Slovakia's public health system is facing a critical period this Christmas as doctors threaten to quit and parliament bans them from doing so.

Long underfunded, with low wages and decrepit facilities and outdated equipment, the public health system is currently suffering from an exodus of qualified medical staff to better paying jobs abroad and in the country's private sector. The crisis has been worsened by spending cuts to help bring the government budget down.

Slovakia’s healthcare labour union (LOZ) accused the country’s Ministry of Health of escalating the crisis in healthcare ahead of negotiations starting on December 16.

LOZ chair Peter Visolajský criticised the Minister of Health Kamil Šaško (Hlas) for widening the meeting to a tripartite format and for playing media games.  

“In the current situation, it is wholly clear that the more people, often with various interests in healthcare who have nothing to do with the memorandum between the Slovak government and LOZ, will take part in the discussion, the less probable it is that a consensus will be reached,” Visolajský told the country’s media.

He also said that LOZ “insists” that two-sided talks should take place between the ministry and LOZ and that the ministry’s move is “only escalating the situation in the hospitals”.

LOZ was backed by the labour union of nurses and midwives (OZ SaPA), which stated that “we consider this wide meeting to be an imitation of effort to solve issues of  Slovak healthcare and not a sincere interest in solving the situation”.  

In October, LOZ stated that close to 2,500 doctors are ready to quit their jobs in response to savings measures in healthcare and other steps of the sitting left-right cabinet of populist Prime Minister Robert Fico, which LOZ accuses of not observing the memorandum between LOZ and the government.

Earlier this month, media reported that over 3,300 doctors had filed papers to quit their jobs by the end of the year in a quick escalation of the situation reminiscent of late 2022, when the then centre-right cabinet of Eduard Heger averted a mass staff exodus.

The renewed tensions in healthcare already led to the resignation of Šaško's predecessor, Zuzana Dolinková (Hlas), who cited a lack of support in Fico’s cabinet in her efforts to improve the situation.

In an interview with bne Intellinews at the end of November, a senior legislator from the largest opposition party, liberal Progressive Slovakia (PS), Tomáš Valášek slammed Fico for not paying attention to the issues in healthcare. 

“How can a prime minister of a country where healthcare is collapsing declare that healthcare is not a premier’s issue to attend?” Valášek said, describing Fico's earlier statements as "rude" to "the whole electorate, not just Smer voters, but to all the citizens of this country, where we all have an issue accessing quality healthcare for us and our close ones.” 

Amid the looming paralysis of the country’s healthcare, the embattled ruling coalition passed a bill last week to make work in the healthcare sector mandatory if the government declares an emergency.

The bill was slammed by the opposition, which described it as blackmailing of healthcare workers. “There is still room for solutions as there are three weeks remaining before the end of the year,” PS legislator Oskar Dvořák told media last week and called on Fico to enter into negotiations with healthcare unions.

If turned into law, the bill would criminalise not providing duties required under emergency situations, including available healthcare.  

LOZ called on President Peter Pellegrini not to sign the bill into law.

“I would like to address an appeal to the president to consider signing this legislation, not to sign it, because it is clearly discriminatory and insulting towards doctors,” Dalibor Fedák of LOZ stated.  

During a regular political programme O 5 minút 12   [at 5 to 12] run by state broadcaster STVR, Pellegrini admitted that the situation of Fico’s coalition is reminiscent of the turbulent years 2020-2023 when three different cabinets ruled the country.

Pellegrini was also referring to the coalition rows, which left the coalition relying on the slimmest possible majority of 76 (in the parliament of 150).  He denied the speculation of far-right SNS leader Andrej Danko that he is plottingagainst the cabinet.

“I want to say very clearly, I am not thinking about, nor taking part in the fall of the government, and I do not want to appoint a caretaker government,” Pellegrini was quoted as saying by STVR.