The Central Council of the Turkish Medical Association (TTB) drew attention to the fact that healthcare workers continue to provide healthcare services in every field with great diligence and devotion in a period when the whole world is struggling with a severe pandemic and many employees in many segments of the society are confined to their homes, and stated that working conditions and personal rights should be adapted to the conditions of this extraordinary period.
Signs and symptoms include respiratory symptoms with fever, cough and shortness of breath. In more severe cases, the infection can cause pneumonia, severe acute respiratory syndrome and sometimes death. Standard recommendations to prevent the spread of COVID-19 include: frequent hand cleaning using alcohol-based hand rubs or soap and water; covering the nose and mouth with a bent elbow or a disposable handkerchief when coughing and sneezing; avoiding close contact with anyone with a fever and cough.
WHO is working closely with global experts, governments and partners to rapidly expand scientific knowledge about this new virus and provide timely advice on measures to protect people’s health and prevent the spread of this outbreak.
The full text of the statement is as follows:
Job Security for Health Workers
In order to prevent the spread of the pandemic, people should limit their social relations and stay indoors as much as possible; in order for the health system to focus on the pandemic, people should avoid applying to health institutions in non-emergency or non-essential situations. Due to these measures, activities in many fields of work have completely stopped in general, and many health institutions have limited their activities or focused on virus outbreaks.
Due to the rate of spread of the virus in the world and in our country and its more severe fatal consequences, especially in the elderly and those with chronic diseases, it has become a necessity to reduce the rate of spread and, on the other hand, to reorganise health services accordingly and to ensure continuity in service. Various administrative measures aimed to reduce the rate of spread of the virus, and measures such as the transformation of some private health institutions into pandemic hospitals or the prohibition of the dismissal of health workers from their duties were taken to protect health service capacity.
On the other hand, some workplaces are dismissing their employees on the grounds that the number of applications has decreased in general and similar reasons. It should be noted immediately that, according to the Decree of the Ministry of Health, health workers are prohibited from leaving their duties by resignation or dismissal until 27.06.2020. This prohibition covers all health workers working in public or private health institutions and organisations. The right to work or not to work is among the Constitutional fundamental rights. Although the justified discussion on the illegality of limiting such a right in this way is made separately; Until 27.06.2020, health workers -except for health excuses- cannot leave their duties by resigning, and unless one of the reasons in Article 25/2 of the Labour Law and Article 125/E of the Civil Servants Law is fulfilled, termination of the employment contract or dismissal from public office cannot be made. For this reason, it has been deemed useful to provide brief information on the job security of health workers whose contracts have been terminated.
1) By stating that the employment contract cannot be terminated during this period, it can be requested to apply to the Provincial Directorate of Health and not to leave his/her job and to warn the employer by informing him/her about the decision of the Ministry of Health.
2) If the conditions are appropriate (if there are at least 30 employees working in the workplace where the physician has been working for at least six months), it is necessary to apply to the mediator within one month from the date of notification of the termination of the employment contract, stating that the termination is not based on a valid reason and requesting reinstatement. During this period, the periods in the judiciary were also suspended until 30.04.2020. Therefore, the beginning of the one-month period will be 01.05.2020. However, it is also possible to apply to the mediator without waiting for the start of the period and for the mediator to conduct this process by teleconference method if necessary.
3) In the event that a reinstatement decision cannot be made as a result of the mediator negotiations, a lawsuit for reinstatement can be filed with the labour court within two weeks. At the end of this lawsuit, if the reinstatement decision is made but the employer does not accept the reinstatement, the compensation determined by the court in the amount of 8 to 12 months of the applicant’s wage shall be paid by the employer.
4) If the reinstatement request is rejected by the court or the employer, labour receivables may arise due to the termination of the employment contract. These are, basically, severance pay in the amount of one month’s wage for each year of employment, notice pay in the amount of 2-8 weeks’ wage depending on the working period at the workplace, unused annual leave days and overtime work. If these indemnities and receivables are not paid voluntarily by the employer, mediation is requested first, and if no agreement is reached, it is requested by applying to the court.
5) Within the scope of the Additional Article 10 added to the Social Security and General Health Insurance Law No. 5510 in 2015, physicians working in some private hospitals were contracted and their wages started to be paid against invoices. Although the working method remains the same, this change in the method of payment of wages will not lead to a difference in the status of the employees, and the above-mentioned rights remain valid in the termination of the employment contracts of these physicians.
6) In addition to these rights, which aim to compensate those whose employment contracts are terminated without just cause, rather than protecting the jobs of the employees, occupational physicians have an additional compensation opportunity.
If the workplace physician’s employment contract is terminated due to the fulfilment of the notification obligation, the employer is entitled to compensation not less than one year’s contract fee. In this period when the whole world is struggling with a severe epidemic disease and many employees and almost all segments of society are confined to their homes, health workers provide health services in every field with great care and devotion. We demand that the knowledge and labour of our colleagues be respected, that all private health institutions and organisations be given public duties to participate in health service provision, that health services be provided free of charge in this process and that public support be provided for the personnel expenses of these health institutions. In addition, we once again share with the public that it is the fundamental responsibility of the state to ensure that employees are not dismissed and we invite the authorities to fulfil their responsibilities in this direction.
The rights, roles and responsibilities of health workers, including occupational health and safety
Healthcare workers are on the frontline in responding to any outbreak and are therefore exposed to hazards that put them at risk of infection with the pandemic pathogen (in this case COVID-19). Hazards include pathogen exposure, long working hours, psychological distress, fatigue, occupational burnout, stigmatisation and physical and psychological violence. This document emphasises the rights and responsibilities of health workers, including the specific measures needed to protect occupational health and safety.
The rights of health workers require employers and managers in health facilities to (RIGHTS):
Assume overall responsibility for ensuring that all necessary preventive and protective measures are taken to minimise occupational health and safety risks.
Provide information, instruction and training on occupational health and safety, including
Refresher training on infection prevention and control; and
Use, donning, doffing and disposal of personal protective equipment (PPE);
Provide sufficient quantities of adequate infection prevention and protection measures and PPE (masks, gloves, goggles, aprons, hand sanitiser, soap and water, cleaning supplies) to healthcare and other personnel caring for suspected or confirmed COVID-19 patients in such a way that workers do not have to spend on such occupational health and safety requirements.
Inform staff of technical updates on COVID-19 and provide appropriate tools to assess, triage, test and treat patients and share infection prevention and control information with patients and the community;
Provide appropriate safety measures for personal safety when necessary;
Create a non-accusatory environment for employees to report incidents such as exposure to blood or body fluids from the respiratory system or incidents of violence, and take measures for close follow-up, including support for victims;
Advise workers on self-assessment, symptom reporting and staying at home when ill;
Maintain appropriate working hours with breaks;
Counselling health workers on occupational health and safety aspects of their work and reporting cases of occupational diseases to the appropriate authorities;
Not forcing workers to return to a working situation where there is a continuing or serious danger to life or health until the employer has taken any necessary corrective measures.
Allow workers to exercise their right to exclude themselves from a work situation that they have reasonable grounds to believe poses an imminent and serious danger to their life and health. Protect from unintended consequences when a health worker exercises this right.
Ensure the right to compensation, rehabilitation, and remedial services in the event of infection with COVID-19 after exposure in the workplace. (This is considered occupational exposure and the resulting illness is considered an occupational disease.)
Provide access to mental health and counselling services; and
Ensure co-operation between management and workers and/or their representatives.
Healthcare workers must
Follow established occupational health and safety procedures, avoid exposing others to health and safety risks and participate in occupational health and safety training provided by the employer;
Use recommended protocols for assessing, triaging and treating patients;
Treat patients with respect, compassion and dignity;
Maintain patient confidentiality;
Promptly follow local public health reporting procedures for suspected and confirmed cases;
Provide accurate infection prevention and control and public health information, including to relevant persons who have neither symptoms nor risk;
Properly fit, use, remove and dispose of personal protective equipment;
Self-monitor for signs of illness and, if they occur, isolate the illness or report it to managers;
Advising management if they are experiencing symptoms of extreme stress or mental health problems requiring support interventions; and
Immediately report to their superiors any situation which they have reasonable grounds to believe poses an imminent and serious danger to life and health.
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