With the revisions made to the Sectoral Collective Agreement (GKU) for the healthcare sector in November 2022, medical professionals believe they have been placed at a disadvantage compared to their non-medical counterparts who hold the same level of education and work in the same institutions.

According to representatives of medical personnel from health centers in the northern region, these changes resulted in increased coefficients for non-medical staff, leading to salary percentages that surpass the parity expected based on education level. They point out that non-medical employees with advanced degrees now earn more than nurses and technicians with similar or even higher qualifications.

Moreover, they note that non-medical staff with secondary education also experienced salary increases, equating their earnings with those of colleagues in healthcare institutions who possess the same level of education.

Medical workers conveyed to “Vijesti” that “both nurses and technicians, regardless of whether they possess higher or secondary education, as well as physiotherapists, are financially undervalued when compared to non-medical staff.”

They emphasize that, under the revised GKU, healthcare professionals, including senior nurses and applied physiotherapists with a VI level of education (basic studies – three years or 180 ECTS credits), have a coefficient of 8.35, while non-medical roles such as social workers, lawyers, and economists in the same institutions have a coefficient of 9.37.

The disparity becomes even more pronounced at the VII level of education (basic studies – four years or 240 ECTS credits). For instance, they state that a graduate lawyer, economist, social worker, psychologist, or speech therapist has a coefficient of 11.91, while medical professionals (healthcare specialists, applied physiotherapy specialists, etc.) are assigned a coefficient of 9.37.

“It is evident that non-medical professionals with university degrees are regarded as more valuable within the healthcare system than their medical counterparts, creating a paradox both in the implementation of the law and the fundamental essence of the GKU. This kind of GKU and the salary policies in healthcare fail to recognize the contributions of nurses, technicians, and physiotherapists. They form the backbone of the healthcare system and must be appropriately compensated for their roles.”

The Ministry Remains Silent, Šćekić Pledged a Salary Increase

As of the publication of this issue, the Ministry of Health has not responded to inquiries from “Vijesti” regarding the alignment of the GKU with existing laws, nor has it explained why coefficients for non-medical workers were raised, resulting in higher salaries than those for medical personnel with equivalent or superior qualifications. Questions regarding how the Ministry plans to address these issues and whether any steps are being taken to remedy the situation remain unanswered.

In September 2023, the then Minister of Health Dragoslav Šćekić responded to a letter from medical professionals highlighting challenges within the GKU, asserting that the Ministry would “strive to ensure that the impending amendments result in an appropriate increase in coefficients for calculating salaries for medical workers, including nurses with higher education.” Šćekić anticipated support from the Ministry of Finance, hoping for an appropriate increase in salaries for healthcare workers during negotiations, contingent on financial feasibility.

Medical professionals in the north contend that the wage disparity has become even more evident since the initiation of the Europe Now 2 program. They report that non-medical staff with secondary qualifications and lower responsibilities, such as hygienists, are now earning the same wages as nurse technicians, also with secondary education. The gap in salaries between healthcare professionals and their non-medical peers with advanced degrees is becoming increasingly significant.

Additionally, they warn that “the stark salary disparity between doctors and other healthcare personnel can greatly diminish the morale and motivation of healthcare providers.”

They emphasize that the efforts and contributions of nurse technicians, physiotherapists, laboratory technicians, radiologists, and other supporting medical staff are frequently undervalued, despite being essential for the day-to-day operations of hospitals, health centers, and other healthcare agencies.

They assert that increasing salaries and acknowledging the importance of all team members in healthcare, alongside ongoing investments in their education and professional growth, is “critical for sustaining motivation and delivering high-quality healthcare services.”

Medical workers argue that the signatories of the GKU, including the then minister of the relevant department and leaders of the Independent Health Trade Union and the Health Workers’ Union, did not adhere to the Labor Law and the Law on the National Qualifications Framework. They claim that alterations were made without transparency, as health workers only learned about the changes six months later, leading them to address the apparent unfairness.

Directors Indifferent

They further state that many directors of health institutions have shown little interest in proactively addressing this “serious issue.” Instead of engaging in problem-solving, they explain, “many newly appointed directors have concentrated on extending the Job Systematization Rulebook.”

“These changes have resulted in an increase in the number of non-medical personnel, both with secondary and higher education. This expansion has unnecessarily bloated the ranks of administrative roles and other positions that do not provide direct health services. While non-medical staff play a vital part in the system, their numbers have become concerning, as their salary allocations come at the expense of medical professionals who are essential for the healthcare system’s operation.”

They stress that an urgent reassessment of priorities within the healthcare system is necessary, asserting that the primary focus should be “on ensuring the quality of healthcare services rather than on unwarranted growth in administrative positions.”

They point to the collective agreement at the Institute for Physical Medicine and Rehabilitation and Rheumatology in Igalo, which they assert has achieved “a fair correction and alignment of coefficients between healthcare and non-medical workers holding the same educational qualifications.” They view this as a model for how the GKU for healthcare should be structured.

According to the Institute’s Collective Agreement, they note, all employees, whether medical or non-medical with a VI level education, receive salaries based on a coefficient of 9.37, and for level VII the coefficient is 11.91.

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