Remuneration

The level of remuneration in relation to earnings in other sectors is a good indication of the value that society places on its health services, and an important factor in their ability to attract and retain competent staff. Overall remuneration in public sector health services has deteriorated over the past decade in industrialized countries, apart from Japan and the United States. Cost-containment measures have often reduced public spending in the health sector and led in some countries to the replacement of highly qualified by less qualified or less experienced workers in order to reduce the sector's wage bill. Earnings tend to vary only slightly between the public and the private sector. In some countries there is a trend to replace central bargaining mechanisms by local or hospital based arrangements. The Nursing Personnel Recommendation, 1977 (No. 157) contains a special section on remuneration (number VII) which highlights the criteria for salary determination and payment procedures.