Metalina, T.
REGIONAL COMMITTEEOF THE HEALTH WORKERS’ TRADE UNION
SAMARA OBLAST’
Information.The regional committeeof the health workers’ trade union of Samara oblast’unites 169 primary organizations which cover 82% of those employed in the industry. 92 % of the primary organizations (155) are covered by collective agreements.
The apparatus of theregional committeeconsistsof 8 people. In addition to the chairman and deputy, the following work in the apparatus of the regional committee:
Twospecialists in the social and economic department. They are responsible forcollective agreementactivity, labour safety, consultations on legal questions in the sphere of work, protective functions, participation in the resolution of disputes, the organization of training of trade-union activists and so forth.
Twospecialists in the financial department. Their duties include the organization and the control of financial activity and accounting service for primary organizations
Consultant of theregional committeecarries out organizational work, registration of organizations, membershipaccounting.
The receptionist is in charge ofpaper-work.
At the moment they are deciding whether to add a legal inspector to the staff.
The regional committeeof the health workers’ trade union of Samara oblast’in recent years has operated in a rather friendly environment which was characterized by quite big attention of former Governor K.Titov to problems of the public health services and the presence of a strong social partner at the level of the region in the form of the Ministry of Health of Samara oblast’. At the end of August 2007 V.Artyakov[1]was appointed as the new Governor, and it is difficult to say just now how mutual relations with him will be constructed, but from the very beginning he has paid a lot ofattention to public health services. Rearrangements in the government of Samara oblast’ have begun with the replacement of the minister for public health services and social development[2] and the appointment of an adviser to the governor on the organization of public health services[3]. In the opinion of the new governor it needs two people to supervise public health services and it is necessary to dividetheir powers: the minister should solve operational questions, and the development of strategy will be undertaken by the adviser to the governor. In one of his first interviews the new minister declared: I would like the activity of the ministry to be clear to the wide medical public so that decisions are taken openly and jointly[4],which can be regarded as his aiming at social dialogue.
The reform ofpublic health services in the oblast has been going on since 1988, and the situation with wages in this sphere in comparison with other regions looks relatively favourable. In particular, since the beginning of 2005 there have been no wage debts in the industry and since 2004 for workers in the non-productive sphere(public health services, education, culture) additional payments above the tariff rates have been establishedfor the most underpaid workers (grades 1 to 9), 25% additional payment for specialists living and working in the countryside and other kinds of additional payments, financed from the regional budget.[5]The salary of state employees in the oblast’ in 2006 was increased significantly more than at the federal level. Across the country as a wholethe tariff rate of the first grade was increased twice, the total increase over 2005 amounting to 26% (15% in May and 11% in September). In Samara oblast’, for workers financed from the regional budget, the increase was 37,5%. Although in recent years there has been a tendency for pay to increase, the level of salaries in health care isstill appreciably lower than the average oblast’ level of pay.[6]Pay in the branch has also increased due to the realization of the national project "Health". Since January, 2006 workers in primary health carein villages (local physicians, general practitioners, paediatricians and nursing staffand staff of FAPs [obstetric and medical assistance centres] working with them), alongside the federal supplementary payments, began to receive additional payments from the regional budget[7]. From the same time workers inobstetric services began to receive a salary increase, and from April the salaries of narrow medical specialists have growna littledue to additional prophylactic medical examination. However,wage increases within the framework of the national project have affected only 29,4% of the medical workers of Samara oblast’, therefore work directed at increasing pay in the branch still remains relevant.
STRATEGIC PRIORITIES AND PRACTICE OF THE WORKOF THE REGIONAL COMMITTEEON PROVISION OF DECENT PAY AND WORKING CONDITIONS
In the regional committee of the health workers’ trade union activity directed at increasing thestandard of living of medical workers is considered important and promising. Since questions of increasing the pay of health workersare resolved, basically, at the federal level, pressure of the trade union here is considered to be the most effective. This is carried out within the framework of cooperation with the Central Committee of the Health workers’ trade union of the Russian Federation. The Chairman of the regional committeeis a member of the Presidium of the Central Committee and in this capacity takes part in the development of documents and adoption of strategic decisions, taking his proposals directly to the Central Committee.
At the regional level there are also certain reserves for the improvement of the situation in the sphere of pay and the priority in the resolution of this problem in the regional committeeеis given to institutional methods, with the use of the possibilities of negotiation. Joint activity with trade unions of other budgetary branches (education, culture) is considered to be the preferable tactic in upholding their rights. The main reason for the formation of such a block is, first of all, that the adoption of the majority of regional laws and decisions is, as a rule, directed not at the problems of separate branches, but concerns all of the non-productive sector financed from the regional budget. Therefore practically all activity directed at increasing the salary and standard of living of public health service workers is carried out in association with the regional committees of thebudgetary branches under the aegis of FPSO, so thepossibilities of all joint bodies of the federation (Executive committee and Council), and also working groups and the commissions,are used. L.A. Klementova is a member of the Executive committee of FPSO. According to specialists of the trade unionfederation, the health workers’ union is one of the most enterprising participants in regional social dialogue.
In resolving problems at the regional level the following algorithm of actions is used, as a rule. First, the question is discussed by the chairmen of the territorial committees of the budgetary branches (public health services, education, culture), various methods of its resolution are agreed, after which a working group is created of interested staff of the regional committee. The working group carries out an analysis of the situation, prepares the normative documentation, if necessary makes financial calculations and creates the concrete appeal (demand, proposal) which is then discussed, amended and supplemented in eachregional committeeеseparately. Then the final document is discussed and signed by the three chairmen, and the document is set in motion. If the authority of FPSOis requiredto solve a problem, or there is a need to fix it in a legal act or the tripartite agreement, they take the materials to the regional trade-union structure. In this case, the social and economic department of the federation is involved, a decisionmade at theFPSO Executive committee, and proposals and requests are submitted to the authorities in the name of the federation. Such a schema of joint actions has proved the most effective since, by means of FPSO,it is possible to involve all possiblestructures of social dialogue developed in the oblast’ in the resolution of problems.
Using such a mechanism, starting in 1999 up to the present time, it has been possible to achieve an increase in the regional addition to the tariffs of low-paid workers in the budgetary sphere though it is necessary to note, that trade unions struggled for additional payments for all grades. In a similar way, the trade unions have defended the list of above tariff additionalk payments financed from regional and municipal budgets. This was how the trade unions operated in achieving the allocation of funds from the budget to provide for sanatorium treatment of workers of the non-productive sphere. Together with FPSOthey participated in the development of regulations about sanatorium treatment. A result of this work was the law «On the provision of workers of the budgetary sphere of Samara oblast’ with permits for sanatorium treatment», adopted in December, 2005 by the Provincial Duma of Samara oblast’. 44 million roubles has been assigned from the regional budget for 2008 for these purposes Constant appeals of the trade unions of the non-productive sphere to the Government of the oblast’ and to the Provincial Duma with the demand to increase wages became an important argument for their more substantial increase in 2006 in comparison with the general federal increase.
The territorial committee takes a rather cautious vies of protest actions as a tactic of struggle for the interests of workers, including for wage increases, and especially does not have any confidence in the effectiveness of such actions. However,they do not stand aside from the All-Russia actions, actions organized in the framework ofFPSO, providing support with people. In 2007 they took part in meetings, pickets and processions under the slogans «For a worthy life!», «For a worthy pension and a worthy salary! , «For the observance of the rights of workers!» (24.01.07, 10.04.07, 1.05.07, 24.05.07).
The regional committeeitself has not initiated any collective actions for a long time, holding the viewthat it is not necessary to mobilize primary organisations in collective actions and to express their demands in this way in a situation in which civilized dialogue with the governor and the municipal authority is possible and when there is the tribune of the tripartite commission.We have already given up active actions in the form of strikes and collective actions. Only in the event that dialogue with the authoritiesshould stop can one goto extreme measures but for now one should negotiate. If there is a result, it should be followed. The governor and our deputies have an interest in there not being poor doctors.
Specialists of the regional committeerepresent and assert the interests of workers of the branch in regional structures of various levels where questions concerning pay,the implementation of labour legislation and health and safety are raised in one form or another.
The regional committeecooperates closely with executive bodies in the sphere of health through a system of agreements, but, basically, through its inclusion in the work of various kinds of administrative commissions and other such structures. The Chairman of the regional committeeis a member of the board of the regional Ministry of Health, is a member of the board territorial Medical Insurance Fund and of the public council on public health services of the Provincial Duma. She is a member of thecoordinating council for the management of the priority national project in the sphere of public health services in Samara oblast’, a member of the working group on the organization and control of the provision of personnel for the project "Health" and so forth, that allows her to use the platforms of these representative meetings to publicise the most acute problems of workers of the branch and the opinion of the trade union.
The regional committee has a regularexchange of information with the Ministry of Health of the oblast’ on all questions involving interaction with the trade union. Specialists of the regional committeeconduct constant monitoring of the level of payment in the branch and in the region, scrupulously trace changes in the legislative base, atboth federal and regional levels. Branch information, concerning questionsof pay, level of salaries in the region, working conditions and so forth which the Ministry of Health has is always accessible to them. The trade-union committee in turn brings to the notice of the Ministry information which is received from workplaces about the infringement of legislation in medical institutions.
Leaders of the trade union estimate the established interaction as constructive, noting, in particular, the efficiency of the Government of Samara oblast’ in implementing federal decisions about the increase of salary, in which theyalso see their own achievement: to influence the situation at the level of a subject of federation, it is constantly necessary to prove to the authorities the need for a salary increase. To do it, it is constantly necessary both to supervise the process and to participate in it. When adeadline is approaching, and a decision has not yet been adopted, the trade union appeals, starts to disturb the authorities, reminds, asks. These actionsof ours naturally push, stimulate the acceleration of the process.
ACTIVITY OF THE REGIONAL COMMITTEEWITHIN THE FRAMEWORK OF THE REALIZATION OF NATIONAL PROJECTS
With the introduction of the national project "Health",a wide field of action for the trade unions has opened. The re-structuring which has begun in the sphere of provision of medical services, has generated a set of problems connected to the adaptation of workers to innovations, mistakes in the transition to new working conditions, redistribution of workloads and changes in the system of payment which quite often became reasons for social tension in labour collectives. The significant increase of salary within the framework of the project has still affected less than 1/3 of the medical workers in Samara oblast’. The pay of other categories of workers has not changed significantly. From the very beginning of the introduction of actions to implement the national project, theregional committeestarted to undertake measures in the interests of those who havebeen left behind by the reform.Goodspecialists work in hospitals, but in general they will not get anything,neither from prophylactic medical examination, nor from patrimonial certificates. Some of the health workers seem in general to be outside the framework of the national project (vice-president of the regional committee).
From the beginning of the implementation of the national project, the regional committee of the health workers’ trade union has been actively included in the resolution of the most acute problems which arose in the process of its introduction. In labour collectives of medical institutions there is a certain social dissatisfaction. The problems arising in the course of the realization of the project, especially concerning pay, are reflected,not in the best way, in the moral and psychological climate and overall performance of medical institutions. And discontent began to be shown from the very beginning. It is not clearto people, why one has a good increase in salary, and others have none. And the project refers to "Health" and by definition should cover all public health serviceworkers. We constantly analyze these problems, we write to the Duma, we address the management bodies of the public health services of the oblast’ so that the question of the other categories of workers will be solved (specialist of the social and economic department).
Already at the end of 2005 a number of consultations of the trade union took place with specialists of the Ministry of Health and Social Development and the Medical Insurance Fundon the normative documents regulating the order and conditions of additional payments within the framework of the national project. And in January, 2006 the vice-president of the regional committee(Ageeva G.F.) and chairman of the public commission on public health services of the Kirov district of Samara city (Dolgova V.P., chairman of the Kirov district committee) spoke at a session of the committee on public health services, education and social policy of the Samara Provincial Duma. They raised the question of the unsatisfactory level of social protection of workers of the branch in connection with the realization of the national project and suggested that the problem should be discussed at one of the sessions of the public commission on public health services of the Samara Provincial Duma. They suggested involving all interestedparties in the discussion: chiefs, doctors, specialists, economists. As a result a working group ofthe committee on public health services of the Provincial Duma has been created to study and consider the situation that has arisen.
Reacting to the large number of appeals from primary organisations, specialists of the regional committee,together with the state labour inspectorate, have carried out a series of scheduled inspections of treatment-and-prophylactic establishments. On the basis of the material collected a Plenum of the regional committee wasprepared (April, 2006), devoted to questions of payment during the implementation of the national project "Health". As a result, appeals to the Central Committee of the health workers’ trade union, the State Duma, the Council of the Federation, the Ministry of Health of the Russian Federation and also to local authorities were drawn up, with the request to consider some questions with the purpose increasing the level of social protection of workers of the branch in connection with the reform of public health services. In particular,a question was raised that in the calculation of average wages to calculate holiday payments and for the invaliditylists, the additional payments paid within the framework of the national project should be taken into account. The task was set to increase the salaries of other categories of workers of medical establishments with local services, who do not receive extra payments within the framework of the national project (managers of therapeutic branches, junior medical personnel, registrars, bookkeepers and so forth).