Observation (CEACR) - adopted 2018, published 108th ILC session (2019)

Nursing Personnel Convention, 1977 (No. 149) - Poland (Ratification: 1980)

The Committee notes the observations of the all-Poland Alliance of Trade Unions (OPZZ) received on 31 August 2018, together with the Government’s report, as well as the Government’s reply to these observations, received on 22 October 2018.

Articles 2 and 5 of the Convention. National policy concerning nursing services and nursing personnel. Consultations with social partners. The Committee notes the detailed information provided by the Government on the measures taken to guarantee that nursing personnel are ensured adequate employment and working conditions, including in relation to career development and remuneration, as well as measures to promote increased interest in the nursing and midwifery professions. The Government reports that a team established by the Minister of Health in 2017 developed the “Strategy for the development of nursing and midwifery in Poland” (hereinafter “the Strategy”), a document setting out a series of actions, agreed in consultation with representatives of nurses and midwives, to be undertaken to improve the quality of nursing care for patients and working conditions for nurses. The Government indicates that the Minister of Health will take the Strategy into account in implementing the health-care policy. The OPZZ observes that the All-Poland Trade Union of Nurses and Midwives was the sole trade union to participate in the development of the Strategy. It adds that the Strategy does not make provision for financing of the actions to be taken, nor does it indicate the manner in which achievement of the objectives will be monitored, or clarify the weight to be accorded to the Strategy. The Committee notes that a salary agreement was concluded on 23 September 2015 between the National Professional Association of Nurses and Midwives, the National Council of Nurses and Midwives, the President of the National Health Fund and the Minister of Health. In its observations, the OPZZ expresses concern that a subsequent salary arrangement was concluded in July 2018, highlighting that both agreements were discussed with only one trade union, thereby discriminating against other trade unions, in violation of the Polish Constitution and the Trade Unions Act. In its reply to the OPZZ’s observations, the Government indicates that the agreement concluded by the Minister of Health with representatives of nurses in 2015 formed the basis for the draft of the relevant resolution of the Minister of Health, which was the subject to public consultations with the social partners. In this respect, the Committee notes the issuance of the resolution of the Minister of Health of 8 September 2015 on the general terms and conditions of contracts for the provision of health-care services, amended by the resolution issued by the Minister of Health on 14 October 2015, ensuring additional funds for the services rendered by nurses and midwives. The Government reports that the new resolution provides for an annual increase of the average monthly remuneration of nurses and midwives in the amount of 400 Polish zloty gross per year (4x400). The Committee notes the Government’s indication that the regulations apply only to nurses and midwives employed by entities having concluded contracts with the National Health Fund. The OPZZ alleges that the resolution of 8 September 2015 discriminates against other health-care sector workers, as it provides for annual increases only to the salaries of nurses and midwives, omitting other health sector professionals. It adds that the allocation of funds for salary increases for nurses and midwives is being implemented as agreed with trade unions representing nurses and midwives providing services on the premises of health service providers, thereby omitting many nurses and midwives that provide services in other settings. In its response, the Government indicates that the resolution of 8 September 2015 does not discriminate against other professional groups in the health-care sector or trade unions associated in organizations represented at the national level, because these organizations can bring matters of significant social or economic importance to the Social Dialogue Council, and express their opinions or initiate negotiations with respect to an agreement with a specific subjective and objective scope. The OPZZ also indicates that, since 2015, the funds allocated to increasing the salaries of nurses and midwives have been drawn from funds allocated by the National Health Fund for health-care services to patients. The Committee notes the information provided by the Government concerning the Act of 8 June 2017, on the manner of defining the lowest base salary of employees in the medical profession employed at medical facilities, including nurses and midwives. According to the Act, as of 1 July 2017, the lowest base salary of an employee practicing a medical profession, including nurses and midwives, was increased by at least 10 per cent of the difference between the lowest base salary and the base remuneration of the employee. The Government reports that an additional increase in the lowest base salary took place on 1 July 2018. The Committee requests the Government to provide updated information on the measures taken to ensure that nursing personnel are provided with employment and working conditions, including in relation to career prospects and remuneration, aimed at attracting individuals to the profession and retaining them in the nursing profession.