Bulgaria's parliament on Wednesday, 7 October, rejected changes to the Healthcare Facilities Act that would set minimum pay levels for medical staff. We Continue the Change (PP) had proposed them. The changes failed at first reading. They failed again in a second vote, which Venko Sabrutev asked for: 60 MPs voted for, 4 against, and 116 abstained.

This story follows our earlier report on the bill, which was due for a first reading this week.

The bill covers medical staff in state and municipal hospitals, emergency care centres, blood transfusion centres, and cancer and dialysis centres. It also covers psychiatric care facilities and facilities run by government departments. Under the bill, they would have had to guarantee adequate minimum pay. Part of the pay would depend on ongoing training and extra qualifications.

The bill also set penalties for facilities that miss the minimum levels: their contracts with the National Health Insurance Fund (NHIF) would end, and their managers would face fines.

Sabrutev said only the ruling parties dispute decent pay for doctors, nurses and other medical specialists. He noted that the vote fell on World Day for Decent Work.

Yulian Dimitrov of Progressive Bulgaria said funding for hospitals that run as commercial companies and public enterprises must be tied to a specific task and method. He said the bill adds costs without guaranteed income, and without extra money it would lead to debts and bankruptcy. "You can't impose minimum pay by law and then penalise them for not meeting it," Dimitrov said. He added that Progressive Bulgaria does not back any corrupt schemes, and that the unauthorised activity uncovered in Plovdiv shows that they are "plugging the leaks".

Georgi Petrov of Progressive Bulgaria said his party will not back the bill, but that does not mean it does not want nurses to earn more. He said a mechanism exists and people will soon see a difference in pay.

Nikolay Denkov of We Continue the Change pointed out that there are selective funds to finance healthcare facilities. "What I miss is your proposal to solve this problem," he told the ruling parties. Velislav Velichkov of We Continue the Change said the bill includes a proposed mechanism, while the ruling parties say "we have one" and should present it.

Lachezar Ivanov of GERB-SDS said it makes sense for the Ministry of Health and the Ministry of Education and Science, not the health insurance fund, to pay for young doctors and trainee specialists. He said the system needs to be built up, not patched with fixes to earlier fixes.

Georgi Georgiev of Revival asked whether Progressive Bulgaria will change a model that drains the NHIF and leaves pay inadequate. He said that if the ruling parties claim they cannot act because of unauthorised financial aid, they are keeping the same corrupt model in healthcare.

Democratic Bulgaria backed the bill. Aleksandar Simidchiev said "the bleeding of specialists out of the system" threatens the whole system. He said small healthcare facilities would have been at risk if the text had passed as written, but it could have been made workable between first and second reading.