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How do national private healthcare providers react to the new situation? Our conference reveals:
The opinion of the Hungarian Medical Chamber on the law on the legal relationship of the health service, which was extended without prior agreement with Prime Minister Viktor Orbán, begins with the announcement of the MOK on Tuesday.
The article also discusses in detail the expected effects of the law passed Tuesday. The forceful introduction of the law without preparation and conciliation undermines the acceptance within the medical community of the huge step that is taken to the desired salary and that will be maintained in the home and public service and the prohibition of gratitude money.
In its current form, which restricts rights in various respects and maintains uncertainty and vulnerability, the law is widely rejected by the broad strata of the medical community. This also makes it difficult to accept and support new transformations. The care system has already been exposed to unprecedented pressures and uncertainties in the last 50 years due to the epidemic situation, so it is not appropriate to generate other types of doubts and uncertainties in order to defend effectively. All forecasts predict a worsening of the epidemic situation, which highlights the priority of the proper functioning of the care system.
The uncertainty is increased by the fact that colleagues do not know, nor the presidency of the MOK, the master plan, the “big picture”, that is, the objective model of the transformation process. This should definitely be communicated so that clinicians can see that it is a coherent system of ideas into which each piece of the puzzle is placed.
Together, rather than stabilizing local care, this can result in a higher attrition rate than in the spring (a refusal to sign a new contract) among doctors and professionals who are also covered by the law but therefore receive little compensation.
According to their concerns, the entry into force of the current form of the law on January 1, 2021 carries serious risks to the security of supply.
Today, legal relationships in the healthcare sector are so opaque and intertwined that their rapid one-step transformation without a parallel rearrangement of capabilities can cause serious supply disruptions.
Banning the use of personal contributors will put a large number of service providers in a difficult position to manage. Until now, it is impossible for specialized clinics operated by specialists employed with a personal contribution contract, who predominantly apply there for one day., similar to youth health services (schools, kindergartens). But larger hospitals with pathologists and anesthesiologists and radiologists, who have been used in this way, will also find themselves in a difficult situation, while in smaller ones, entire departments can become inoperable with the loss of hospitalized patients.
The clarification of legal relationships and the elimination of unregulated and self-exploited employment can only be problem-free if skills and competencies are reordered and patient pathways are re-regulated. It is not possible to transform this during this time near the peak of the COVID-19 epidemic. Therefore, the social and public health impacts are also unpredictable if citizens face massive supply bottlenecks due to the epidemic and the lack of scheduled screenings or benefits.
Financing rules that are not yet known can cause more anomalies
– projected.
If the salary increase reaches new legal hires through MÁK rather than based on performance funding, then in fields where private company services represent a significant portion of the supply segment, such as imaging diagnostics , laboratory diagnostics and especially artificial treatment, serious supply disruptions are expected.
In general, it was written that “although the law guarantees a salary in accordance with the previous needs of the medical community and prohibits gratuity, it violates fundamental rights and generates serious resistance to the way it is created and its content, such as the security of supply and epidemiology can cause defense-threatening malfunctions. “
Therefore, the law in its established form there is a need for a substantive and concerted amendment that is unacceptable to the IOC.
Conflict of interests
Paragraph 1, which restricts other lucrative activities, causes serious harm and must be remedied, the organization said. On the one hand, it unjustifiably subordinates the performance of non-health activities to authorization and, on the other, grants any unauthorized authorization to a body not yet known in relation to the authorization. In consecuense:
- in the case of non-health related activities, a maximum of notification to the employer may be considered,
- in the case of health care activities, the conditions and principles of the restriction must be established in law and the licensing body must be appointed (based on actual decisions, we recommend the employer),
- in the implementing regulation
- The evaluation criteria should be established in accordance with objective criteria (eg working time standards) and the MOK should be involved in their development.
- Article 6 (3) of the Labor Code, which establishes the principle of equitable consideration, must be taken into account.
“Paragraph 5) excludes, except in emergency cases, the treatment by a doctor of a patient established in this Law who has not been treated in the public service for the same disease. It is necessary to clarify it, at least with regard to the Deadline Legislative intention a reduction in cases of self-referrals and gratitude, but this is counteracted by the inclusion of a volunteer helper in law and the promise of a maternity event exemption in the explanatory memorandum.
Paragraph 10 prohibits curative-preventive activities for the head of the service provider, but at the same time includes the time spent in this way in practical time and in mandatory continuous training. Therefore, this is incomprehensible in terms of content, as a prohibited activity is considered a practice.
§ 11 Employment other than an employment contract
This stage, secondment, causes the most pushback in the medical community, because a 1 + 1 year position without detailed rules is certainly unacceptable.
– think of the MOK.
A general note is that it can be requested in an emergency. [521/2013. XII. 31.) Korm. rendelet] Furthermore, stricter regulation is both fundamentally and professionally unjustified.
Sections 1 and 2 have an effect incompatible with the chosen medical profession on the way of life, the family and the private life of doctors, are contrary to the requirements of legal certainty and do not comply with the requirements of the Basic Law.
It is unacceptable that the obligation to create detailed rules and its mandatory content elements are not included in legislative tasks.
Although the law states that publication cannot be disproportionate to the age, health or other circumstances of the employee, stricter and clearer rules would be needed.
The medical community can only accept a commission of service in a health crisis situation, but it is still necessary to clarify the regulations in force by law and regulations regarding Section 53 (2) of Mt.
It would also be comforting to have a legal provision that displacement not only does not cause financial disadvantage, but also involves a supplement to offset the additional costs and inconvenience involved.
Regarding paragraph 4): “age, health status or other circumstance” referred to in the bill is only a list, “disproportionate harm” is always subjective; judicial practice may examine it accordingly. Section 53 (3) of the Labor Code defines very specific exceptions when it is not possible to send an employee without the employee’s consent (e.g. pregnant, with a young child, raising a child alone, etc.)
Ref. (5): it is recommended to include here the question of costs and other reimbursements and compensation associated with the service commission, that is, in addition to the order and duration of the service commission, also the conditions of the same.
§ 12 Termination of the legal relationship
The concept of relocation is unclear. According to paragraph 2, a transfer must be agreed, but it does not appear that the two employers should agree or the person in a health service relationship. The first case, that is, the possibility of relocation without the consent of the worker and without restrictions or exceptions, is considered unacceptable to the medical community, for the reasons already listed in the case of long-term secondment.
With respect to paragraph (4): in the interest of performing a public task, an indefinite transfer between healthcare providers belonging to the same maintainer will terminate the legal relationship of the healthcare service in accordance with Section 12 (1) (a). Here, the legislator presumably took into account the legal relationship with the employer from which the person is transferred, but the legislation is in no way adequate, on the one hand because it is a permanent but not permanent transfer (so why is the relationship) and on the other hand because you have to guess its application, you cannot know exactly what your intention is with it.
Cover Image Source: Getty Images
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