Nurses’ union mulling strike

Negotiations between nurses and employers were held between June of last year and March and got nowhere. PHOTO: Madis Veltman

The collective labor dispute between the Estonian Nurses’ Union (EÕL) and employers is showing no signs of nearing a solution as even the public conciliator failed to bring about a compromise. Negotiations between nurses and employers were held between June of last year and March and got nowhere. The dispute landed on the desk of the public conciliator in April and ended in stalemate the next month. The corresponding decision was made official in June.

At the same time, another healthcare collective agreement was signed that has not been signed by the EÕL. The latter’s position is that nurses were not involved in the making of the collective agreement that directly concerns their profession. Head of the union Anneli Kannus told Postimees that nurses were invited to join the agreement once the other parties had agreed on everything it entails. “It started with efforts to keep us away from the negotiating table,” Kannus said.

Nurses demand involvement

As a final peace offer, the EÕL turned to the health and labor minister, employers and the Health Insurance Fund for an agreement for the development of nursing. The core issues include giving specialist nurses official status and rights, professional care workers’ wage specifications and nurses’ workload.

Sides to the healthcare sector signed a voluntary collective agreement based on mutual trust in late April that the Estonian Nurses’ Union did not sign. The association claims it was not involved in the negotiating process. “We cannot be party to an agreement in which we have had no say. Furthermore, the agreement does not reflect important developments in the healthcare sector, such as specialist nurses and professional care workers’ wages that were important parts of EÕL’s collective agreement proposal,” Kannus said.

EÕL proposed a solution after the conciliation process failed to produce results. A nursing development agreement that needs to be signed by the health and labor minister, Estonian Hospital Association, Health Insurance Fund and the Medical Emergency Union. It seeks development of specialist nursing services, determining their rights and responsibility on the level of legislation.

Simply put, a nurse has a bachelor’s degree, while a specialist nurse has a master’s degree. Specialist nurses have different training and capacity, with matters of their rights and responsibilities in need of regulation. A draft amendment for giving specialist nurses the right to write limited prescriptions and incapacity for work certificates has been prepared.

There are plans to create a working group to determine the relative importance of nurses and specialist nurses per patient and find a balance between workload and quality of service. Proposals include hiking the wage coefficient of nurses and care workers and equate nurses’ training expenses to that of other highly education specialist. EÕL expects the sides to send in comments and proposals by the start of August.

President of the union Anneli Kannus told the “Otse Postimehest” webcast that the union is within its right to go on strike after the public conciliation process failed.

“While there are attempts to suggest that the collective agreement signed with other employees covers all employees and restricts further steps we might take, we are now basically within our right to go on strike,” she said.

Kannus explained that the union has proposed the nursing development agreement as a way to avoid a strike. “We need certainty in that the state sees and understands needs for developments in healthcare. Working conditions need to be improved and healthcare workers treated equally.”

The goal is to reach an agreement before the end of summer. “Failing that, we need to consider our next steps one of which is preparing for a strike,” Kannus said.

Valid agreement a hindrance

Minister of Health and Labor Tanel Kiik (Center Party) said the ministry will surely address the nurses’ proposal. “It is sensible to discuss these proposals on a broad base in the interests of a comprehensive agreement in healthcare,” the minister said.

Kiik added that there is an existing healthcare collective agreement the nurses have not joined. “It is very difficult to hold separate negotiations with one of the parties on the side. The remaining parties have already agreed on a collective agreement for the next two years,” he said.

The Medical Emergency Union sees common elements with EÕL, especially concerning the matter of specialist nurses. “The Medical Emergency Union finds it important to give heads of nurses’ brigades with specialist nurse training a higher hourly rate, and we value training for all medical emergency personnel,” said union head Lilian Lääts. The board of the union will convene to shape its official position in August.

The Estonian Hospital Association pointed out that medical workers already have a valid collective agreement that also covers nursing salaries and working conditions. “The public conciliator urged all sides to join the agreement. Unfortunately, the nurses’ union has still not signed the agreement and has decided to pursue separate negotiations,” chairman of the board Urmas Sule said, adding that more favorable working conditions agreed on in the document will nevertheless apply to nurses from April 1.

The union will discuss the nurses’ project and send in comments and proposals, Sule promised.

“It has recently been the good practice of the Estonian healthcare sector for all sides to sign the collective agreement,” Rain Laane, head of the Estonian Health Insurance Fund, said, adding that it did not happen in full this year. “The main issue is the role of specialist nurses and their pay, while it is something that cannot be put to bed without consulting all parties,” he said.

Laane assured Postimees that communication with EÕL is ongoing and that he hopes no one is considering a strike in today’s crisis. “The pace of introducing new activities might not be equally acceptable for all sides,” he said.