Demands of pregnant employees towards clinical hospital centre administration
Authors: Lalić Hrvoje 
Published: May 2019

The healthcare sector in Croatia is predominantly composed of female employees across all levels. The Clinical Hospital Centre Rijeka with 3,000 employees is no exception. The Republic of Croatia is populated by a little over 4 million inhabitants and the numbers have been in a constant decline due to multiple factors, which include aging of the population and economic migrations. These two factors significantly impact the healthcare workforce and specifically medical personnel. In the era where there are less and less new marriages and newborns, the government struggles for every child and thus offers families exceptional parental benefits. For hospitals, which are mainly staffed by women, confronting the government politics that seek to advantage the pregnant employees’ presents a problem and a significant financial burden. This is due to the fact that they are entitled to the full salary whilst staying at home from the very early stage of pregnancy. Theoretically, if the hospital management offered their pregnant employees all the benefits that law provides, the hospital would soon be left without sufficient number of nurses and particularly doctors, because they would very soon after becoming pregnant simply stop working.  The Health and Safety Law states that if the employer in health care, i.e. in a hospital, cannot provide a safe working environment for their pregnant employees, prior to their regular maternity leave financed by the state, they are not obliged to work and are entitled to a full salary, which is financed by the hospital itself. A female medical doctor found the article in the law that allows a full salary when she stopped working. She claimed such a benefit at the very beginning of her otherwise regular pregnancy and soon after that other cases followed. The occupational medicine doctors, after this first claim were soon put in a position to issue another 15 certificates of work incapacity to women at the very early stages of their pregnancy.  That seriously exhausts modest hospital funds due to the prevalence of female employees. Thus, in the Clinical Hospital Centre, urgent action is needed to prevent future “epidemic” compensation claims.  Occupational Medicine in cooperation with the Health and Safety Service together with the hospital management found a solution to the problem to the mutual benefit of all the parties involved. The personalized work post for pregnant medical staff was to be created, one without the exposure to biotic agents. Pregnant employees can hold administrative or educational work places, and should they feel unwell, they can always take regular sick leave, organised by their family doctor or gynaecologist and paid for by the Croatian Institute for Health Insurance. Pregnancy is not an illness; women can work and help the work of the hospital which is extraordinarily important especially when medical doctors are concerned for their absence is very expensive and hard to compensate. Although the sick leave pays less than the regular salary, the compromise is necessary to maintain the hospital solvent.