A “voluntary obligation” of medical students, for example through a national doctor quota, is possible, as medical lawyer Karl Stöger (University of Vienna) now explains. He came to this conclusion in a report commissioned by the Chamber of Labor (AK).
The starting point for the report was Chancellor Karl Nehammer’s (ÖVP) demand last year to impose some kind of professional obligation on doctors for a certain period after they have completed their studies. Those who complete medical training in Austria must “then give back a little of what they used to society for free.”
Last year, Stöger wrote a report for the Medical Association in which he concluded that a statutory obligation to work in public hospitals or health insurance practices would not be permissible under constitutional and EU law.
Priority access with subsequent commitment
The situation is different with a ‘voluntary obligation’, Stöger says in the AK report. There would be a ‘voluntary obligation’ that initially sounds like a contradiction if, in return for preferential access to publicly funded studies, applicants commit to working in an area of the public health system for a certain period of time after graduation to work.
System already present, adjustment required
Such a system already exists: according to the University Act, up to five percent of study places can be devoted to “tasks of general interest”. The federal army, for example, uses this. Applicants for these places have preferential access in the sense that they are not subject to the actual selection process for the best test results, but are only required to obtain 75 percent of the points of all applicants.
According to Stöger, this system can be expanded, but only within certain limits. Only about as many places can be set aside for voluntary service as will later be needed in the public health system. This quota should not serve as a substitute for better working conditions and remuneration for doctors in the public system, but only as a supplement.
In addition, there must always be sufficient “non-binding” places available. For example, an arrangement was made for Germany under which a maximum of 20 percent of places (for example for rural doctors) may be devoted to promoting quotas. Conversely, 80 percent remains without obligation.
And finally, details must be taken into account: for example, the commitment period should not be too long – in Germany this is about ten years after the end of the training, in South Tyrol this is five years within a ten-year period. According to Stöger, starting immediately after training is also less damaging to fundamental rights than delaying it.
Set an appropriate penalty
Limits must also be taken into account when determining a penalty in the event of violation of the obligation. On the one hand, the threshold must be high enough to have a deterrent effect. On the other hand, it should not economically ruin those who break the contract and should include hardship provisions and the possibility of repayment in installments. The average expected physician income could serve as a benchmark to measure the amount.
Choices for debtors
A role in the assessment of the admissibility of fundamental rights may also be the choice of the obligated persons with regard to their future area of work: the more freedom of choice they have with regard to their geographical location, the choice of subject or the resident/stationary area , the better.
The AK calls for making use of this leeway. Those who volunteer for the public health service should be given “preferential” access to medical studies. In addition, there should be a modern, national total contract for doctors with flat-rate elements, thus moving away from the system of individual fees. In addition, to reduce the burden on doctors, other healthcare professions must be included in practice-oriented care through the total contract.
Babler for voluntary efforts in two phases
SPÖ leader Andreas Babler, in turn, advocated a two-stage voluntary commitment in exchange for preferential access: students would commit to working as public health doctors once at the start of their studies and once towards the end of their studies – the second time allows specific subjects to be chosen that will be needed in the foreseeable future.
Source: Krone
I am Wallace Jones, an experienced journalist. I specialize in writing for the world section of Today Times Live. With over a decade of experience, I have developed an eye for detail when it comes to reporting on local and global stories. My passion lies in uncovering the truth through my investigative skills and creating thought-provoking content that resonates with readers worldwide.
