Why Ukraine's Frontline Doctors Still Didn't Receive Their Salary Bonuses, Despite State's Promises

07 May 2020 13:32

Medical workers have not yet received the 300% surcharge promised by the government and other additional money under the new package of the National Health Service of Ukraine. The Government says that the resolution has just come into force.EPA-EFE / PABLO GIANINAZZI

Who is now responsible for the surcharges promised by Ukraine's Ministry of Health and on what conditions will the National Health Service be able to sign contracts with medical institutions and transfer a further $558 million?

Ukraine's Ministry of Health and government have promised additional payments in March and April of 300% to the salaries of Ukrainian doctors treating patients with COVID-19. Various surcharges were earlier promised to doctors and local administrations in Ukraine, too.

But it seems like not everyone received these amounts.

Medical staff and doctors are in the highest risk zone during the pandemic. In Ukraine, 2,660 medical workers have already been infected with the coronavirus, which is about 20% of the total number of infected people across the country.

Who is now responsible for the surcharges promised by the Ministry of Health and on what conditions will the National Health Service of Ukraine be able to sign contracts with medical institutions and transfer a further 15 billion hryvnias ($558 million)?

Doctors Speaking Loudly

The fact that not all health workers have received the promised surcharges surfaced after the staff of the Kyiv City Clinical Hospital №8 in the Obolon district started protesting on April 30. It was attended mainly by nurses and paramedics, and there were no doctors among them.

"With such work and such patients – I wouldn’t call it a salary. I received 4,100 hryvnias ($152). We were given this in April. In March, I received 5,300 hryvnias ($197). Even though I work 150% [of my usual shifts],” the nurse, who declined to be named, explained the situation to hromadske.

In the Kyivan Facebook group "Life of the Minskyi Block – Obolon district" the post about this protest garnered over 5,000 reactions. In comments, employees of other medical institutions added photos and screenshots with the actual amounts of their salaries as proof that they did not receive an additional 300% in March and April.

“Doctors at Hospital №8 did not receive any additional payments for March because the head of the medical institution did not provide information on the treatment of patients with coronavirus infection,” Kyiv Mayor Vitaliy Klychko then said at a briefing.

A day after the action in Kyiv, employees of six brigades of Ternopil’s Second Emergency Medical Substation organized a one-minute protest. Doctors, paramedics and drivers took to the streets and turned on the car sirens.

"Today we demand that our salary be raised three times for the fact that we are still at the forefront. When we got to the fight against the coronavirus, a bonus of 300% [was announced] for all ambulance workers. However, the salary remains the same,” explained Oksana Oberleitner, an emergency physician.

Lyudmyla Ivaskiv, a paramedic of one of the brigades, showed a printout of salaries: “We did not receive any surcharges. Those we were promised and those that were meant to be paid to us. We take a lot of risks because we handle all calls, including coronavirus ones.”

Doctors Speaking Softly

Maiia Moskvych, a Donbas war veteran and founder of a shooting club, allowed hromadske to publish the story of her sister, who now works at the Volyn Regional Hospital. In the post, she encloses a screenshot with her sister's salary – a little over 2,000 hryvnias ($74):

Maiia Moskvych

We also talked to a nurse from Chernivtsi (where now more than 2,000 cases of coronavirus infection have been recorded in the region). The woman asked not to give her name and place of work. She says the hospital's management unofficially warns that it will fire and even open criminal cases for "inciting panic." Even though there are no such proceedings in the country.

The nurse says that due to a lack of personal protective equipment and a busy work schedule, she herself was hospitalized on suspicion of being infected with the coronavirus. It was not confirmed. Back in January, the woman said, she received more than 5,000 hryvnias ($186) in wages, and in April it was a little over 4,000 ($149).

But Olga Kobevko, an infectious disease doctor from Chernivtsi, admits she did receive a certain surcharge: “My salary is a little over 4,000 hryvnias ($149), I have a higher category and 13 years of experience. During the epidemic in March, we were given an extra net salary – these were funds allocated from the regional budget. In mid-April, we received our minimum wages and were very offended because we were promised so much by the state. But doctors are generally used to promises. Then we were genuinely paid a surcharge. On average, it amounted to 10,000 hryvnias ($372) for doctors and 7,000 hryvnias ($260) for nurses."

She also says that she is not a fan of one-off surcharges, and hopes that the extra money from doctors from the state is not a one-off deal, but a normal and adequate assessment of their work: “We are not service personnel, we are people who save lives. Doctors deserve the best so they don’t go abroad, but stay to help Ukrainians," says Kobevko.

Ольга Кобевко

Promises on the Ground

In addition to extra payments to doctors promised by the Ministry of Health, the authorities of some cities also offer assistance.

For example, Vitaliy Klychko announced on April 30 that the Kyiv City State Administration would allocate another 900 million hryvnias ($33.5 million) for additional payments to doctors in the capital.

Speaking to hromadske, Valentyna Ginzburg, director of the Kyiv City State Administration's health department, spoke about surcharges of nine salaries for work in March: "Kyivan authorities have allocated 10.8 million hryvnias ($402,000) for surcharges to all employees involved in treatment, and 12.4 million hryvnias ($461,000) to stimulate emergency medical staff."

According to her, on average, doctors received from 30,000 to 50,000 hryvnias ($1,116-1,860), nurses – from 25,000 to 30,000 hryvnias ($930-1,116), and junior staff – from 20,000 to 25,000 hryvnias ($744-930).

One of the paramedics in Kyiv contacted hromadske, but was afraid to be named in the material. He said that the management was threatening to fire for disseminating information about salaries, that they still did not have additional payments, and his colleagues were simply afraid to speak publicly about it: “I received about 7,000 hryvnias ($260) in April. This is taking into account the surcharges for the specifics of our work. But this is the same amount that we always received, even a little less. How can this be? And it’s the same with all my colleagues. The only thing is that in March I was paid a bonus of about 5,000 hryvnias ($186), but that is not the amount that Ginzburg from the Kyiv City State Administration mentioned."

He says that on calls, people often accuse doctors of making big money now. And this also affects the psychological state of ambulance workers. The paramedic is considering resigning. He says $260 is too low a price for their health.

In addition, ambulance workers were not initially included in the list of medical specialties, whose salaries will be tripled due to the epidemic.

So what about money for March?

The head of the Ministry of Health, Maksym Stepanov, assures that the government has indeed transferred all the money to the regions, and delays in payments are only occurring at the local level

"Manipulations have begun, and in some cases, I am told that payments are counted hourly or otherwise. This is unacceptable. Without exception, all payments must be made in full," he clarified.

Deputy Health Minister Svitlana Shatalova said on April 29 that the funds for surcharges were already in the regions: “The medical subvention to the tune of 552.8 million hryvnias ($20.56 million) was transferred to the regions on April 16. In addition, we have made an approximation from the last quarter of 2020 to April in the amount of 241.8 million ($9 million)."

Stepanov says that he has already sent letters to the heads of regional state administrations to report on each medical institution. He added that those who did not receive the promised salary should call the ministry's hotline to solve the problem.

An ambulance paramedic in Kyiv says that on calls people often accuse doctors of making a lot of money now. This also affects the psychological state of ambulance workers. Photo: EPA-EFE / VLAD STASOV

How will April work be paid for?

From April onwards, hospitals will receive payment for services through the National Health Service of Ukraine (NHSU). But the head of the NHSU press center, Lilia Hudz, says that they have not been able to start this process until the relevant decision of the government comes into force – it was not published on the website of the Cabinet of Ministers until May 4.

The allowance will be paid to those who provide inpatient care to patients with COVID-19. That is workers of mobile teams collecting materials for testing, and emergency medical teams that attend to patients. Moreover, they will help health care facilities that have treated patients with COVID-19, although they were not identified as support hospitals previously. The same resolution of the cabinet approved the tariffs for these services.

"I want to emphasize that the tariffs include additional payments to employees of healthcare facilities in the amount of up to 300% of wages, as well as providing patients with medicines and medical devices," said Deputy Health Minister Shatalova.

The same government decree came into force only on May 4. This is the reason why health workers have not yet received the promised 300% surcharge and other additional money under the new package of the National Health Service of Ukraine. Signing contracts with hospitals is set to begin in the near future.

"The moral basis of these surcharges is that often our doctors have to cover the shortcomings of the system. In my memory, the mechanisms for receiving funds always contain an element of injustice. At the government level, everything sounds great, and when the money goes to a particular doctor, it often turns into a farce and has no motivating effect. I'm not even sure that doctors are happy with these surcharges. I think that they would be more happy if they were provided with personal protective equipment and the necessary equipment properly," said Pavlo Kovtonyuk, former Deputy Minister of Health of Ukraine (2016-2019).

On May 6, Stepanov announced at a briefing that all physicians who had not received the 300% surcharge for March will do so by the end of this week. The minister has instructed all heads of regional departments to report about this by May 8.

Moreover, May 7 brought more positive news for Ukrainian medics – the parliament passed a bill that insures medics and equates them with soldiers serving on the frontline. A separate bill also increased the social protection of doctors.

For all the latest updates on the coronavirus in Ukraine, follow this link.