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Labour relationsLabour relations in the health services are very complex: different labour legislation applies in public institutions and in the private sector; the services may be subject to national as well as to local regulations; the wide range of personnel has differing professional qualifications and occupational interests; at least in large units there is a highly structured system of work organization; and as the sector provides an essential service to the public, restrictions on trade union rights might be deemed necessary by the authorities. Labour relation systems in this sector evolved in many countries only in the 1980s. The right to strike varies greatly. In countries with no legal restrictions, employers and workers reach mostly voluntary agreements on minimum services during labour disputes. Other countries make this a legal requirement. Some countries prohibit all strike action in this sector, either on the grounds that the sector performs essential services or as part of the ban on industrial action applying to the public sector. The decentralization of bargaining has been perceived as a
challenge as well as an opportunity for the various stakeholders, depending on
the negotiation skills and resources available to them at the different levels
of the health system. The move from centralised bargaining has often required
a significant training effort within organisations or services and a decentralisation
of finances as well as responsibilities for the social partners. Social dialogue Social dialogue in the health services: A tool for practical guidance was developed based on the Conclusions of the Joint Meeting on Social Dialogue in the Health Services: Institutions, Capacity and Effectiveness, held in October 2002. The Tool has reached policy makers as well as those persons who plan and organize processes of social dialogue in the health services by providing instruments to manage and to facilitate processes of social dialogue and by offering guidance on issues to be considered. In order to complement the Tool, a Handbook for practitioners has been developed as a companion document to provide practical direction for the facilitators and organizers of the ILO constituents and other stakeholders in health services. Practitioners will thus have access to a series of useful advice and exercises to assist them in either conducting training courses for participants in social dialogue, or in actually implementing social dialogue processes. Two country case studies are also available as working papers: |
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