First conciliation talks in Estonian doctors' and nurses' pay dispute end without a deal
Estonian health care unions and employers failed to reach agreement at their first conciliation meeting on a new collective agreement. The unions say no deal is possible without state funding for pay rises.
Health care unions and employers in Estonia failed to reach agreement on a new collective agreement at their first conciliation meeting on Wednesday. The deal would cover more than 20,000 health care workers, and pay increases are at the heart of the dispute. The unions say the meeting brought no progress, as Minister of Social Affairs Karmen Joller was again unable to meet representatives of health care workers and medical providers.
The budget of the Estonian Health Insurance Fund for next year still includes no money for pay rises for health care staff. Although the state is not formally a party to the collective agreement, the unions argue that no deal is possible without government funding. They also say the participation of the minister, who is responsible for organizing and financing health care, is essential to the process, noting that previous ministers worked with the sector and signed funding arrangements alongside collective contracts.
Labor shortages
The agreement affects nurses, caregivers, midwives, physicians, clinical psychologists, clinical speech therapists, physiotherapists, support specialists and emergency medical personnel. The unions warn that labor shortages are already severe and could worsen if wages are frozen.
Kätlin Lillemaa, president of the Estonian Nurses Union, said one-fifth of health care workers now hold multiple jobs, mainly because of pay. She warned the system could break down if overworked employees keep leaving the profession.
Emigration risk
Ulvi Tasane, president of the Estonian Health Care Workers' Professional Union, said nurse emigration has fallen significantly thanks to raises negotiated in earlier agreements, but the trend could reverse. A large number of job offers have come from abroad in recent months, she said.
Klaus Martin Klettenberg, president of the Estonian Medical Students' Association, said abandoning planned raises could also hurt the future supply of doctors. The unions are also concerned about ongoing reforms, including changes to emergency medical services, rehabilitation, assistive devices, the integration of health and social care, and a shift to e-consultations for specialist referrals. Medical professionals broadly support the goals but argue the plans could reduce access to care because staffing is already insufficient.
Estonian Medical Association President Neeme Tõnisson said health care needs stability and labor peace. The statement was signed by six sector organizations, including the Nurses Union, the Medical Association and the Physiotherapists' Association.
