To eliminate COVID-19, establish infectious disease response system, and strengthen public healthcare!

The dramatic conclusion of labor-management negotiations before the start of the Health and Medical Workers’ Union!

Together with the public, we will surely overcome the pandemic. We will protect the health and life of the people in the medical field.

 

● To prepare standards for medical personnel responding to COVID-19! To institutionalize the life safety allowance!: To improve makeshift manpower management and enhance measures of forcing medical staff to take more burden!

● By 2025, to designate and operate at least one accountable medical institution for each of 70 mid-size care areas and specify the priority areas for the establishment of public hospitals: A new turning point for public health expansion!

● To establish optimal manpower standards for each occupation and institutionalize the ratio of patients to nurses: A historical opportunity to move to the Human Resources Standards Act!

● To implement a pilot project for a predictable and regular shift system: A turning point for shift reform!

● To eliminate five major unlicensed and illegal medical practices: a valuable opportunity to protect patients’ safety and people's lives

● To fully expand and implement the integrated nursing and care service system in acute-phase treatment providing hospitals with more than 300 beds by 2026: A turning point for resolving the burden of the public’s care costs

 

KHMU_Government Agreement_Press conference September2,Sep.docx

KHMU_Government Agreement_Press conference September2,Sep.pdf

 

To eliminate COVID-19, establish infectious disease response system, and strengthen public healthcare!

Briefing on Labor-Government Agreements for resolving health and medical workers’ issues

l  To prepare standards for medical personnel responding to COVID-19! To institutionalize the life safety allowance: To improve makeshift manpower management and enhance measures of forcing medical staff to take more burden!

 

l  By 2025, to designate and operate at least one accountable medical institution for each of 70 mid-size care areas and specify the priority areas for the establishment of public hospitals: A new turning point for public health expansion!

 

l  To establish optimal manpower standards for each occupation and institutionalize the ratio of patients to nurses: A historical opportunity to move to the Human Resources Standards Act!

 

l  To implement a pilot project for a predictable and regular shift system: A turning point for shift reform!

 

l  To eliminate five major unlicensed and illegal medical practices: a valuable opportunity to protect patients’ safety and people's lives

 

l  To fully expand and implement the integrated nursing and care service system in acute-phase treatment providing hospitals with more than 300 beds by 2026: A turning point for resolving the burden of the public’s care costs

 

1. As the union and the government have reached an agreement, we cancel the general industrial strike scheduled at 7 a.m. today.

 

 ○ The Korea Health and Medical Workers’ Union (KHMU) and the Ministry of Health and Welfare (MOHW) finally reached an agreement by narrowing the gap in our opinions on the remaining five issues after 11 hours of marathon negotiations, the 13^th-round labor-government negotiations starting at 3 p.m. on September 1, one day before the general strike.

 

○ The central executive committee and the board of delegates of the KHMU went through a procedure for collecting opinions on the final draft the union prepared through final coordination with the MOHW. After three hours of intense discussion at the temporary delegate meeting held online, 241 out of 246 registered delegates attended (98%) and 200 voted in favor (83%) to accept the final draft. Accordingly, KHMU president Na Soon-ja and Minister of Health and Welfare Kwon Deok-chul finally signed the labor-government agreement at 2 a.m. on September 2. As a result, the agreement was dramatically concluded after three months of negotiations between the KHMU and the MOHW, five hours before the strike began. Accordingly, the KHMU cancels the strike scheduled at 7:00 a.m. on September 2.

○ Through the negotiations, the two reached a very meaningful and fruitful agreement in relation to the expansion of public healthcare, the establishment of an infectious disease response system, the hiring of more health and medical personnel, and the improvement of treatment.

In particular, in order to establish an infectious disease response system and expand public healthcare, we have agreed on the preparation of standards for medical personnel responding to COVID-19, the institutionalization of the payment of life safety allowances to medical personnel responding to infectious diseases, the designation and operation of at least one accountable medical institution for each of 70 mid-size care areas by 2025, and support for construction, relocation, and extension of public hospitals, thereby laying out a foundation for preventing the exhaustion of personnel responding the pandemic, keeping their turnover low, and substantially expanding and strengthening public healthcare.

 

In addition, we have reached a groundbreaking turning point for addressing chronic personnel shortage and poor working conditions, hiring more health and medical personnel, and improving their treatment by agreeing on the establishment of optimal manpower standards for each occupation, the institutionalization of the actual ratio of patients to nurses, the expansion of the integrated nursing and care service system to acute-stage treatment providing hospitals with more than 300 beds by 2026, the expanded implementation of the training-only nurse system to private medical institutions, the application of the night care fee system and the fixed nighttime shift system to all medical institutions from January 2022, the eradication of the five major unlicensed and illegal medical practices, the implementation of a pilot project for a predictable and regular shift system, the enhancement of the system to limit the employment of non-regular workers, and the reduction of working hours of Blood Donation Center workers on Saturdays and holidays by two hours.

○ We would like to express our deepest gratitude to the people who have given us encouragement and support until such an agreement was reached. We will work harder to protect the health and life of the people in the medical field, while keeping in our hearts the strong interest in and support for the KHMU and our efforts to address the challenges raised by the pandemic: to expand public healthcare and increase health and medical personnel

 

 

2. We will tell you about key agreements between the union and the government.

 

○ The KHMU (president Na Soon-ja) and the MOHW (minister Kwon Deok-chul) have mutually confirmed that protecting the lives and health of the people from the pandemic and building a strong contagious disease response system is the demand from the public and one of the most important national challenges to overcome the pandemic, and also a social responsibility that the union and the government should address together.

 

○ Based on this shared perception, the KHMU and the MOHW sincerely discussed how to overcome the pandemic, establish an infectious disease response system, expand public healthcare, and increase the number of health and medical personnel. We had also in-depth discussions on the hiring of more health and medical personnel, the improvement of their working conditions and treatment, and the enhancement of their labor rights and interests so that health and medical workers who have sacrificed and devoted themselves to treating and caring for COVID-19 patients during the prolonged pandemic of 20 months, can take care of their patients in a better working environment.

 

○ Through 13 rounds of negotiations for three months from May 31 to September 1, 2021, the KHMU and the MOHW reached an agreement in the last negotiation one day ahead of the start of the general strike.

○ The major issues agreed are as follows.

 

 

1. Strengthening of public healthcare and establishment of an infectious disease response system

① Establishment of hospitals specializing in contagious diseases

▶ Strive to build four regional infectious disease hospitals by 2024 and construct three more hospitals

▶ Complete the construction of the Central Infectious Disease Hospital by 2026

 

② Standards for infectious disease responders

▶ Prepare standards for nurse arrangement per duty by COVID-19 severity by September and detailed action plans by October

▶ COVID-19 and cooperative hospitals to directly hire nurses if there is any shortage

▶ Infectious disease hospitals apply new personnel standards and adjust loss compensation for the period of designation.

▶ Promote policy research for setting up medical personnel standards to establish a hospital resource management system responding to new infectious diseases, including infectious disease hospitals and treatment of critically ill patients

 

③ Life safety allowances

▶ Institutionalize and implement the financial support system for medical personnel responding to contagious diseases (life safety allowance) in January 2022 (by revising the Infection Prevention Act)

▶ Life safety allowance to be supported by the government

 

④ Expansion of public hospitals and reinforcement of their functions

▶ Designate and operate at least one accountable medical institution for each of 70 mid-size care areas

▶ Determine whether to establish public hospitals in areas with a high demand of residents for such hospitals, including Ulsan, Gwangju, Daegu, Incheon, Dongbusan, and Jecheon, after discussions with the relevant local governments and the Ministry of Economy and Finance

▶ Support the relocation of Uijeongbu Medical Center, Yeongwol Medical Center, and Samcheok Medical Center to new facilities

▶ Extend regional medical centers and Red Cross hospitals with 400 beds or less, such as Masan Medical Center and Seosan Medical Center

▶ Establish a consultative body for promoting the expansion and strengthening of public healthcare, in which the KHMU participate

 

⑤ Expenses for preliminary feasibility studies to be covered by government funds

▶ Revise the preliminary feasibility study system first within 2021 for the expansion of public hospitals and strengthening their functions and strive to ensure the preliminary feasibility study exemption bill will pass the National Assembly

▶ Prepare measures to alleviate the financial burden of local governments, such as the provision of differential subsidies, within 2021 so that local governments with poor finances can establish local medical centers

 

⑥ Support for essential operating expenses and deficits for the public interest

▶ Complete policy research on the causes of the deficits for the public interest in the course of providing essential medical services in regional hub public hospitals within 2021

▶ Based on the research findings, plans to address the deficits and figure out the volume of financial resources by the first half of 2022

▶ Examine the purpose of special-purpose public hospitals and their operating conditions according to activities for the public interest and prepare improvement and support measures

 

⑦ Matters on the National Medical Center’s functions

▶ Improve clinical competency by relocating the National Medical Center to a new facility, thereby scaling up its size equivalent to a tertiary general hospital

▶ Actively support the establishment and operation of various national centers

▶ Establish an ISP strategy to promote the construction of public health and medical personnel database and the integrated emergency medical response system of public hospital

▶ Push forward the construction of the (tentatively) Public Health and Medical Development Center

 

⑧ Matters on the increase of doctors, such as the establishment of the National Medical Graduate School and the introduction of the local physician system

▶ Come up with a plan to improve the treatment environment and working conditions so that medical personnel can be appropriately deployed in the local, public, and essential sectors through legislation and social discussions

▶ Prepare and promote ways to increase doctors, including nurturing public doctors and introducing the local physician system

 

⑨ Change of the ministry in charge of national university hospitals

▶ Conduct inter-ministerial consultation on the law to change the ministry in charge of national university hospitals to the Ministry of Health and Welfare

⑩ Heightening of the public nature of private university hospitals and others

▶ Prepare measures to encourage and support the strengthening of public roles and functions of private university hospitals and small and medium private hospitals

▶ Prepare measures to heighten the public interest by examining the feasibility of institutionalizing the public interest-centered participatory medical corporations

 

⑪ Participation in public health governance

▶ Workers' organizations providing public health care to participate in the public health and medical policy deliberative committee

▶ Find a way for the workers' organizations to participate in the municipal and provincial public health and medical committee

 

⑫ Establishment of the medical safety net, etc.

▶ Promote social discussions on strengthening the medical safety net, such as providing more support for disastrous medical expenses, establishing the injury and sickness allowance system, and improving the self-funded expense cap system

 

2. Hiring of more health and medical personnel

① Standards for health and medical personnel by occupation

▶ Phase in personnel standards from 2022 by setting priorities of health and medical personnel, such as nurses and medical technicians, through surveys on actual conditions and research on optimal health and medical workers

▶ Further discuss the establishment of standards for employees at medical institutions based on the results of surveys on current conditions

▶ Build an integrated health and medical personnel information system within 2022

② Nursing grade system and integrated nursing and care service system

▶ Upgrade the nursing grade system to apply the actual ratio of patients to nurses and prepare the reform plan within 2022 and implement it in 2023

▶ Induce changes in the behavior of medical institutions by analyzing the current status of medical institutions that have not reported nursing grades, and if there is no improvement, adjust admission fees

▶ Prepare a plan to fully expand the integrated nursing and care service system to acute-phase treatment providing hospitals with 300 beds or more in the first half of 2022 and implement it by 2026

 

③ Training-only nurse system

▶ Maintain supports of this year for the system at national and public medical institutions

▶ Implement the system at private medical institutions as part of a pilot project for shift rotating from 2022 before fully expanding it

 

④ Night care fees, night nurse management fees

▶ Night care fees and fixed nighttime shift management fees will be applied to all medical institutions including tertiary general hospitals from January 2022 after discussions by the Health Insurance Policy Deliberative Committee.

 

⑤ Eradication of illegal medical practices

▶ Eradicate unlicensed and illegal medical practices such as proxy prescriptions and illegal consent forms, procedures and surgeries, dispensing of medication, and medication guidance at medical institutions

▶ Prevent medical staff from instructing unlicensed medical practices in the medical field by specifying rules on the scope of work according to the licenses of doctors and medical support personnel and applying them from 2023 after public hearings and verification of application on the medical sites.

▶ Strengthen punishment for and prepare eradication of illegal medical practices, including the expansion of reasons for medical personnel’s disqualifications, in order to prepare cases of committing illegal medical practices outside the scope of the license for proxy prescriptions, preparation of consent forms, procedures and surgeries, dispensing of medicine, and medication guidance, including medical practices, performed using the license of other medical personnel

⑥ Improvement of the shift rotating system

▶ Prepare a pilot project and plan including a predictable and regular shift system within 2021 and implement them by March 2022.

▶ Secure sufficient financial resources to expand the scale and scope of the pilot project and form and operate a working group for the project in which hospitals, nursing, and labor groups participate together so as to facilitate acceptance of the system in the hospital field

 

⑦ Five-day working system put in place at medical institutions

▶ In order to ensure that a five-day working system and the medical communication system can take root at medical institutions, the labor union and the government work together to identify the current status of outpatient services on Saturday at the general hospital level or higher and prepare measures for improvement

⑧ Hiring of non-regular workers

▶ In order to provide high-quality medical services and ensure the job security of healthcare workers, prepare measures to reform the system so that medical institutions will reduce the number of non-regular workers

* For example, inclusion of the ratio of regular workers by occupation to the standards for the designation of tertiary general hospitals, the criteria for the medical institution evaluation, the standards for medical quality evaluation-based subsidies, etc.

 

3. Exception in the application of total labor cost-related regulations

▶ When it comes to the labor cost support, such as night care fees according to this agreement, accept an application by an individual institution for an exception for total labor cost-related rules

 

4. Government-ruling party consultation

▶ The government and the ruling party to make the consultation on and implement the matters specified in this agreement related to life safety allowance, the exemption from preliminary feasibility studies, training-only nurse system, the exemption for the application of total labor costs, and supports for public interest-driven deficits

 

5. Support by the Prime Minister's Office

▶ The KHMU and the MOHW check the implementation to ensure that the abovementioned agreements are faithfully honored in the policy process and in the medical field, while the Prime Minister's Office supports inter-ministerial coordination.

 

6. Annexed agreements to enhance the public interest by sector

① Matters related to the improvement of the operation of rehabilitation and nursing hospitals

▶ Promote a plan within 2021 to allow applicable workers’ groups to participate in the steering committee of a rehabilitation and medical institution

▶ Examine the improvement of the consigned operation of regional rehabilitation hospitals and public nursing hospitals and the revision to standards for night shift arrangement at nursing hospitals while closely cooperate with and collecting sufficient opinions from the labor circle

▶ Prepare continuous support measures to strengthen weak infection control of nursing hospitals, etc.

 

② Matters related to enhancing the quality of mental healthcare services

▶ Establish governance to collect opinions for mental health policy from labor groups and civil society

▶ Strive to enhance the standards for workers at mental health institutions under the Mental Health and Welfare Act, conduct research on the improvement of manpower standards in 2022, and allow the labor circle to participate in deliberative groups during research

▶ Overhaul laws and systems to enhance the public interest of the mental healthcare sector, such as designation and operation of regional mental emergency medical centers

▶ Gather opinions from the labor community for research and discussion to define the functions of the mental health and welfare centers and improve the treatment of workers in the field

 

③ Matters related to the stabilization of blood supply and the operation of blood donation centers

▶ Operate a tripartite deliberative body of labor, management and government to discuss the improvement of the blood-related working environment, the stabilization of blood supply, and the development direction of the blood-related business

▶ The operating hours of Korean Red Cross blood donation centers will be determined by the labor and the management, taking into account the timing of the establishment of the center, the amount of blood collected, the optimal arrangement of workers and operation efficiency, the distribution of blood donation centers, and precautionary measures for blood donors, and be implemented. after consultation with the MOHW.

▶ Shorten the operating hours of Korean Red Cross blood donation centers to 18:00 on Saturdays and holidays (effective on October 1, 2021)

 

 

○ The agreements made by the KHMU and the MOHW have the following significance.

First, we have established hospitals specializing in infectious diseases and prepared the standards and compensation plans for medical personnel responding to COVID-19, thereby providing an opportunity to put a proper response system in place, instead of a rule-of-thumb response, and helping to lay a foundation to address makeshift manpower management that demands medical workers’ sacrifice and depends on temporarily dispatched personnel.

Second, we have come up with a concrete plan to expand public healthcare and measures to revise the legal systems and secure financial resources to back up the plan, making it possible to expand public healthcare in a practical and speedy manner.

Third, we have reached a turning point to address chronic manpower shortage and improve poor working conditions by preparing the manpower standards for each occupation, institutionalizing the ratio of patients to nurses, revising the shift rotating system in a regular and sustainable manner, fully expanding the training-only nurse system, fully introducing the integrated nursing and care service system by 2026, applying the night care fees and fixed nighttime shift management fees to all medical institutions, eradicating five major unlicensed and illegal medical practices, and specifying the scope of work.

 

3. The KHMU will tell you about our future plans.

 

Though we cancel the general industrial strike with the conclusion of today's labor-government negotiations, we still have on-site negotiations with each medical institution. We will do our best to reach an amicable agreement by setting a one-week period for intensive negotiations from today to Tuesday, September 7 next week to reach a complete agreement in on-site negotiations.

 

However, if there are any medical institutions that engage in insincere and high-handed bargaining, and ignore and suppress the union, we will let the public know about their wrong behavior and should correct the wrong practices through intensive industrial struggles with our 80,000 members.

 

We also appeal to the government and the National Assembly. The general strike we prepared was the last hope for health and medical workers who ended up standing on the brink after they were exhausted and driven to resign, after they cried out, “I can’t stand it any longer,” “Nothing will last in this way.” It was not a strike to raise wages or to satisfy selfish greed, but to protect the lives and safety of the people. It was not the strike aimed at a medical crisis amidst the pandemic, but the most desperate strike in the world to prevent the collapse of quarantine and medical services.

 

Today's agreement is not the end for us. The Prime Minister's Office promised support, such as adjustment of the roles among ministries, so that today's agreements are faithfully implemented. We urge the government to play a responsible role in putting today’s agreements into practice. In addition, we call on the National Assembly to take the responsibility for performing its role in revising related acts and expanding the budget in the upcoming regular session.

 

The KHMU will continue to fulfill our social responsibility for the safety of patients and the provision of quality medical services with pride and duty to protect the health and life of the people. Thank you.