The Federation 'Solidaritatea Sanitară' from Romania (FSSR) has expressed its support for the principle of supplementary salaries based on performance within the healthcare sector, but it firmly opposes the form proposed by the Ministry of Health. The federation argues that the draft law currently under public debate is fundamentally flawed and violates numerous legal and contractual provisions regarding salaries.
In a statement released on April 15, 2025, the FSSR emphasized that the principle of performance-based supplementary salaries has been a consistent demand made to all governments over the past decades. This principle is also reflected in the new salary law project developed in collaboration with representatives from the Ministry of Health and other social dialogue partners, which includes a significant dimension of performance-based supplementary salaries aimed at all categories of healthcare employees.
However, the FSSR does not support the draft law recently launched for public debate by the Ministry of Health. They argue that it was developed in flagrant violation of legal and contractual provisions and does not meet the minimum conditions necessary for implementing supplementary salaries based on performance. The federation pointed out that the procedure used by the Ministry in drafting this law violates social dialogue rules, several legal provisions, and express and imperative provisions of the collective labor agreement.
One of the key objections raised by the FSSR is that introducing performance-based supplementary salaries before addressing existing salary inequities will only exacerbate employee demotivation. They highlighted that the current salary system for healthcare professionals is riddled with glaring injustices, which are becoming increasingly visible in social terms. For instance, additional shifts have been paid at the base salary level since January 2018, and the healthcare system remains the only public sector that has not implemented Law 153/2017 for certain employee categories. This has resulted in significant difficulties in ensuring shifts in public hospitals, affecting both healthcare professionals and patients.
Moreover, the FSSR noted that over 80% of healthcare professionals have work condition bonuses below the minimum level established by Government Decision no. 153/2018. The public health system also has employees with the highest average duration of professional life, with some exceeding 60 years, and the largest number of professionals working under particularly dangerous conditions. The federation argues that before discussing performance-based salaries, it is essential to update the hourly rate for additional shifts to align with the current base salary.
Additionally, the FSSR criticized the draft law for not covering all categories of personnel in the public health system, which they believe introduces another major distortion in the system that affects both the medical team and the overall collaborative relationships among employees. They also raised concerns over the lack of necessary funding to implement a performance-based payment system, as the proposed model relies on a variable funding source that varies from one hospital to another, leading to uncertainty about its existence.
In response to these issues, the FSSR has initiated a working group to develop an alternative draft law that adheres to the principles of performance-based supplementary salaries and is coherent with existing normative acts. They are inviting professional bodies to collaborate on creating a performance evaluation system based on relevant criteria and objective procedures.
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Public hospitals in Romania can grant merit allowances to medical and sanitary personnel from their own revenues, provided they stay within the budget limits and based on performance evaluations. These allowances can be up to 2% of the basic salary expenses, with an annual cap of six minimum gross salaries.
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As the healthcare sector continues to grapple with these challenges, the need for an equitable and coherent salary system that acknowledges the complexities of performance evaluation remains a pressing issue. The FSSR's ongoing efforts to advocate for fair treatment of healthcare professionals reflect the broader struggles within the public health system.
