RIGA - Latvian anesthesiologists took a further step last week in their game of brinkmanship with the government, saying they would only treat emergency cases beginning Nov. 1 if the government did not meet their demands for a significant pay hike.
Both anesthesiologists and doctors want a nearly fivefold increase in wages, enough to boost their current pretax monthly income from 220 lats (331 euros) to 1,200 lats, or 800 lats after taxes. In addition, nurses are demanding a post-tax income of 600 lats. Officials say that the raises will be made but not to the levels requested.
"Prime Minister Indulis Emsis is convinced that a compromise will be reached shortly but not by raising their salaries to the amount they want. We don't have that kind of money," said Ilona Lice, spokeswoman for the prime minister.
However, Antonina Sondore, president of the Latvian Republic of Anesthesiologists and Intensive Care Workers, painted a grim picture of the country's medical sector.
"In at least six hospitals there are no anesthesiologists or intensive care workers at night," she said.
Many doctors have gone abroad where salaries are higher and the workload less, while at home many anesthesiologists have been forced to work at more than one hospital, often putting in 24-36 hours straight to make ends meet, she said.
To prevent a further loss of doctors, anesthesiologists and intensive care workers, salaries must be raised to insure proper support for their families, Sondore explained.
If the government does not address the situation soon, then Latvia could face a medical crisis in the next 10-15 years with dangerously few doctors and medical staff.
"We acknowledge that the salary is not high enough, but there is little we can do. There is not enough money in the state budget," Zaiga Barvida, head of Welfare Ministry's communications department, said.
She further acknowledged that retaining doctors and medical staff is also a problem, saying that in some places there are no doctors.
Yet steps are being taken. The Riga City Council, following two weeks of debate, planned on Sept. 29 (after The Baltic Times went to press) to release a "master plan" that aims at reforming its medical sector.
After a decision on this move, the government intends to borrow money on international finance markets to pay for the overhaul. Barvida said the plan would then apply to all of Latvia, at which point the state would step in.
Meanwhile a tentative agreement was reached between Health Minister Rinalds Mucins and Riga Mayor Gundars Bojars on Sept. 28 over the direction of the "master plan."
"Our previous cooperation with the Riga City Council has been neutral, yet right now it is forming a constructive and effective dialogue for both sides in solving important questions," Mucins said after the meeting.
Emsis, meanwhile, assured that the situation would be sorted out, although it may take until the beginning of December - or longer - before a compromise is reached.
As the government has already increased expenses for 2005 aggressively, it remains doubtful that much more could be added to the budget.
Medical problems and threats of strikes have cropped up on numerous occasions in the past. Last year, while the New Era-led government fought over the budget, the medical field turned up at the center of the debate. At the time medical expenses threatened to spiral out of control as former Prime Minister Einars Repse's austerity measures set to reduce the state insurance benefits.
The cuts were eventually defeated.
Under the proposed budget for 2005, those who can afford to pay for medical expenses will be required to do so, while those in need will receive government support.