Medical institutions that provide state-funded inpatient healthcare services will now have unified guidelines for increasing salaries, according to amendments to the Cabinet of Ministers’ regulations on the organization and payment of healthcare services approved by the government.
Henceforth, salary increases will no longer be governed by each institution’s internal rules or its individual agreements with the National Health Service (NHS). This change aims to prevent imbalances in how additional state funding is distributed, explains the Ministry of Health (MoH).
Going forward, healthcare institutions will direct additional funding for salary increases to medical professionals whose average monthly pay for inpatient services over the past 12 months does not exceed twice the national average wage, without any conditions, the MoH emphasizes.
Additional funds will also be allocated to those medical professionals whose average monthly salary exceeds twice but does not surpass three times the national average wage, the new provisions stipulate.
The MoH notes that this approach ensures a transparent, fair, and gradual salary increase for healthcare workers, rationalizes pay across the sector, ensures real salary growth, and reduces the proportion of variable components in total pay.
The need for these changes is driven by the goal of retaining the workforce in hospitals.
A balanced wage increase is necessary across all staff categories, especially for medical professionals receiving significantly lower pay “compared to the unjustifiably overpaid salaries of some medical personnel,” the ministry states.
If proportionality is not observed when allocating additional budget funds for salary increases in inpatient care institutions, there is a risk that wage growth for some groups will significantly lag behind that of others within different hospital units or professional categories. This could, in turn, prompt staff to consider changing jobs, the MoH warns.
To support targeted increases for lower salaries, a new threshold has been introduced: for healthcare professionals delivering state-funded inpatient care, the primary target level for salary increases is at least twice the national average wage.
During discussions with the MoH, the Latvian Trade Union of Health and Social Care Employees (LVSADA) insisted that physicians’ pay should be at least three times the national average. Therefore, the government-approved amendments specify that no additional funding will be directed toward specialists whose wages already meet or exceed this level.
These regulations are binding for all institutions and will apply automatically
—there will no longer be a need to include these provisions in individual contracts with the NHS.
The NHS will continue to monitor how institutions spend the allocated funds. If discrepancies are found—for example, if funds are misused and not directed toward increasing the lowest salaries—institutions will be required to immediately correct the situation or repay the misallocated funds.
Based on analysis of available data on actual healthcare workers’ pay, the MoH found significant variations between institutions and staff groups. This underscores the need to amend regulations to ensure that additional state budget funding for salary increases is distributed in a justified and targeted way—specifically to raise the lowest wages of healthcare professionals involved in providing state-funded inpatient care across the sector.
The ministry has coordinated the amendments with industry stakeholders and received conceptual support from LVSADA. The union and the MoH have agreed that the unified salary principles will apply to base pay, not total remuneration.
The MoH believes these changes will help improve staff retention in the long term, reduce wage disparities between institutions and professions, and ensure more efficient use of public resources in healthcare.
Read also: Several amendments adopted to the regulations on teachers’ remuneration in Latvia