The Junior Doctors Strike in South Korea: The Government And the Doctors Are At an Impasse for Resolution

South Korean junior doctors protested against government plan to increase medical student admissions, suspending 90% of 13,000 medical interns and residents, potentially escalating doctor-to-patient ratio issues.

The Junior Doctors Strike in South Korea: The Government And the Doctors Are At an Impasse for Resolution
The doctor strike in South Korea has led to cancellation of hundreds of surgeries, by National Cancer Institute, via Unsplash, 2020/January 22nd

17-04-2024

Pauliina Majasaari

Human Rights Researcher

Global Human Rights Defence

 

On February 20th, 2024, thousands of junior doctors collectively walked off their job to protest the government plans to increase the number of medical students admitted to medical school per year. This led to the cancellation of multiple surgeries and other medical treatments with turning away patients in need of care due to shortage of medical staff. The Health Ministry immediately urged the doctors to return to work to avoid endangering the lives of their patients.

The government plan on medical school reform includes of increasing the amount of people admitted to medical school by 2,000, which at the moment is 3,058. The ultimate plan is to increase the number of students admitted by 2035 to 10,000 which would be used to address the shortage of doctors affected by the fast-ageing population of South Korea. By March 2024, more than 90 percent of the 13,000 medical interns and residents have been within the protests and not returning to work. Moreover, some senior doctors have submitted their resignations to support the junior doctors strikes, such has major impacts on the efficiency of medical services provided.[vii] The doctor-to-patient ratio is quite low in South Korea, especially within low-paying essential professions, such as paediatrics and emergency departments. However, the government plan is criticised as inefficient, as the medical schools would not be able to handle a sharp increase in medical students which would ultimately lead to undermining the country’s medical services as the graduating students might not hold the required competencies. Furthermore, a likely consequence of increasing the admission numbers is not the envisaged increase of doctors within needed essential services, but an increase of doctors in the high-paying fields, such as plastic surgery and dermatology. Under South Korea’s medical laws, the government can issue back-to-work orders when strikes can have grave risks to lives and public health, amongst refusal of the order medical licences can be suspended, prison sentences and fines can be imposed. The government of South Korea has taken steps to suspend the licences of the striking doctors due to their refusal to end the walkouts from their professions by an order of the government.

When assessing the international law pertaining to the right to strike, two points of views should be considered, the rights of the workers to strike as well as the rights of those who are affected by the strikes. Firstly, the International Covenant on Economic, Social and Cultural Rights (ICESCR), under article 8, sets out the right to strike if it is in accordance with the laws of the state. Furthermore, article 8 sets further derogations, according to which the limitation of the right is allowed in order to protect public order or the rights and freedoms of others. Public order can be interpreted to entail  a combination of rules which ensure the functioning of the society and ensure people can enjoy their respective rights. Moreover, the Freedom of Association and Protection of the Right to Organize Convention No. 87 does not explicitly grant the right to strike, however supervisory bodies of the Convention, the Committee on Freedom of Association and the Committee of Experts on the Application of Conventions and Recommendations, have continuously expressed the right to strike as a fundamental right of workers and an integral part of the right of workers’ and employers’ organisations  to organise their administration and activities and formulate their programs as well as the aim of such organisations to further and defend the interests of workers and employers. Secondly, article 12 of the ICESCR sets out the right of everyone to enjoy highest attainable standard of physical and mental health as well as the duty of every state to create conditions which assures medical services to all in the event of sickness.

Strikes which are not purely of political nature and which aim to seek solutions to economic and social policies which can affect workers interests, are deemed to fall under the right to freedom of association and are thereby legal in nature. As such the junior doctors have had the right to strike, as the strike conducted can be considered not to be a strike purely of political nature as the aim is to show their dissatisfaction towards the government plan to increase medical school admissions based on social policy to address the shortage of medical personnel and thereby ensure all people receive the medical care they need. As such the proposed reform would result in lower pay for the doctors, as well as undermining the efficiency of the whole medical profession as the universities would not have the means to train such a high amount of fully qualified professionals. Additionally, underlying reasons for the protesting includes bettering working conditions such as long workdays and under-staffing as well as addressing the inadequate investment in essential healthcare, which deters doctors from taking up employment within such fields.

However, as mentioned the right to strike can be limited upon specific derogations and the permission of specific derogations are crucial to protect the rights of those whom the strikes are affecting. Within the present situation, derogations on protecting the public order can be invoked as accessible and effective healthcare services can be regarded to form a part of the public order in South Korea since the absence of such impairs the functioning of the society. Additionally, as mentioned by the Committee on Freedom of Association, strikes can be prohibited for workers in essential services where the interruption of such services can endanger the life or health of the population. Thereby, the government imposed back-to-work order given to the striking junior doctors has a legitimate basis as the amount of striking doctors has already fallen on the detriment of health services, by forcing hospitals to turn away patients due to staff shortage, and in some cases such has led to the loss of life due to lack of medical care. Such is in contradiction with article 12 of the ICESCR as highest attainable standard of physical health cannot be achieved when there is no doctors to treat the ones in need of care. Similarly, the right in article 12 of the ICESCR aligns with the derogation to the right to strike to protect the rights of others, as healthcare is a critical aspect to the wellbeing and survival of the population and thereby it should be protected. Furthermore, the government of South Korea, should be taking stronger measures or better negotiation stands to address the ongoing walkouts by junior doctors as it has a positive obligation to create conditions where everyone is assured medical services when needed.

Thereby, South Korea is urged by international actors as well as experts from the medical field, to enter negotiations with the Korean Medical Association, leading the strike, and approach with the will to make compromises to the planned government policy on medical school reform to gain back the thousands of doctors absent from their workplace. Additionally, the South Korean government is asked to reassess their actions of suspending the licences of the striking doctors, as it has not seemed to change the stance of the strikers, and such actions could lead to a more critical stalemate between the doctors and the government. Finding a resolution to the ongoing strike would be crucial to ensure the treatment of all patients and thereby upholding the rights of its citizens on the right to receiving adequate healthcare and medical attention.

Sources and further readings:

 

Bernard Gernigon, Alberto Odero and Horacio Guido, ‘ILO Principles Concerning the Right to Strike’ (1998) 137 International Labour Review 4.

 

 

 Hyung-Jin Kim, ‘South Korea will take final steps to suspend licences of striking junior doctors starting next week’ AP News (21 March 2024) <https://apnews.com/article/south-korea-doctors-strike-suspensions-efbdddae9c6a4ddee19f4ba294202db3> accessed 17 April 2024.

 

 

Hyung-Jin Kim and Jiwong Song, ‘Here’s why thousands of junior doctors in South Korea walked off the job’ AP News (28 February 2024) <https://apnews.com/article/south-korea-doctors-walkouts-patients-explained-326632dd061fc3b004b663cc761f9016> accessed 17 April 2024.

 

International Covenant on Economic, Social and Cultural Rights (adopted 16 December 1966, entered into force 3 January 1967) 993 UNTS 3 (ICESCR).

 

Jiwon Song and Hyung-Jin Kim, ‘South Korean doctors walk out to protest medical training push, causing surgery cancellations’ AP News (20 February 2024) <https://apnews.com/article/south-korea-trainee-doctors-walk-off-d991fc8a07c535ea737b4f31b01c5658> accessed 17 April 2024.

 

‘Limburg Principles on the Implementation of the International Covenant on Economic, Social and Cultural Rights’ ESCR-net <https://www.escr-net.org/resources/limburg-principles-implementation-international-covenant-economic-social-and-cultural> accessed 30 April 2024.

 

 Raphael Rashid, ‘Why South Korean doctors have walked off the job’ Medium (6 March 2024) <https://medium.com/@koryodynasty/long-read-why-south-korean-doctors-have-walked-off-the-job-c1678e1f883b> accessed 17 April 2020.

 

‘S Korea deploys military reinforcements to hospitals hit by doctors strike’ Al Jazeera (11 March 2024 ) <https://www.aljazeera.com/news/2024/3/11/s-korea-deploys-military-reinforcements-to-hospitals-hit-by-doctors-strike> accessed 17 April 2024.

 

The Freedom of Association and Protection of the Right to Organize Convention No. 87 (adopted 9 July 1948 , entered into force 4 July 1950) 68 UNTS 17.