Case study - IPiN |
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Case study: “Collective dispute between doctors and hospital management” In October 2007 the consultants from Markert Mediacje mediated in a dispute between the doctors on strike and the management of the Institute of Psychiatry and Neurology in Warsaw. After several weeks of intensive negotiations: six mediation meetings lasting several hours each on 31 October 2007 the parties signed an agreement in the presence of mediators from Markert Mediacje. Kinga Markert and Alicja Krata, the mediators, and Agnieszka Polska, a restructuring consultant, were involved in the mediation process. Parties of the conflict 1. Local Branch of the Doctors’ National Trade Union at the Institute of Psychiatry and Neurology in Warsaw (IPiN), which was represented by the Strike Committee. Five doctors were involved in the mediation process. 2. Management of IPiN, which was represented by 4 persons, including the Institute's Managing Director. History of the dispute prior to start of the mediation The collective dispute started in spring 2007. It focused around salary-related postulates of the doctors. As a result of obtaining information on the very difficult financial situation of the Institute, the issue of IPiN restructuring very quickly became the next important element of the dispute. In the earlier years the Institute not only had no debt but even some savings. During the first stage of the dispute, since 31 May, a strike following a relevant referendum started in the IPiN. It involved: · not filling in the documentation for settling the accounts with NFZ (National Medical Fund) · stopping scheduled admittance of patients to clinics and wards · reduction of the number of doctor's appointments in clinics · partial absence from work, that is ending work at noon. Meanwhile, talks between the strike committee and the hospital management continued. At the end of June an agreement was signed by virtue of which the strike was suspended on 27 June. One of the conclusions was a commitment made by the management to present the program of IPiN restructuring by 27 June, which would enable salary rises for doctors. Since in the doctors’ opinion the management failed to present a restructuring plan that was satisfactory for them, thus the strike was restarted on 10 October. This time the strike involved, among others: · not filling in the documentation for settling the accounts with NFZ (National Medical Fund) · taking the ”on request” vacation leaves · handing notices to terminate employment · declarations of changing the place of specialty training · starting a hunger strike. Course of mediations On 9 October the representatives of the doctors on strike contacted Markert Mediacje. Following a phone conversation an offer was presented as regards the mediation process aimed at ending the dispute. The offer was first accepted by one of the parties of the dispute (the doctors). Following a meeting with Markert Mediacje, the other party of the dispute (the hospital's management) expressed consent to commencing the negotiations conducted by a third, neutral party. Separate preparatory meetings of the mediators with each of the parties took place first, followed by 6 mediation sessions between 19 and 31 October. At the last session, on 31 October, a composition agreement was signed by the representatives of the doctors, the management and the mediators. The strike was suspended till 15 January 2008, that is till the moment when the most important provisions of the agreement, related to salary rises for the doctors, are to be fulfilled. The main goal of the negotiations was to reach an agreement related to salary rises but also to the hospital's restructuring and the method of its management. The role of the mediators during the dispute at IPiN was to act as intermediaries in the dispute so as to conclude a mutually satisfactory and voluntary agreement. First, the mediators organized mediation meetings: they brought about a selection of the parties' representatives, set the dates and duration of meetings as well as their place. Second, they helped determine time schedules of the meetings as well as topics to be raised and their sequence. The role of the mediators was to make sure that the set agenda was followed or obtain the parties' consent to potential changes. Third, the mediator played the role of a facilitator in the discussions: she gave permission to speak, made sure that order was observed (statements were not interrupted, speakers stuck to the topic, time was observed as regards the duration of statements, etc.). The mediator took care of the balance between the parties as regards the possibility to speak and present one's arguments. The mediator's task was to motivate the parties to come up with various ways of solving the conflict on their own, so that the ways of solving the conflict would coincide with the parties' interests. When the agreement was being reached, the mediator made sure that all the arrangements were recorded in the agreement. She also checked the feasibility of fulfilling the commitments and made sure that arrangements were satisfactory and realistic for the parties of the dispute. Concluding the agreement The strike was suspended on the date of signing the agreement, that is on 31 October. The agreement contained numerous mutually accepted arrangements regarding the bonuses and salary rises for the doctors along with the time schedule of their introduction. In addition, it specified such issues as: the schedule of restructuring hospitals, the guarantees for the parties involved in the strike, improvement of social welfare conditions as well as conditions of patients' treatment. Simultaneously with signing the agreement some 60 doctors handed in their conditional notices to terminate employment. These notices served as a guarantee by the other party of meeting the commitments found in the agreement. The management promised to hire the doctors again on the same terms should the dispute be ended successfully. The realization of the notices to terminate employment, if the terms of the mediation agreement were not met, poses a threat of the wards in the Institute being closed effective 1 February 2008. This will prevent providing psychiatric and neurological care to at least 300 thousand inhabitants of several districts of Warsaw: Mokotów, Ursynów and Wilanów. Opinions regarding the mediation process: Kama Katarasińska-Pierzgalska – the representative of the doctors on strike: “We asked the mediators since we had the feeling that negotiating with the hospital's Board on our own was not constructive, chaotic and did not lead to any rational conclusions. Before the talks were started with the involvement of the mediators, conflicts flickered and intensified until they finally exploded. Thanks to the mediations we could reach the agreement. The mediation process structured our meetings. It disciplined both parties to discuss specific problems which could be solved instead of just mutually expressing resentment. It reduced the temperature. There was a conflict but not a quarrel. Our party had the feeling that we were listened to and finally treated like a partner rather than a subordinate. The mediations shortened the time of negotiations and reaching the agreement. They enabled us to specify our expectations in detail. We do not rule out the possibility of returning to mediations if the important items of the agreement are not fulfilled. Prof. Danuta Ryglewicz – Director of Psychiatry and Neurology Institute “Initially I was against hiring the mediators. However, I am happy that I was persuaded to do so. The involvement of a third, neutral party accelerated the process of reaching the agreement. Markert Mediacje mediators did not allow us to diverge from the topic and efficiently managed our negotiations. They helped us reach the agreement.” |
