day of 45 hours is set, below the limit of 48 hours set by European regulations. In addition, 24-hour on-call duties are abolished and a maximum of 17 hours of effective work is established. The days off and rest periods derived from this activity will not generate an hour debt, so they cannot be claimed later as ordinary working hours.
A minimum rest of 12 uninterrupted hours between shifts is also guaranteed. Staff will also be entitled to a weekly rest of at least 24 consecutive hours, which will be added to the daily rest of 12 hours.
What happens in Europe?
The European trend sets general minimums - with an average limit of 48 hours per week - although States develop specific frameworks for doctors due to high clinical responsibility or the need for continuity of care, among other aspects.
However, a report by the European Federation of Salaried Doctors (FEMS), published a year ago, pointed out the great inequalities in on-call duties and in hospital and home-based availability.
In the former, the differences are very relevant: in Spain, according to the document, the remuneration was 24.70 euros per hour, while in Italy it ranges between 27.64 euros per hour in day shifts and 35.75 euros per hour in night shifts. In Portugal, the compensation is between 1.5 and 2.5 times the normal salary depending on the shift, while Sweden pays up to 240% of the base salary for qualified on-call duties. Croatia pays 50% more than the normal hour, with increases of up to 150% on holidays.
In the case of on-call duties in hospitals (the so-called on-call), France pays 268 euros for each night or 10-hour period, while Finland pays between 1.75 and 3 times the usual salary. Portugal applies the same remuneration as for in-person on-call duties. In Spain, the remuneration is also 24.70 euros per hour.
The situation is different for localized on-call duties - or stand-by - from home, with an evident underestimation of availability time in numerous countries: In Spain, the payment is 5.18 euros per hour from Monday to Friday, an amount that rises to 5.77 euros per hour on weekends and holidays. Italy pays 20.66 euros per on-call duty, which are converted into overtime in case of activation. In Croatia, 4% of the base salary is paid on working days and 7% on weekends or holidays. In France, 43 euros are set for each 10-hour period and in Sweden, the compensation is equivalent to 22% of the time not worked.
FEMS indicates that, in many countries, localized on-call duties are not considered effective working time, which leads to low compensation and lack of recognition of the care burden. The document concludes that the homogenization of working conditions is a key challenge for the European Union to thus guarantee equity, quality, and sustainability of healthcare for the 27.