When Itziar Fortuny started working as an emergency doctor at the Hospital de la Paz in Madrid in 2003, she got a part-time contract. The other half she covered by making guards. After a few gap contracts, he got an interim job at Infanta Sofía five years later. Since then it has remained in the same place. “I’ve been in the ER for 19 years and not even one opponent has come out who has applied for a permanent position,” he laments.
In fact, two calls came out: both were canceled. “I studied for free and paid fees,” he says. His career is no exception in the health sector, where temporary work accounts for 40%, according to a December 2021 report by the workers’ commissions. Starting with sick leave, maternity, summer replacements and finally in a temporary position for five years, it is common; and not getting a place in property until over fifty, although there are those who retire without taking possession. This provisional nature has consequences: charging less than the established fees and not being able to plan the race or transfers.
The government wants to solve this with a royal decree that the Council of Ministers wants to pass on Tuesday. He expects that 67,300 interim positions will become permanent and wants to prevent similar cases of contingencies from forming again. It is forbidden by law to hold a position longer than three years. The Autonomous Communities must then cover them with permanent staff. This, Health Ministry sources explain, does not mean that a person cannot make this transition period if they change travel destinations. Places are determined, not people, although most often the norm will benefit whoever occupies it.
There are two formulas: those temporarily and continuously occupied before January 1, 2016 go to a merit contest. And those who find themselves in this situation for at least the three years prior to December 31, 2020 will go into contest opposition. This includes not only theoretically configurable positions or those that are in the list of positions, but all those that are actually filled.
The decree will bring order to a totally anomalous situation, enable the best professional development of health workers and eliminate the insecurity of those who fill the permanent posts and, to a certain extent, of their patients. But as some unions in the sector point out, it will not help solve structural problems in the National Health System (SNS), such as the shortage of GPs or the difficulties hospitals and health centers are facing this summer.
Tomás Cobo, President of the Collegiate Medical Organization, explains that the formula has been agreed with the Inter-Territorial Council of the National Health System and with the unions. “Although it is true that it is the European Union that is forcing us [el organismo reprochó a España la temporalidad que tenían en el empleo público, lo que llevó a una profunda reforma para reducir los interinos], the royal decree is realistic and is intended to try to solve one of the serious bankruptcies of our national health system, precariousness. The other two are salaries, which are lower than in the EU, and medical training. But in my opinion, this is the most important of the three. It will enable many professionals to set up projects for the future and for the family,” he emphasizes.
Although it may seem like good news for the sector, some healthcare professionals, who after many years of resistance have been given a place, are suspicious of this regularization, which in many cases leads to professionals going straight to permanent contracts without passing an exam .
Sonia Melantuche, 49, has followed the same path as many of those who are now benefiting from regularization. Except that the last public job offer she was presented with in 2019 was number 50. Although the call is undecided, she is virtually certain that she will retain the position of warden, which he has held at Móstoles Hospital for more than 13 years. Before that, the usual: substitution contracts, losses. “The atmosphere is disturbed. We don’t think it’s fair that you had to apply for a job three years ago and now just give it away for the time worked, which will be almost 90% of the scale. Those of us in my situation are super outraged,” he protests.
Elia Fernández, another guard working in Asturias who is likely to benefit from the government’s action, understands the complaint: “I understand that there are critics. I put myself in their place: they were in sacks and admitted contradiction. But they have to understand that we have been there for many years and that experience is a degree, we have been there through thick and thin. It’s compensation for all the years we’ve had.”
She was caught just before retirement. He is 62 years old and given the rhythms with which public administrations operate, it is not even clear whether he will take office before his retirement. He has been employed at the Valle de Nalón Hospital since 2008 and has worked at the SNS for almost three decades. “What happens is that time goes by and the job offers don’t come out. And the people who end up occupying the seats sit down. The years go by and you don’t have much energy left to prepare the opposites when they are called,” he explains.
Disadvantages of not having the space
However, the interim has more downsides than the simple fact that the place is unowned. There is no professional career for them, resulting in a lower salary and no opportunity to move or advance in their job. Eduardo Jara, a nurse at the Puerta de Hierro in Madrid, calculates that after 24 years of interim work he earns 700 euros gross less per month than if he owned the place.
There are many reasons why these skilled workers have not achieved permanent employment. From the case of Fortuny, the first testimony of this report, who did not stand a chance due to the lack of calls, to that of Jara, who says that in the successive oppositions it was not possible for him to get the seat: “ The first was very easy , but it was designed so that those who had worked with it for more than 15 years could get it. I got a 10, but since I didn’t have enough seniority, I was left out. In another, I passed at six and a little and stayed at the gates. Then years went by without a call. And the last one from 2019 is not solved yet.”
Alejandro Cruz, a 30-year-old nurse from Almería, has not yet reached this situation. It is in the previous phase, the chaining of substitution or accident contracts. He has been 17 since returning from Manchester in 2018. “They even gave me a contract from December 1st to 15th and another one from December 16th to 31st,” he says. After completing his studies, he went to the UK, attracted by better working conditions than in Spain. And he found them: more salary and better education. But after three years he decided to return for family reasons.
“There, when they changed your position, they trained you for a month to adapt to the new one. Because it is not the same, for example, to work in an oncology day clinic as in a cardiology ward or in an intensive care unit. In Spain you are still shifted from week to week and you arrive without knowing your job. You end up learning them, but it also ends up hurting patient care.”
The new rule will try to prevent this. He wants to reduce temporary work to 8% and only allow this type of contract if there is really a reason. “For example, when lab workers are hired to analyze monkeypox, it’s normal for them to be temporary,” a Health source explains. “But if those positions are still active after three years or have been converted to another role within the hospital, they must become permanent,” he adds.