On October 6, 2020, the Parliament adopted Act C of 2020 on the Status of Healthcare Professionals (“Status Act”). The new regulatory environment applies to physicians working for state and municipally maintained healthcare providers. The primary legislative goal was to create better wage conditions and a more transparent public healthcare system.
In addition to significant changes in the wages, the new Status Act stipulates that a person employed under the Status Act may enter a parallel employment relationship, with the prior consent of a body designated by the Hungarian Government (except for certain activities), to prevent the fusion of private and public healthcare.
However, the Status Act entered into force on January 1, 2021, under which healthcare professionals (“HCPs”) are entitled to statutory increased wages but the transformation of their new status and the starting date of this new legal relationship will only take place on March 1, 2021, following the signing of a new employment contract establishing their status.
The main cause of this transition period between January 1 and February 28, 2021 is that the detailed specifications on the HCPs status, including the additional allowances and the regulation on parallel employment, will be drawn up during this time. In connection with these two important regulatory fields, the resolutions of the National Director of Hospitals (“NDH”) was published on February 9, 2021.
1. Resolution on the Additional Allowances of the HCPs
Annex 1 of the Status Act determines the wages of HCPs. In Annex 1, only the years of service are considered as a factor for determining the wages of HCPs. Based on the annual performance evaluations of the HCPs, as prepared by their employers, it is possible to increase their wages by a maximum of 20% compared to wages constituted in Annex 1 of the Status Act.
Resolution No. 1/2021 of the NDH summarizes the detailed rules of the additional allowances, which already concern many HCPs. Additional allowance can be provided to HCPs inter alia as an on-call duty and standby fee or as a supplement for the specialization and qualification of the HCP. Pursuant to the resolution, the remuneration for the on-call duty will be as follows from March 1, 2021:
- on weekdays or in case of a different work schedule working days on the weekend, 70% of the employee's hourly wage;
- if the on-call duty falls on a weekly rest day, 80% of the hourly wage; and,
- if it falls on a public holiday, 90% of the hourly wage.
The NDH may increase the above remunerations by 10%, taking into account the level of patient turnover and progressivity level of the healthcare institutions.
The amount of the standby fee is determined as 25% of the hourly wage of the HCP, and it may not exceed HUF 30,000 gross for the entire standby period.
The NDHs resolution also introduces a specialization and qualification supplement that accounts for the HCPs scientific degree and qualification. In addition to the on-call, standby fees, or the qualification and specialization allowance, the resolution also includes the rules of the shift allowance, the replacement fee, the salary supplements, and the executive allowance.
The resolution also introduces the “bonus” concept, according to which HCPs with continuous outstanding results related to their work may be eligible to bonuses awarded by the person exercising the employer's right.
2. Regulations on the Authorization Process of Parallel Employments
Resolution No. 2/2021 issued by the NDH provides rules on the activities which can be performed without authorization, activities that can and cannot be authorized, and on the authorization procedure.
According to the resolution, the following activities may be performed without the prior consent of the designated body, in parallel with the services performed under the Status Act:
- scientific, educational (including examiner activities), art, lecturers, editorial activities under legal protection of intellectual property if the HCPs working hours are not impacted;
- forensic expert and specialist activities;
- activities of a deceased examination consultant;
- holding a position in the medical chamber,
- healthcare activities in social institutions; and,
- conduction of donor aptitude tests.
Pursuant to the NDHs resolution, the designated body may authorize HCPs to perform the following activities in parallel with the medical service rendered under the Status Act:
- non-medical activities;
- medical activities, if it does not affect the HCPs working hours;
- scientific, educational (including examination activities), art, lecturers, editor activities under legal protection of intellectual property if the HCPs working hours are impacted; and,
- additional activities, which fall under the scope of the Status Act and is needed for the supply of the healthcare system, provided that the parallel activity impacts the working hours of the HCP.
The resolution clearly states that (apart from the above exceptions) no other activity may be permitted which impacts the regular working hours of the HCPs.
The authorization procedure is carried out electronically and in each case the HCP must attach to the application a statement testifying the support of the HCP's immediate supervisor to establish a legal relationship outside of the scope of the Status Act. From March 1, 2021, the designated licensing body will be the Legal Deputy Director of the Human Policy Department of the National Hospital Directorate, who will be required to make a reasoned decision within eight (8) days following receipt of the application.