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Latest developments in progress at Health Ministry: Differentiated wages based on performance, competitions organised at a regional level not by hospitals

de Mariana Bechir , 24.6.2019

Sorina Pintea announced on Thursday further new changes that will be brought to the functioning of the health care system, including new rules for employment competitions in hospitals and wage payment for doctors based on performance.

New developments for job competitions in hospitals

The organization of these competitions is radically changing, as authorities hope that the new system will “eliminate suspicions and promote meritocracy,” as Minister Sorina Pintea explained in an interview to Hotnews.

Main changes:

  • competitions will no longer be organized by the employer unit but in university centres
  • there will be eight centres in university cities “where the residency is also carried out”
  • competitions will be organised quarterly for the vacancies in hospitals from a certain region
  • the examination committee will be established at the level of the Public Health Directorate
  • in order to launch a job competition, each health care legal entity with legal personality will send the list of vacancies to DSP
  • the hiring exam will include a written test, with grid type of topics selected out of up to 2,000 options, and an oral test which will be recorded

Health Minister spokeswoman Oana Grigore, quoted by Hotnews: “This way, we want all competitions to be transparent, based on merit, away from any suspicion, as they will be organized depending on centres and with people from other regions – meaning that not me, in Bucharest, I organize my contest, but observers from other areas will also be present.”

“Some part of the system does not agree for these competitions to be transparent,” Oana Grigore emphasized.

Doctors paid based on performance

The Ministry of Health is working on a regulation that will include indicators based on which wages will be established.

Unitary wage Law includes grids of identical amounts for physicians with the same specialization and same seniority from similar hospitals so that a surgeon from a clinical hospital in a provincial area who performs a few easy surgeries per week gets the same amount as another one from a hospital in a university centre where complex interventions are carried out on a daily basis and which patients from that area prefer instead of the unit in its county, precisely because doctors are better and have more experience.

Labour ministers have always explained that the principle of unitary wage law sets equal pay for equal work, but it never referred to exactly accounting the work done by health professionals.

Now, the Health Minister says “it is not normal for a doctor who performs five surgeries to receive the same salary as one doing 30 operations.”

The team appointed to regulate these differences is to choose a series of indicators not limited to the number of operations, but also to consider their difficulty.

Sorina Pintea:

“The differentiation will be done as follows: within the same unit, there are the same conditions for all doctors. Everyone does approximately the same type of surgery – one of them performs 5, another one 30.

Doctors also have raised the issue of differentiation. And then, the differentiation will be made by hospitals through the organization and functioning regulations, not the manager, but the head of the department, who is a department administrator, has a management contract, a budget of revenues and expenses, including personnel expenses, depending on the cases, complexity and level of payment, according to the law, because this is constant (…)

Theoretically, the doctor does not receive the same salary, because the doctor who goes to the surgery room benefits from a 50% bonus for the time spent in the operating room.

He has something extra in any case, but we will have to make a differentiation by performance indicators of the unit. So every department will manage itself – if the head of the department believes that everyone deserves the same salary, I have no problem. It is not me who decides.

But by regulation, the head of a department is given some indicators which they must respect.

It is very difficult to define these indicators; you need to do that by medical departments, surgery departments (…)

By the end of the year it (the regulation – editor’s note), could be ready because I want to launch it to debate, for us to discuss it. It is a delicate matter and I want to activate as many participants as possible in this debate.

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