Law on the Status of Employed Physicians

This Law, framed within the principles of social justice of the Labor Code and those of Public Administration, protected by the Civil Service Law, regulates the labor or work services of duly registered Physicians and Surgeons both as servants of State dependencies in centralized, decentralized or deconcentrated organisms and when providing their services under the continued dependence of natural or juridical persons of private law.

The objectives of this Law are:

• 1)

  To protect, dignify and train duly registered Physicians;

• 2)

  To increase the efficiency of work rendered by Physicians;

• 3)

  To establish just bases for the norms of income and salary regime of the employed Physician;

• 4)

  To guarantee job stability of the employed Physician;

• 5)

  To regulate work shifts, turns and mandatory rest periods in order to guarantee medical professional efficiency;

• 6)

  To guarantee just distribution of their positions;

• 7)

  To guarantee adequate working conditions in accordance with norms established between the Medical College of Honduras and employing institutions, and 8) To seek compliance with national and international agreements in order to promote sources of employment.

Excluded from the regulations of this Law are those medical activities performed in the free exercise of the profession, by judicial mandate or due to an officially declared national emergency. CHAPTER II OF THE FIELD OF APPLICATION

This Law is applicable to Physicians duly registered with the Medical College of Honduras. CHAPTER III OF REQUIREMENTS

In all hiring or appointment for the provision of services whose nature is proper to the exercise of general or specialized medicine, the employed Physician must fulfill the following requirements:

• 1)

  To have obtained the degree of Physician and Surgeon issued or recognized by the National University of Honduras;

• 2)

  To be registered with the Medical College of Honduras and to be in full enjoyment of their professional rights; and,

• 3)

  Not to be in default with the Medical College of Honduras.

When the service requires specialization in any branch of Medicine, the Physician must hold recognition from the Medical College of Honduras.

All hiring or appointment for the provision of general or specialized Medical Services, under the subordination or dependence of a natural or juridical employer of public or private law, shall be subject to competitive selection, without prejudice to its legal powers to decide the hiring, contracting or appointment; the employing entity shall regulate such competitive selections after previously hearing technical recommendations from the Medical College of Honduras. CHAPTER IV OF RIGHTS

Employed Physicians enjoy the following rights and guarantees:

• 1)

  To receive full payment of their remuneration from the day the provision of service began, even if their appointment is pending, in order to guarantee the material relationship of work and protect the service effectively rendered;

• 2)

  To stability in work or employment; consequently, they may not be transferred without their express consent and without adequate justification of cause; nor shall they be demoted without just cause and observance of the procedure guaranteeing their defense;

• 3)

  To be promoted or advanced to a position of higher rank and salary, through proof of their efficiency and merits, in accordance with the position and salary classification that the Law establishes;

• 4)

  To enjoy annually paid and regulated vacations in the terms established by this Law;

• 5)

  All rights and guarantees recorded in the Constitution of the Republic, this Law, the Labor Code, the Civil Service Law and other applicable laws. In any case they may invoke those dispositions contained in said laws when they are more favorable. CHAPTER V OF PROHIBITIONS AND OBLIGATIONS SECTION I OF OBLIGATIONS OF EMPLOYERS OR PROPRIETORS

In addition to those contained in other Articles of this Law, the obligations of employers or proprietors are the following:

• 1)

  To pay the employed Physician the remuneration established in the conditions and periods indicated in this law;

• 2)

  To pay the employed Physician the salary corresponding to the time they stopped working for reasons attributable to the employer or proprietor;

• 3)

  To provide a safe place for the safekeeping of the means, instruments and work tools belonging to the employed Physician, provided that these remain in the place where services are rendered, and it is not lawful to retain them as indemnification, guarantee or any other purpose. The inventory of means, instruments and work tools shall be made whenever either of the parties requests it. SECTION II OF PROHIBITIONS TO EMPLOYERS OR PROPRIETORS

It is prohibited to employers or proprietors:

• 1)

  To hire or appoint less than 90% of Physicians who are Honduran by birth, percentage which shall be calculated on the basis of the total number of Physicians to be employed, appointed or hired;

• 2)

  To pay Physicians employed who are Honduran by birth, less than 85% of the total salaries earned by Medical personnel in the respective company, establishment or institution; and,

• 3)

  To discriminate against Physicians on grounds of race, religion, political creed and economic situation, preventing them from working in social assistance establishments, educational or any other type.

The obligations of Employed Physicians are:

• 1)

  All those imposed by laws, individual contracts, collective contracts, regulations or arising from any other source with legal force, provided that said obligations do not diminish, distort or modify the rights arising from this Law. In case of controversy, the parties may submit their case to the Medical College of Honduras, which shall act as mediator;

• 2)

  Every employed Physician is obligated to take training courses or participate as an instructor or speaker in the same, periodically and at intervals not exceeding two (2) years; and,

• 3)

  Every Employed Physician to apply for dependent positions shall previously submit to competitive selection; in case it is a management position they must submit to competitive selection every three (3) years. Obligations 2 and 3 shall be regulated. SECTION IV OF PROHIBITIONS TO EMPLOYED PHYSICIANS

It is prohibited for Employed Physicians:

• 1)

  To enter into labor contracts or accept appointments involving the provision of Medical Services for two employers during the same work shift or schedule;

• 2)

  To overlap work shifts or schedules. Overlap is understood to mean when the beginning of the following shift or schedule is included before the hour of conclusion of the preceding shift; and,

• 3)

  To apply for dependent positions or posts, even if they do not receive remuneration, if in doing so they would substitute a colleague who is on justified strike or stoppage, or would be dismissed due to unjustified dismissal or suspension. CHAPTER VI OF THE WORK SHIFT

The dispositions of this Chapter are of general observance; nevertheless the modalities of the work shifts of the Employed Physician subject to laws or regulations, and contracts or agreements legally executed shall have validity if they do not contravene or modify this Law.

The work shift may be: Ordinary, extraordinary, daytime, nighttime, mixed, on-call and hourly.

The daytime shift is comprised between seven o'clock in the morning (7:00 a.m.) to seven o'clock in the evening (7:00 p.m.). The nighttime shift is comprised between seven o'clock in the evening (7:00 p.m.) to seven o'clock in the morning (7:00 a.m.). The mixed shift comprises daytime and nighttime periods.

The ordinary work shift shall be six (6) hours for full-time, intermediate of four (4) or five (5) hours; and half (½) time of three (3) hours daily from Monday to Friday. Two (2) ordinary work shifts may be performed provided there is no overlap of schedules.

The extraordinary work shift shall be any effective labor executed beyond the maximum limit of six (6) hours that determines the ordinary work shift for the same employer or proprietor. It includes mandatory weekly rest and national holidays or festive days.

On-call duty shall be the effective working time performed by the Physician as support to hospital emergency services, which shall not exceed twelve (12) hours daily in each period of twenty-four (24) consecutive hours, and shall be subject to the control procedure established by the regulation of this Law.

The Employed Physician may only perform one on-call duty shift, which shall not exceed seventy-two (72) hours per month, except in qualified cases.

The Medical Association of Honduras through its Board of Directors shall maintain a register of work shifts to ensure strict compliance with this Law.

The hourly shift shall not be less than two (2) hours daily. CHAPTER VII REGARDING VACATIONS AND REST AND LEAVE PERIODS

Every Employed Physician shall have the right to annual paid vacation, paid in advance, taking as a basis the average of ordinary salary earned during the last six (6) months.

The vacation period of the Employed Physician, for each year of continuous service with the same employer, shall have a minimum duration as expressed below:

• 1)

  After one (1) year of continuous service, twelve (12) consecutive business days;

• 2)

  After two (2) years of continuous service, fifteen (15) consecutive business days;

• 3)

  After three (3) years of continuous service, twenty (20) consecutive business days; and,

• 4)

  After five (5) years or more of continuous service, thirty (30) consecutive business days.

The Physician who is habitually exposed in the performance of duties to the harmful effects of agents such as anesthetics, ionizing radiation and other duly qualified risks, shall have the right to twelve (12) working days of annual special rest, which shall be taken six (6) months after their ordinary vacations. This special rest shall not be cumulative and must be taken mandatorily once per year.

The right to annual paid vacation shall not be prejudiced by having enjoyed mandatory legal rest, licenses or permits with salary compensation, leave for illness or other similar causes.

The Employed Physician shall enjoy mandatory weekly rest after having completed his ordinary weekly work shift.

Employed Physicians shall have the right to special leave or licenses in the following cases:

• 1)

  To hold public or administrative senior management positions or elected positions, for the time for which appointed, without salary compensation and without losing labor rights;

• 2)

  For the purpose of pursuing postgraduate studies, for the time their specialization warrants, and in accordance with the Specialization Regulation of the Medical Association of Honduras;

• 3)

  Leave with salary compensation for justified personal reasons in accordance with the corresponding Internal Regulation, not exceeding twenty (20) business days annually;

• 4)

  Leave with compensation to attend Ordinary and Extraordinary General Assemblies of the Medical Association of Honduras, Seminars, Medical Congresses, Conferences, Training Courses and fulfill professional commissions and missions; whose extension and timing shall be regulated by regulation and,

• 5)

  For common illness or any other type, with salary compensation, up to five (5) consecutive days in one (1) month, provided these do not exceed twenty (20) days in the year; having to present Medical Certification.

The enjoyment of vacations, licenses or leave shall not affect continuity or seniority in work; however, in numerals 1) and 2) of the preceding Article, only seniority shall be compensated.

The Employed Physician cannot be interrupted during vacations, licenses or leave; however, the employer may order reintegration due to justified necessity, in which case the expenses incurred shall be borne by the employer and the employee shall retain the right to resume them.

Vacations may be accumulated for two (2) consecutive periods for justified cause and may be taken continuously prior to request and approval by the respective supervisor.

The vacation period shall be designated with at least three (3) months advance notice before the date on which the enjoyment thereof begins. The remuneration to which the Employed Physician is entitled shall be made effective within the ten (10) days preceding the start of his or her vacation. CHAPTER VIII SALARY

The salary or wages that the Employed Physician shall earn may be stipulated through Individual Contracts, Collective Contracts, or budget allocations, but in no case shall they be less than the minimum prescribed by this Law.

The minimum salary or initial base for general practitioners shall be L.2,500.00 (two thousand five hundred Lempiras Nº/100) monthly, compensating an ordinary daytime working day of six (6) hours. The minimum salary for ordinary nighttime working hours shall have a twenty-five percent (25%) increase over the minimum salary of the ordinary daytime working day.

The minimum salary or initial base for specialist physicians shall be L.3,000.00 (three thousand Lempiras Nº/100) monthly, compensating an ordinary daytime working day of six (6) hours. The minimum salary for ordinary nighttime working hours shall have a twenty-five percent (25%) increase over the minimum salary of the ordinary daytime working day.

Employers or patrons shall establish the classification of positions and salaries of medical professionals, subjecting themselves in all pertinent respects to this Law.

Salaries shall be fixed in direct relation to the position or office; consequently, each Employed Physician shall receive the remuneration corresponding to the office or position actually performed, in accordance with this Law.

The minimum salary or base for general practitioners or specialist physicians, on an hourly basis shall be proportional to the salary of the ordinary daytime working day. The minimum salary for the nighttime hourly working day shall have twenty-five percent (25%) more over the minimum salary of the ordinary daytime hourly working day.

Salaries in all the foregoing shall be calculated according to the working day or schedules established, subject thereto but never less than the minimum stipulated in this Law.

The institutions shall equalize the salaries of the Employed Physician in teaching, administrative, and service positions in such a manner that all those with the same classification shall enjoy equal base salary.

The institutions shall make effective the payment of monthly wages corresponding to their Employed Physicians no later than the twentieth (20) day of each month at the place where they perform their duties. When for reasons not attributable to the institution payment is not made effective on that date, payment shall be made within the following five (5) days.

The salary paid per month includes the payment of rest days and holidays.

Overtime work shall have:

• 1)

  a twenty-five percent (25%) surcharge over the ordinary daytime working day when carried out during daytime hours;

• 2)

  a fifty percent (50%) surcharge over the salary of the daytime working day when carried out during nighttime hours; and,

• 3)

  a seventy-five percent (75%) surcharge over the salary of the nighttime working day when the overtime is a continuation thereof.

The on-call shift shall have a salary equivalent to an ordinary daytime working day of six (6) hours.

During the term of the contract or appointment, the Employed Physician has the right to receive a zone allowance, equivalent to twenty-five percent (25%) of his or her salary, when the provision of service is performed permanently in a rural, inhospitable, difficult to access, or border zone, as determined by the corresponding Regulations.

If by virtue of an Agreement the Employed Physician works during rest days or national holidays or festivities, he or she shall be paid double the salary corresponding to the ordinary working day, in proportion to the time worked, without prejudice to the right to any other rest day during the week.

Every Employed Physician who is unjustifiably removed from his position shall have the right to receive compensation equivalent to one month of salary for each year of service, not exceeding eight months, and in addition to the payment of two (2) months of salary as severance notice when such notice has not been granted to him.

When the termination of service provision concludes unilaterally, he shall be granted a bonus for services rendered not less than 60% calculated on the basis of what is established in the preceding Article.

The provisions contemplated in the preceding Articles are not exclusive of the enjoyment of other benefits established in the Labor Code and the Civil Service Law. CHAPTER IX OF LIABILITY.

Employed Physicians are responsible during the exercise of their functions or in the performance of their duties in accordance with what is stipulated by the laws.

When the Employed Physician is appointed or elected to perform functions of superior direction, teaching, or administrative duties, he shall perform them during the time assigned for his position and may not perform other functions during the same schedule.

The Physician shall be responsible for the care provided to patients under his responsibility and shall require the same conduct from the personnel he directs.

On-call Physicians shall be responsible for the care of hospitalized patients and those treated in emergency situations. CHAPTER X OF SANCTIONS.

Infractions committed by Employed Physicians shall be sanctioned with disciplinary measures according to the severity of the violation in accordance with what is established in this Law and its Regulations.

Infractions are classified as minor, less serious, and serious. The following measures are established:

• 1)

  Warning;

• 2)

  Temporary suspension without pay; and, 3) Dismissal from office. This shall be subject to special regulation.

The sanctions referred to in the preceding Article shall not be applied without first having investigated the charges and heard the Physician in question, guaranteeing him full defense through the use of applicable legal remedies.

Sanctions, when applicable, shall be applied by the appointing authority, the employer, or his representative in accordance with what is established in the preceding Article and what the laws and regulations prescribe in this regard.

Employed Physicians may be dismissed or removed from their positions for the causes or reasons established in the current laws and the Regulation of this Law.

Regardless of which Law is to be applied, the Employed Physician may not receive notice of dismissal except when the corresponding regulatory investigation has been exhausted.

Once the requirements set forth in the preceding Article have been met, the employer shall communicate the decision in writing to the Employed Physician, who may appear before the competent authority to claim his rights.

In case of unjustified dismissal, the Employed Physician shall have the right, at his election, to compensation in the form of unpaid salaries as damages and losses, and to legal indemnities conventionally provided, or to be reinstated to work with the recognition of unpaid salaries as damages and losses calculated from the date of dismissal until the day his reinstatement is executed and in accordance with the last salary earned by him.

Any action for dismissal concerning an Employed Physician, regardless of the competent authority to hear the claim or lawsuit, shall prescribe within a period of 60 business days counted from the following day after the dismissal notification was personally received.

When the appointing authority, employer, or proprietor wishes to proceed with a reduction of services or personnel, for reasons of budgetary order or to obtain a more efficient and economical Administrative organization with respect to the Medical personnel under its command, it shall comply with the requirements imposed by the Labor Code or by the Civil Service Law as applicable, and shall proceed to implement it; if such formalities have not been fulfilled, the existence of unjustified dismissal shall be presumed. In all cases, seniority shall be respected. CHAPTER XI OF INCENTIVES

Automatic incentives in favor of Employed Physicians are hereby created, their observance is mandatory and shall be included in all position and salary classifications. This shall be regulated. CHAPTER XII OF RETIREMENTS AND PENSIONS

Physicians in the service of the Central Government and its autonomous, semi-autonomous, or decentralized bodies shall have the right to the benefits granted by the Law of the National Institute of Retirements and Pensions of Employees and Officials of the Executive Branch. The corresponding contributions shall be mandatory for employers and employees.

The Employed Physician upon entering retirement status shall enjoy the retirement benefits to which he is entitled, in accordance with the time and salaries earned in the different institutions where he has worked and shall continue as a contributor to the Honduran Institute of Social Security (IHSS). CHAPTER XIII OF FINAL AND TRANSITORY PROVISIONS

The regulations referred to in this Law shall be issued by the Secretaría de Estado in the Office of Public Health and within a period of three months from its effective date, after previously hearing the opinion of the Medical Association of Honduras and of the public or private institutions that have Employed Physicians in their service.

Problems that may arise due to difficulties in the application of this Law and its Regulation may be consulted before the General Directorate of Civil Service or before the Secretaría de Trabajo y Asistencia Social, without prejudice to the Employed Physician being able to resort to the corresponding jurisdiction.

All institutions that have Employed Physicians in their service shall, within a period not exceeding three months, adapt their schedules, work hours, and salaries to this Law.

The seniority of Employed Physicians appointed prior to the promulgation of this Law shall be counted from the date of their appointments in any institution provided that the provision of services has been continuous.

This Law shall be applied to the National Autonomous University of Honduras (UNAH), without prejudice to its constitutional autonomy, but in accordance with its economic possibilities, materialized through collective bargaining. Employed Physicians in assistance services are hereby exempted, whose employment relationship shall be regulated in accordance with the norms established in this Law.

The application of this Law, with respect to the execution of economic benefits, shall be carried out over a period of three years, through consecutive increases or adjustments not less than thirty percent (30%) annually, effective as of January 1, 1986.

This Law shall enter into force as of the day of its publication in the Official Gazette "La Gaceta". Done in the city of Tegucigalpa, Central District, in the Session Hall of the National Congress, on the ninth day of the month of October of one thousand nine hundred eighty-five. JOSE EFRAIN BU GIRON President MARIO ENRIQUE PRIETO ALVARADO Secretary JUAN PABLO URRUTIA RAUDALES Secretary To the Executive Branch Constitutionally Ratified Tegucigalpa, D.C. October 31, 1985. JOSE EFRAIN BU GIRON President MARIO ENRIQUE PRIETO ALVARADO Secretary JUAN PABLO URRUTIA RAUDALES Secretary ROBERTO SUAZO CORDOVA President The Secretaría de Estado in the Offices of Governance and Justice ARNULFO PINEDA LOPEZ [page omitted]