LABOUR LAW EQUAL CONDITIONS OF WORKERS IN THE EU oProhibition of discrimination on grounds of nationality between EU Member States oAny discrimination in working conditions between domestic workers and persons coming to work in the territory of a given State from other Member States is considered inadmissible oGender equality – equal wage for equal work oThe right to vocational training under the same conditions as domestic workers oThe right to join unions in the country of employment LABOUR CONTRACT BEFORE SIGNATURE AFTER SIGNATURE MINIMUM REQUIREMENTS DURATION OF THE CONTRACT TERMINATION OF EMPLOYMENT By Employee Usually, the reason does not need to be stated Notice period By Employer Usually, the reason must be stated – not for employmet „at-will“ (typically some states of U.S.A.) For breach of obligations by the employee Change of organizational structure/cancellation of job position Termination of employer RIGHTS AND OBLIGATIONS UNDER THE LABOUR CODE OBLIGATIONS OF HEALTHCARE PROFESSIONAL ACCORDING TO HCA UNIONS UNION Legal entity consisting of employees or workers having a common interest E.g. all the assembly workers for one employer, or all the workers in a particular industry Formed for the purpose of collectively negotiating with an employer (or employers) over wages, working hours and other terms and conditions of employment Often use their organisational strength to advocate for social policies and legislation favorable to their members or to workers in general THE COMMUNITY CHARTER OF THE FUNDAMENTAL SOCIAL RIGHTS OF WORKERS - 1989 Employers and workers of the European Community shall have the right of association in order to constitute professional organisations or trade unions of their choice for the defence of their economic and social interests. Every employer and every worker shall have the freedom to join or not to join such organisations without any personal or occupational damage being thereby suffered by him. SALARY SALARY Remuneration for work performed on behalf of an employer Including such elements as a basic rate, a piecework bonus and other forms of bonus, overtime, etc. DETERMINING THE AMOUNT OF SALARY MINIMUM WAGE Should be in the amount that allows a decent living for workers and their families. Most EU Member States have a statutory national minimum wage in place, although its level, adjustment mechanisms and coverage vary. Austria, Denmark, Finland, Italy and Sweden have minimum wages set within collective agreements, while Cyprus has statutory rates for different occupations. WORKING HOURS (DIRECTIVE 2003/88/EC concerning certain aspects of the organisation of working time) BREAKS MAXIMUM WEEKLY WORKING TIME The average working time for each seven-day period, Should not exceed 48 hours including overtime ANNUAL LEAVE At least four weeks Minimum period of paid annual leave may not be replaced by an allowance in lieu, except where the employment relationship is terminated NIGTH WORK Night workers whose work involves special hazards or heavy physical or mental strain do not work more than eight hours in any period of 24 hours during which they perform night work. Health assessment Obligation of an employer to notify authorities of regular use of night workers DEROGATIONS FROM DAILY REST, BREAKS, WEEKLY REST PERIOD AND LENGTH OF NIGHT WORK In the case of activities involving the need for continuity of service or production, particularly … treatment and/or care provided by hospitals or similar establishments, including the activities of doctors in training … CHANGE IN WORKING ABILITY CHANGE IN HEALTH CONDITION PREGNANCY Pregnant worker worker who informs her employer of her condition, in accordance with national legislation DIRECTIVE 92/85/EEC - https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:01992L0085-20140325 PREGNANCY Employer shall assess the nature, degree and duration of exposure, in the undertaking and/or establishment concerned If the adjustment of her working conditions and/or working hours is not feasible, or cannot reasonably be required on duly substantiated grounds, the employer shall take the necessary measures to move the worker concerned to another job. If moving her to another job is not feasible or cannot reasonably be required on duly substantiated grounds, the worker concerned shall be granted leave in accordance with national legislation and/or national practice for the whole of the period necessary to protect her safety or health. PREGNANCY Workers shall not oblige to perform night work during their pregnancy and for a period following childbirth which shall be determined by the national authority competent for safety and health PREGNANCY Prohibition of dismissal from the beginning of pregnancy to the end of the maternity leave, save in exceptional cases not connected with their condition which are permitted under national legislation, provided that the competent authority has given its consent; EMPLOYEE LIABILITY ASSUMPTIONS OF LIABILITY THE OBLIGATION OF PREVENTION The employee is obliged to act in such a way as to prevent material damage, non-material damage or unjust enrichment. If intervention is urgently needed to prevent damage to the employer, the employee is obliged to intervene; employee does not have to do so if it is prevented by an important circumstance or if employee would put himself or other employees at serious risk. DAMAGES LOSS HEALTH INSURANCE AND OUT-OF POCKET PAYMENTS OF PATIENTS FOUR REVENUE SOURCES OVERALL Government spending (tax) Compulsory „social“ insurance Commercial insurance Out of pocket payments REVENUES SHARE Revenues of financing schemes Government Social insurance contributions Compulsory prepayment Voluntary prepayment Other private (insurance) Country Norway 85,4 .. .. .. 14,6 Sweden 83,4 .. .. 0,6 16,0 United Kingdom 80,1 .. .. 2,9 17,0 Canada 71,7 1,4 .. 9,9 16,9 Spain 67,8 3,3 .. 4,6 24,3 Hungary 51,1 16,6 .. 2,2 30,1 Japan 41,0 43,0 .. 2,2 13,7 United States 40,0 10,1 34,4 4,4 11,1 Israel 38,9 24,6 .. 11,2 23,5 Turkey 37,7 40,7 .. .. 21,6 Switzerland 28,4 1,3 33,1 6,7 30,6 Mexico 23,9 28,5 .. 5,6 42,1 Korea 17,5 40,1 1,5 6,8 34,1 Germany 14,7 62,5 7,1 1,4 14,2 Poland 11,3 58,0 0,5 5,4 24,7 Average 46,2 27,5 15,3 4,9 22,3 Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item Information on item CONCLUSION Each system relies on combination of state subsidies and individual insurance Out of pocket payments /prepayments/ are usually strictly regulated if not directly forbidden Physician has to be aware of rules not to be accued of bribery or taking advantage of patient PHYSICIAN NEEDS TO KNOW THE RULES REGARDING: Gratitude and gifts Direct payments Conflict of interest Prefferential treatment (skiping the queue) CONFLICT OF INTEREST SIGNIFICANT POLICY PROBLEM Antyhing that can create risk, that your actions regarding primary interest (patients well-being) will be influenced by your secondary interest. EXAMPLE FROM THE UK: NHS CODE OF CONDUCT Výřez obrazovky EXAMPLE PROFESSIONAL CODE FOR PHYSICIANS IN GERMANY – ADOPTED BY GERMAN MEDICAL ASSEMBLY Výřez obrazovky Výřez obrazovky GIFTS AND TOKENS OF GRATITUDE GIFTS AND GRATITUDE EXAMPLES EXAMPLE – GERMAN CODE OF CONDUCT Výřez obrazovky EXAMPLE – GERMAN CODE OF CONDUCT Výřez obrazovky EXAMPLE – CONFERENCE EVENTS (GER) Výřez obrazovky EXAMPLE NHS CODE OF CONDUCT - UK INVITATIONS TO LUNCHES, CONFERENCES AND EVENTS INVITATIONS TO FREE ATTENDANCE OF CONFERENCES AND EVENTS NHS CODE Výřez obrazovky GERMAN CODE OF CONDUCT Výřez obrazovky DIRECT PAYMENTS FOR TREATMENT IF THE TREATMENT IS FULLY PAID BY THE PATIENT TREATMENT IS PARTIALLY PAID BY THE PATIENT TREATMENT IS PARTIALLY PAID BY THE PATIENT