Health sector trade unionists demand minimum 50% bonuses and amendments to the pay legislation

The "Solidaritatea Sanitară" Federation of Romania (FSSR) is calling for amendments to the draft new unified pay law, following an internal study showing that, over the past ten years, bonuses within the healthcare system have increased in absolute terms but have come to represent a progressively smaller share of employees' total income. The union warns that this trend may exacerbate staff shortages in hospitals.

The study "The Evolution of Supplementary Compensation for Employees in the Public Health System", conducted by FSSR in partnership with the "Solidaritatea" Centre for Social Research and Development, covers the period from May 2016 to June 2026.

According to the study, the share of bonuses awarded for working conditions and for ensuring continuity of medical activity, as a proportion of total basic salaries, fell from 55.5% in 2017 to 31.2% in 2025 — a level lower than that recorded in 2016, when the ratio stood at approximately 34.9%.

The union's explanation: basic salaries have risen more rapidly than bonuses, meaning that the additional compensation for working in special conditions, on shifts, at night, or on public holidays has effectively been diminished in relative terms.

What the new law proposes and why it is being criticised

The Federation argues that, in its current form, the draft unified pay law would reduce the bonus for working conditions and continuity to approximately 27%. FSSR simulations indicate that, in over 27% of the cases analysed, bonuses could decrease, with the proportion of affected cases reaching 45.7% for doctors.

Union members fear that, under these circumstances, fewer and fewer doctors and nurses will be willing to take up posts in high-risk wards, which would further deepen the staff shortages already affecting the public health system.

What the union is proposing

FSSR is calling for the forthcoming pay law to guarantee a bonus of at least 50% of the basic salary for working conditions and for ensuring continuity of medical activity. The federation's main proposals are:

• The award of a bonus of at least 50%, calculated on the basis of the basic salary, for working conditions and continuity;
• Compensation for any reduction in the bonus cap through differentiated increases to basic salaries, according to the place of work;
• Calculation of all percentage-based entitlements on the basis of the basic salary actually in payment, without the possibility of their automatic freezing;
• Separate and transparent funding for bonuses, so that any budgetary shortfalls are not passed on to high-risk wards;
• Separate reporting of payments for shift work, night work, weekends, public holidays, on-call duties, and hourly pay;
• Testing of each version of the draft law, broken down by professional category and place of work, prior to its adoption.

The risk of losing medical staff

The Federation warns that reducing financial incentives for work carried out under difficult conditions may compound the existing problems within the healthcare system. According to union members, posts in high-risk wards could become increasingly difficult to fill, and some employees may seek positions where conditions are better and where bonuses no longer constitute a determining factor in their income.

FSSR maintains that the forthcoming pay law must be structured in such a way as to provide sufficiently motivating compensation for medical staff working in special conditions and on a continuous-duty basis.