Sanitary, a life chaining contracts without a fixed place





“They are contracts for one day, two days, one week, ten days. So, until they give you a four-month leave. The drop is over and you re-enlist with contracts of one, two, three days. A week later you are unemployed, and so on”. A midwife, who prefers to remain anonymous, describes to RTVE.es her work experience for a year and until now: an ordeal of contracts that, be it intermittent or chained, she does not think will end soon.

“Many times you find yourself in the situation of combining two jobs at the same time with a 150% working day for what may happen. You don’t know what it’s going to be like when you’re unemployed, how long it’s going to last,” she continues. In his opinion, this “precariousness” is more frequent in specialized nursing in gynecology and obstetrics, but the abuse of temporary contracts crosses the Health throughout Spain.

The Council of Ministers will approve this Tuesday a Royal Decree with the aim of fix a total of 67,300 toilets, according to government figures. The new statute will prohibit interims from being able to chain temporary contracts for more than three years. Therefore, the communities would have to Create vacancies to fill with permanent staff. However, the sector is still suspicious about how the process will be carried out, which depends on the autonomies, and they judge it insufficient to reverse a perversion of the system that, they say, is long overdue.

No stability on the horizon: from day to interim contracts

On paper, the measure to reduce temporary employment in public employment could benefit Samuel García, an internist with a contract interim since 2016 in Bilbao. “Now I don’t have to sign every month, but the rights are the same as for a temporary worker,” he says.

He, who approved the opposition, but did not get one of the thirty permanent places that were offered, wonders why then fewer fixed contracts came out than the service really needed. And the proof that his position did require a structural form is that he has been in it ever since. Thus, he considers that consolidation will be a good patch for that gap, but he does not believe that it will solve the underlying problem.

“The selection and provision of human resources system, which dates back more than 20 years, is what has led us to this,” he laments. “It is not understood that there is no legislation that says the maximum time that can pass from an opposition, which is how precariousness is combated. Nor has it been considered how penalize administrations that fail to comply. (…) It cannot be that during these five years, when more people have retired, there has not been a replacement system.

In addition, until the interim arrives, it is usual spend years “without any type of labor guarantee”, as described by Rocío Belda, a gynecologist in Valencia and co-founder of the Asociación Médicos Unidos por sus Derechos (MUD).

In his case, he tells us, since he finished his residency in August of last year, He has linked two contracts, but now he is unemployed. The first of them, as a doctor on duty and without a base salary, for which he only received the hours he worked. And the second, with a base salary of 1,200 euros, which ended on the eve of our conversation. With no opposition in sight, his prospects are not rosy.

“We are changing from one place to another because the system has forced us. She is like a trap, ”says the gynecology specialist, who does not rule out going to France in search of better conditions and after a decade training in Spanish universities and public hospitals. “They say there is a lack of doctors and there is no lack of doctors, there are no permanent vacancies.”

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Living from day to day, without long-term plans: “We are skeptical and tired”

At the moment, Belda assures that she distrusts the announcement “until she sees in permanent positions the colleagues who have been changing hospitals for ten years and leaving their lives for the people.” “We are skeptical and tired,” he says.. According to the association of which he is a member, 42% of doctors do not have a fixed contract and this impacts the life plans of professionals and their families.

“I have a colleague who is currently in unemployed with three children and this is happening throughout Spain”, he denounces, and recalls that the 67,000 permanent jobs promised by the Government must distributed among all kinds of professionals in the sector.

Other concerns are repeated in all the professionals consulted by RTVE.es: the difficulty in buying and even renting a living place, because there is no stable contract; have to give up plans with family and friends during vacations, if the hospital calls you to work “from today to yesterday”; and don’t even think about having sons As long as the job changes every six months.

“It translates into anxiety, there are times that I wake up at night and I am thinking about the date on which my contract is going to end”, settles the midwife, who lives in the Community of Madrid, but is registered in the employment exchanges of other autonomies so that may arise. But even the bags have their double edge: “they have you tied hand and foot, because you cannot give up a position. In Madrid I would be penalized 12 months without working”.

Temporality brings precariousness: “There is no no”

And with contracts hanging by a thread, working conditions are devalued. Josep Maria Giribert, a nurse in Catalonia, describes it quickly: “There is no no”, you are there for “whatever they ask of you”. As a consequence, he lists the days off that he has not enjoyed or that he has had to take when it did not suit him. “Then, you have worked all year and you have not taken a single day of vacation. Or you had to take it on a Wednesday, one day here and another there, which is when it came in handy”, he says.

But the situation also affects the public service given to citizens and, ultimately, in the health of patients. “It makes tracking difficult. If I have a complex cure and the next day a colleague sees it and then another, it is not the same as if you have a nurse who can see the progression”, explains Giribert, who also considers it important to build a relationship of trust with patients.

“I see you more tired, María’”, pronounces the nurse, in an attempt to reconstruct one of those scenes in which the human component can outweigh the knowledge acquired at university. In his 12-person unit, only four colleagues have a fixed contract. In the medical team, he says, the situation is even worse.

Thus, in all of this, the opinion that the system is failing in its talent management is a transversal opinion among professionals in medicine, nursing and other health fields. “You see things like they change you from a service in which you have been trained and they take a new person there. So you think: Am I a number that they are moving or do they really care if I have experience or not in that area?” asks Cristina Díaz, another nurse in the Community of Madrid.

“You’ve still been in the ICU for two weeks and you’ve only had time to go home feeling unwell because you don’t master everything. The contract ends and they give you a month in pediatrics. Then in the ER. You go shooting through many places and when you start to know the team and how they work, they change you and send someone else “, agrees Sandra Barquero, from Valencia. Both are experiencing a more stable situation lately, although they still do not see a fixed position.

Under this labor storm, to which the fatigue of the pandemic has been added, the toilets are wondering where some of them have gone. conditions in accordance with the responsibility assumed with their work – in the diagnosis, in the cure, in the care. One thing they do perceive is that they have lost the ability to negotiate and pressure the administration. The change they claim has to be long-term.


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George Holan

George Holan is chief editor at Plainsmen Post and has articles published in many notable publications in the last decade.

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