Observation (CEACR) - adoptée 2005, publiée 95ème session CIT (2006)

Convention (n° 149) sur le personnel infirmier, 1977 - Pologne (Ratification: 1980)

The Committee notes the observations of the Polish Trade Union of Nurses and Midwives (OZZPiP) dated 20 May 2005 on the application of the Convention and the Government’s reply received on 9 November 2005. Following up on its previous comments, the OZZPiP alleges that the crisis experienced by the nursing personnel in the public health care sector since 1999 is deepening leading many nurses and midwives to either leave the profession or seek employment abroad. Noting that the number of nurses and midwives employed in public hospitals has decreased by one-fifth in the last six years, the OZZPiP considers that the Government still fails to apply the Act of 22 December 2000 amending the Act regarding the system of determining by negotiation the growth of average remuneration payable by certain employers (also known as the “203 Act” which guaranteed wage increases for nursing personnel), and the Order of the Minister of Health of 1999 concerning the minimum conditions of employment of nurses and midwives. It also states that the national parliament has discontinued its work on draft legislation which proposed the establishment of a minimum salary level for all nurses and midwives employed in public health-care institutions.

In its reply, the Government contents itself to stating that because the majority of nurses and midwives are employed by independent non-public health-care establishments, it is not empowered to directly enforce compliance with any of the above laws or regulations. As regards public health-care establishments, the Government states that they are not subject to government administration but operate as independent entities. In any event, the Government considers that the head of each health-care institution, whether private or public, is responsible for the financial and human resources management of such institution, while settling individual labour law claims or monitoring compliance with applicable standards falls with the jurisdiction of courts of law.

With regard to accumulated claims under the so-called “203 Act”, the Government refers to the recent adoption and entry into force of the Act on public aid and restructuring of public health-care establishments (Dz. U. No. 78, Text 684) which is meant to help health-care units solve the problem of the growing indebtedness in the health services sector. The Act provides for the possibility of settling individual employees’ claims through loans from the state budget. In fact, under section 35(4) of the Act, loans should be primarily intended for the repayment of liabilities arising from the “203 Act” for the period 2001-04. In this connection, the Government indicates that the state budget for 2005 provides for a loan reserve of 2.2 billion PLN and that 551 health-care establishments are expected to apply to the State Treasury for loans amounting to 1.7 billion PLN.

With reference to the question of adequate pre- and post-diploma training for nurses and midwives raised by the OZZPiP, the Government states that the system of professional training for nurses and midwives takes into account the teaching standards set forth in the European Union’s sector directives, while the National Committee of Accreditation of Medical Schools is responsible for monitoring the nursing schools’ compliance with the binding education and training standards. The Government adds that the number and value of training positions subsidized by the Ministry of Health has been increasing systematically each year.

The Committee notes the Government’s explanations. It recalls that the problems of deferred payment of wages and wage arrears in the health-care sector have been the subject of recent observations addressed to the Government under the Protection of Wages Convention, 1949 (No. 95), and have also been examined by the Committee on the Application of Standards at the 92nd Session of the International Labour Conference (June 2004). The Committee asks the Government to continue supplying detailed information on the evolution of the situation, particularly with regard to ongoing reforms in the field of health care and their implications for the practice of the nursing profession.