Already today we are thinking about the future of our organization

Zdorovye - - NEWS - Lyudmila Malyavlya Valevskaya Head of Dnipropetrovsk regional organization trade unions of workers of public health of Ukraine, Dnipropetrovsk regional organization workers of health care of Ukraine e-mail: [email protected]

The laws of Ukraine on medical reform adopted by the Verkhovna Rada of Ukraine, in particular: No. 2002-V ІІІ, No. 2168-VIIIІ, No. 2206-VIIIІІ and No. 2233-VІІІ, envisage large-scale, but unpredictable transformations in the health care system aimed at the corporatization of the industry and the liberalization of labor relations, and poses significant risks with regard to limiting (abolishing) the volume of existing rights and guarantees of medical workers, reducing the network of public and communal health care facilities.

It should be noted that the Law of Ukraine "On improving the availability and quality of medical care in rural areas" provides for a number of positive norms regarding state obligations, in particular: regarding the development of the network of health care institutions, improvement of their material and technical base and creation of conditions for the activities of medical staff; introduction of modern technologies in medical care; the introduction of effective mechanisms for the involvement of qualified medical and pharmaceutical workers in the medical service, in particular through the creation of additional guarantees of wages and working conditions for such workers.

It should be noted that the financial component of reform is the most uncertain. In the State budget of Ukraine for 2018, health care expenditures are provided for only 3.5% of GDP, which does not meet the requirements of Part 5 of Art. 4 of the Law of Ukraine "On State Financial Guarantees of Medical Care of the Population", where the amount of funds for the implementation of the program of medical guarantees should be at least 5% of GDP. There are also no mechanisms and financial support provided for in Article 10 (3) of the Law on calculation of tariffs and correction coefficients of the base.

The limits of expenditures on scientific activity with constant growth of wages do not meet the needs of scientific institutions of NAMS. In fact, 98% of the approved volumes are only wages and payroll taxes. However, these funds are not enough to pay mandatory surcharges and allowances. The above leads to a drop in the prestige of the work of scientists, rapid aging and a corresponding decrease in the number of scientific staff. Material incentives for the development of medical science in Ukraine are completely lost.

Reforms did not have any effect on solving the key problem of the industry - the extremely low level of wages of health workers. In 2018, "equalization" continues to be maintained in wages with 1 to 12 tariff rates of the ETS. The assessment of work from a doctor to a cleaner is the same at the level of minimum wage. At the level of the promises of the authorities, there remains an increase in the wages of the primary care nursing staff and it is modestly proposed to expect changes in the salary of secondary, tertiary and emergency medical workers after 2020.

In the framework of public oversight in 2017, 142 comprehensive and targeted inspections of compliance with labor legislation in 97 healthcare facilities were carried out jointly. In 2016, 112 such inspections were carried out.

The results of the inspections showed that the overwhelming majority of violations of the labor legislation constitute wage violations (1029), guarantees and compensations to be provided to employees (89). In addition, a significant number of violations were detected in the use of working time (182) and rest time (83), as well as other violations (327).

The number of employees, whose labor and socio-economic rights were violated, amounted to 6400 people.

In order to reinstate the labor rights of employees and to fulfill the legislative powers of the regional trade organization, 114 submissions on the elimination of violations of labor legislation were prepared and sent to employers.

Out of 1733 detected as a result of inspections violations of the current legislation eliminated 1177, ie 68%. The rest - remains on the control.

Such a form of exercising public control over the observance of labor legislation, as systematic carrying out of complex inspections, is chosen by our regional organization, produces positive results.

Here is an example.

At the beginning of December last year, we carried out a comprehensive review of compliance with labor legislation in the Magdalenivsky Central District Hospital. The inspection found numerous violations by law enforcement officers of the institution regarding the use of working time and rest time, remuneration, and labor protection, attempts were made to avoid checks on particular issues. It was given time to eliminate violations, and on January 31 this year, a re-inspection was carried out. Of course, not all violations have been eliminated, but considerable work has been done to remedy the situation: a number of local regulations on the institution's activities have been adopted, work is under way on the preparation and adoption of a new collective agreement and rules of the internal labor regulations, separate issues of use of the worker are regulated from the standpoint of legislation. time, etc.

An active position in this work is occupied by the trade union committee of the institution headed by the head of the primary trade union organization, Bird Olena Leonidovna.

The regional organization of the Trade Union always operatively reacts to the facts of violations of labor rights of the members of the Trade Union. Approximately 20 trips to health facilities have been carried out on air defenses. As a result of consideration of appeals on the ground, changes were made to the records in the labor books, the procedure for the release of employees was brought in accordance with the legislation, assistance was given in solving the issue of working together with relatives, establishing classroom for drivers, etc. An effective mechanism for protecting workers' labor rights, ensuring their social guarantees is a collective agreement. Through collective bargaining work, the rules of conditions and wages, working hours and rest periods, annual additional leave, installment of surcharges, allowances, etc. are regulated.

In order to ensure systematic work on the implementation of human rights activities, our trade union organization continues the practice of expert examination of collective agreements and their projects in health care institutions. Last year, 24 collective agreements were examined and provided with practical assistance.

Unfortunately, it is not always possible to reach agreement from the first time - the draft agreement on the draft agreement of the Petropavlovsk Central District Hospital had to be done three times in a row, paying attention to the same violations.

Such perseverance on our part is based on the desire to protect you from the punitive measures of the influence of the controlling bodies.

It is unclear the persistence of the developers of a collective agreement with violations of the law. What is someone

The development of trade unions, their ability to protect the worker in difficult modern conditions, above all, depends on the professionalism of trade union leaders. To them today are put forward rather high requirements: responsibility, competence, ability to find, analyze and use information, including on legal issues. In any situation, you need to be a worthy partner and, if necessary, an opponent to the representatives of employers. The training and qualification upgrading of trade union assets has always been a guarantee of increasing the quality of trade union activity.

According to the plan of work of the elected bodies of the Dnipropetrovsk regional trade union organization in 2017 nine seminars were held, including 3 regional, 5 regional and 1 directly in the medical institution (state institution "Institute of gastroenterology of the National Academy of Medical Sciences of Ukraine"). They trained the heads of primary trade union organizations, trade unionists, accountants and law enforcement officers on the issues of the implementation by the elective bodies of the primary trade union organization of public control over the observance by employers of labor legislation, the organization of the work of the group and the public inspector on labor protection issues. Particular attention was paid to the training of trade unionists, as the profgrupup is the main source of information in the trade union group, so it has to constantly replenish its own luggage of knowledge.

More than 500 people attended the training.

The city organizations of the trade union held 7 more seminars.

Also, 36 workshops were held with representatives of trade union committees and employers on the ground in health facilities and in the apparatus of the regional trade union organization. This form of work allowed, by providing assistance to primary trade union organizations, ascertaining whether there was a violation of labor rights of employees in each case, receiving the necessary information, listening to explanations of officials, etc., and operatively by negotiating with employers to take appropriate measures to reinstate violated rights.

For legal assistance in 2017, 4850 members of the Trade Union addressed the Regional Trade Union Organization, which provided oral (4704) and written (146) responses. There is ongoing systematic work on the analysis of draft laws, government resolutions, orders of the Ministry of Health of Ukraine. Last year legal expert examination of 11 draft legal acts was submitted. Comments and suggestions were provided. At the request of the Trade Union, including our

organization, the professions of health workers were restored in the National Classification of Occupations of Ukraine DK 003: 2010: "doctor-therapist", "doctor-therapist district", "physician-therapist adolescent" , "Physician-therapist of a shop medical section", "medical assistant in emergency medicine", "instructor on labor adaptation", "instructor on labor therapy", "specialist in physical rehabilitation", "medical sister from medical physical education", "sister medical from the massage "(Amendment No. 7, approved by the order of the Minister tion of Economic Development and Trade of 30.11.2017 number 1744).

We actively participated in the elaboration of new projects Methodical recommendations on job evaluation on working conditions and the new draft of the Procedure investigation of accidents in the workplace.

During the past two years we have done enough work volume to prevent cancellation of preferential entry retirement list №№ 1, 2 specific categories of health workers. According to the results of the work we have achieved that, with the exception of one name of the profession "X-ray Laboratory of the fluorographic cabinet", all other names of occupations in the medical sector remained in the specified Lists.

According to statistical data as of 01.01.2018, the ob last organization in its ranks has 62488 members of the union. Among the working trade union membership is more than 85%.

At present, trade unions, as well as in the state as a whole, are undergoing changes under the influence of time. We can not stop the time. Therefore, we must make positive changes in our society in our trade union life. And at the same time to respond quickly to calls.

It should be noted that during the years of independence we managed to maintain such a high percentage of trade union membership in our organization. This suggests some trust in our organization.

In the health care institutions of the oblast there is a reorganization, which is reflected in the initial organs of production. When several institutions are merged, the parent companies of the merging institutions cease to exist as legal entities. In our opinion, for union members nothing changes. There is only a change in the structure of the trade union organization.

Last year in our region will enter history as a year of creation of united territorial communities: they were created 56. Moreover, this also applies directly to our organizations. Thus, the combined six communities, feeling the strength, have decided to create and set up centers of primary health care, which have been established and primary pro for hanizatsiyi. And each newly formed trade union organization was supposed to carry out state registration as a legal entity. Unfortunately, the requirements for state registration of a public organization are very rigid. O bl pro pro organizatsiy ad id not stand aside these issues, but developed an algorithm for action for the heads of air defense. There are certain agreements with the regional department of justice. Developed samples of documents to be submitted to the justice system. But even after such a great deal of work there are certain misunderstandings. We sent our comments and suggestions on this issue to the Central Committee of the Trade Union. They, in turn, promised to raise this issue at the FPU level.

At the time of the administrative-territorial reform, the Dnipropetrovsk regional organization of the trade union of health workers of Ukraine, within the limits of its authority, directs its activities to implement effective public control over the compliance of employers with the requirements of legislation, in particular, on health and safety of workers of health care institutions providing proper and safe conditions for their work.

To this end, we are working on:

- Training of trade union representatives on labor protection issues;

- Further cooperation with the State Service of Ukraine for Labor in the implementation of public and state control over the compliance of employers of health insurance companies in the field of labor protection legislation.

In carrying out public control over compliance with the requirements of the labor protection legislation, we continue to seek from the LPU region's employers the strict implementation of all legislative acts.

As for occupational injuries, it is necessary to note the following. The total number of occupational injuries in the health care facilities of the region for 2017 is 23 accidents, in which 26 people were injured (2 cases due to accidents due to accident caused by our drivers); in 2016 - 22 accidents (in 2015 - 25 cases).

There are cases of natural death, which according to the results of special investigations, are not associated with production. And in these issues, we strongly encourage employers to more closely address the issue of periodic medical examinations of employees.

We are concerned about the unlawful encroachment on the lives and health of medical staff, which, unfortunately, is taking place. Cases involving beatings of paramedics and emergency medical and primary care physicians while performing their official duties speak about the insecurity of health workers.

. In essence, we are already thinking about the future of our organization. I want to note that the preservation of our organization's integrity is not for the sake of preservation, but to provide members of the union certain guarantees. Unfortunately, today I can speak frankly - sometimes the impression was that we live not in the 21st century - the time of the latest technologies and great communication possibilities, but somewhere in the primitive system beginning. There is no understanding, as such, with the purpose of creating a union. The interaction between the manager and the primary is based solely on the principles associated with the greetings and holidays for the entire workforce on the account of the means of union unionization. Not always the heads of trade unions, agreeing to the election, are aware of the huge responsibility of the members of the union that they are the heads of a legal entity with all the consequences. If the institution where the primary employer violates the rights of members of the union, then to a large extent the blame for this lies in the aforementioned trade union committee and primary trade union organization head. Unfortunately, the priority in the work of many trade unions is still the work to provide material assistance to the members of the trade union and cultural events. And from this false idea of the goals and objectives will be the trade unions and our organization, in particular. I am glad that these phenomena are not massive, and even isolated - not in favor of the trade union movement.

On the part of o bl prof organiza ts ii, the most recent legislative documents, necessary methodological recommendations, and regular training seminars are held. Therefore, we suggest guiding our guidelines.

Trade union committees of primary trade union organizations during the period of the reform of the industry are forced to intensify their work and send it to address the issues of preventing violations of the rights of trade union members. Such systematic work in this direction is carried out in Sin el niko vs kay aC RC( head R eu tovO.B .), Regional clinical therapeutic and prophylactic association "Phthysiology" (head Visisheva NN), Regional Children's Clinical Hospital (head Va run O.E.),Verhn ed ni prov sky central district hospital( head Sernevich O.A.),Vasylkivc enter of primary medical and sanitary care (head Rikun V.O.), Clinical oncological dispensary (head Reshetnikova T.M.).

It is safe to say that human rights work, work on preserving unity in theo bl prof organiz at si ya and its structural divisions is at a rather high level. There are suggestions for improving it, applying new forms and methods. But the main issues in the industry are the financial support of employees. This needs to be addressed at the central and local level. Regarding the issue of remuneration before the Government. In February 2018, a meeting of the Central Committee was held, which adopted a resolution on an immediate meeting with the Prime Minister on one issue: salary and staffing in the industry. In case of refusal of the meeting, or absence of positive changes, to hold a protest action in Kyiv in March. But in our family today we have to ask each of us the question: "Is I ready to defend myself?" Why do I say so?

We have posted on our website and facebook an algorithm for petition support against the destruction of the emergency medical care system. Today, there are only about seven thousand signatures, and ours are tens two. Why? There is another 55 days to support this petition. Join!

About protest actions. In the event of a decision to hold a protest rally, we look forward to the active participation of our union members.

. Keep yourselves.

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