Hospitals that do not provide their staff with the minimum basic remuneration of BGN 1,500 for nurses and BGN 2,100 for doctors stipulated in the Collective Labor Agreement (CLA) will suffer fines. Sanctions are also provided for the medical institutions with too large a cut in the salaries of the employees. This is foreseen by the draft annex to the National Framework Agreement (NRD), which the Bulgarian Medical Union and the Health Insurance Fund are about to sign. This is another attempt to cut the salaries of doctors in recent years. Last year, when the NRD was signed, a reprieve was already given to the hospitals to reach the remunerations laid down in the KTD.
However, this has not yet happened in many places. Municipal hospitals claim that this requirement is too much for them, while some private hospitals refuse the state to interfere in their income policy.
According to the project for an annex to the NRD, if a hospital does not fulfill its obligation to bring salaries into the norms of the KTD, then the Health Fund will impose a financial penalty in the amount of BGN 200 to BGN 500 for each individual case. For repeated violations, the fine is from BGN 500 to BGN 1,000 for each individual case.
Sanctions are also foreseen in cases where the gap in the salaries of the staff of a hospital is too large. There is already a text in the NRD according to which the ratio between the maximum and minimum gross remuneration of medical specialists in hospitals cannot be more than 10 to 1, but so far there have been no sanctions for its non-fulfillment.
This means that if the maximum salary in the hospital is BGN 30,000, then the minimum cannot be below BGN 3,000. It is now a practice for directors of hospitals who are also active doctors, as well as some heads of clinics, to receive remuneration of the order of tens of thousands of BGN per month, while ordinary doctors and nurses have minimal incomes.
Hospitals will be fined from BGN 3,000 to BGN 5,000 for the first violation and BGN 8,000 to BGN 15,000 for each subsequent violation.
According to data from the Ministry of Health, as of June last year, only 26 out of 181 state and municipal hospitals have fully reached the salaries from KTD.
The state hospitals that have fully reached the salaries stipulated in the KTD are the university hospitals “Alexander Chirkov”, “Tsaritsa Joanna – ISUL”, “Maichin dom”, “St. Ivan Rilski”, the National Cardiology Hospital, the Specialized Endocrinology Hospital “Acad. Ivan Penchev”, the Specialized Hospital for Active Oncology Treatment, “Lozenets” Hospital, the Infectious Disease Hospital “Prof. Ivan Kirov”, the “Tsar Ferdinand I” Rehabilitation Hospital in the village of Iskrets and the Specialized Rehabilitation Hospital – Marikostinovo.
The municipal hospitals that have reached the salaries stipulated in the KTD are those in Plovdiv, Burgas, Stara Zagora, Blagoevgrad, Gabrovo, Karlovo, Berkovitsa, Byala, Madan, Devin, Vratsa, Kostenets and others.
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