In accordance with Art. 350 of the Labor Code of the Russian Federation, the Decree of the Government of the Russian Federation of February 14, 2003 No. 101 “On working hours medical workers depending on their position and (or) specialty.
In accordance with Labor Code The Russian Federation establishes a reduced working time of no more than 39 hours for all medical workers (part 1 of article 350 of the Labor Code of the Russian Federation). Depending on the position held and (or) specialty, according to the specified Government Decree, the working hours may be:

36 hours a week - according to the list according to Appendix No. 1;
33 hours a week - according to the list according to Appendix No. 2;
30 hours per week - according to the list according to Appendix No. 3;
24 hours a week - for medical workers who directly carry out gamma therapy and experimental gamma irradiation with gamma preparations in radiomanipulation rooms and laboratories.

How to use these lists?

To determine whether a particular medical worker is entitled to reduced working hours, it is necessary to determine the category of the medical institution in which he works and whether it is on the lists; further, determine the title of the position and the nature of the work performed. A medical worker will be entitled to reduced hours of work if three conditions are met simultaneously with respect to him:

For example, an epidemiologist is entitled to a reduced 36-hour working week if he works in the organization of the state sanitary and epidemiological service and his work is directly related to live cultures (infected animals).

IMPORTANT! In connection with the adoption of Decree of the Government of the Russian Federation No. 101 in accordance with Art. 350 of the Labor Code of the Russian Federation Order of the People's Commissariat of Health of the USSR dated December 12, 1940 No. 584, which previously established a working day of 6.5 and 5.5 hours for medical workers, has actually become invalid.

The relationship between the new Government Decree and the List of industries, workshops, professions and positions, work in which gives the right to additional leave and a reduced working day, approved by the Decree of the USSR State Committee for Labor and the All-Union Central Council of Trade Unions of October 25, 1974 No. 298 / P-22. If you spend comparative analysis section "XL. Healthcare” of the said List and Decree of the Government of the Russian Federation No. 101, two main points can be distinguished:

1. In a number of cases, there has been an improvement in the situation of health workers compared to the 1974 List. So, doctors - heads of departments, offices in psychiatric (psycho-neurological), neurosurgical, narcological and other organizations according to items V and VI of List No. 1 now also have the right to a reduced working week of 36 hours. Another example. Currently, all doctors in dental treatment and prevention organizations, institutions, departments, offices are entitled to a 33-hour work week in accordance with clause III. List No. 2. According to the 1974 List, the right to a reduced work time provided only to the dentist-surgeon of the hospital. There are other changes in favor of workers.

2. The Decree of the Government of the Russian Federation does not indicate all the professions of medical workers that are listed in the 1974 List. In this regard, the question arises whether the List continues to operate in relation to those health workers whose positions and professions are not specified in the new Decree. It seems that the answer to it should be positive. The list has not been canceled and is valid, however, if, according to the results of certification ( special evaluation labor) working conditions are classified as safe, the provisions of the List do not apply (Decision of the Supreme Court of the Russian Federation dated 14.01.2013 N AKPI12-1570). This position is also supported by the Decision of the Supreme Court of the Russian Federation dated January 10, 2013 N AKPI12-1467, which stated that reduced working hours can be established for medical workers both on formal grounds depending on the position held and (or) specialty, and in connection with actual working conditions determined by the results of attestation of workplaces (special labor assessment).

Thus, the question of the relationship between the List of 1974 and Decree of the Government of the Russian Federation No. 101 is resolved, in our opinion, as follows: if both the Decree of the Government of the Russian Federation and the List indicate the same professions and the Decree of the Government improves the situation of medical workers, then this Decree should be applied; in relation to those professions that are on the List, but are not in the Decree, the procedure provided for establishing the reduced working hours of the positions indicated in the List applies.

The labor activity of healthcare workers is associated with great physical and emotional stress, the need in some cases to work in difficult and dangerous conditions for life and health. This determines some of the features legal regulation labor relations in this field of activity: additional requirements when concluding an employment contract, preferential working hours and rest periods, special rules for part-time work, etc. general provisions of the Labor Code of the Russian Federation, medical workers are subject to the provisions of the Federal Law of November 21, 2011 No. 323-FZ “On the basics of protecting the health of citizens in Russian Federation”, as well as a number of other subordinate regulatory legal documents. The main document regulating the work of a medical worker is an employment contract concluded with the employer.

Working hours

The legislator secured a special legal regulation of the work of medical workers, including by establishing a reduced working time for them (part 5 of article 92 and part 1 of article 350 of the Labor Code of the Russian Federation (hereinafter referred to as the Labor Code of the Russian Federation)), taking into account the provisions of art. 251 and 252 of the Labor Code of the Russian Federation, which provide for the possibility of establishing the features of legal regulation for certain categories employees due to the nature and working conditions. These measures are aimed at compensating for the specified category of workers the adverse effects of various kinds of factors, increased psychophysical stress due to the specifics and nature of medical and other activities to protect the health of the population, and, therefore, cannot be considered as violating the constitutional rights of citizens and the principle of equality, enshrined in Art. 19 (parts 1 and 2) of the Constitution of the Russian Federation.

The intensity of the labor process inherent in medical activity has always been compensated for by medical workers by reduced working hours and the provision of annual additional paid leave. Therefore, for all medical workers, Art. 350 of the Labor Code of the Russian Federation establishes a reduced working time - no more than 39 hours per week. For certain categories of medical workers, depending on the position they hold and (or) specialty, the Decree of the Government of the Russian Federation of February 14, 2003 No. 101 “On the length of working hours of medical workers depending on their position and (or) specialty” (hereinafter - Decree No. 101) in accordance with the Lists of positions established the length of working hours - 36, 33, 30 or 24 hours per week. For those positions of medical workers who are not included in said lists, working hours are regulated by Art. 350 of the Labor Code of the Russian Federation.

For your information

It should be noted that not all employees in a medical organization belong to the category of medical workers. For example, these are administrative and economic personnel, who are assigned a normal working time of 40 hours. At the same time, it should be taken into account that the working hours of a particular employee are established in an employment contract on the basis of an industry agreement and a collective agreement based on the results of a special assessment of working conditions.

To determine those who belong to the category of "medical worker", it is necessary to be guided by the norms of the Federal Law of November 21, 2011 No. 323-FZ "On the Basics of Protecting the Health of Citizens in the Russian Federation" (hereinafter - Law No. 323-FZ). According to Art. 2 of the law "medical worker - individual who has a medical or similar education, works in a medical organization and whose labor (official) duties include the implementation of medical activities, or an individual who is individual entrepreneur, directly carrying out medical activity».

Then the question arises: what is medical activity? The answer also contains Art. 2 of Law No. 323-FZ: “medical activity - professional activity providing medical care, conducting medical examinations, medical examinations and medical examinations, sanitary and anti-epidemic (preventive) measures and professional activities related to transplantation (transplantation) of organs and (or) tissues, circulation of donor blood and (or) its components for medical purposes.

Order of the Ministry of Health of Russia No. 801n dated July 25, 2011 approved the Nomenclature of positions of medical and pharmaceutical personnel and specialists with higher and secondary vocational education in healthcare institutions, which contains both positions of employees to be filled by persons with higher (secondary) medical education, and positions of employees to be filled by persons with other higher (secondary) professional education. Thus, in the event that an employee with a higher (secondary) non-medical professional education, in accordance with his labor (job) duties established in the employment contract and job description, carries out medical activities in the sense that Art. 2 of Law No. 323-FZ, he can be classified as a medical worker.

As for the leaders medical organizations and heads of their structural subdivisions, then in the event that, in accordance with their labor (official) duties established in the employment contract and job description, they carry out medical activities, they can also be classified as medical workers.

In accordance with paragraph 1 of Appendix 2 to Resolution No. 101, doctors of medical and preventive organizations, institutions: polyclinics, outpatient clinics, dispensaries, medical centers, stations, departments, offices, when conducting exclusively outpatient admission of patients, are entitled to a reduced 33-hour working week.

According to Art. 33 of Law No. 323-FZ, primary health care includes measures for the prevention, diagnosis, treatment of diseases and conditions, medical rehabilitation, monitoring the course of pregnancy, promoting a healthy lifestyle and sanitary and hygienic education of the population. Primary medical and specialized health care is provided by general practitioners, district general practitioners, pediatricians, district pediatricians and general practitioners (family doctors), specialist doctors, including medical specialists of medical organizations providing specialized, including high-tech, medical care. This type of medical care is provided on an outpatient basis and in a day hospital.

Thus, as part of the provision of primary health care, general practitioners, surgeons, neurologists, otorhinolaryngologists, ophthalmologists and others, in addition to outpatient reception of patients, carry out preventive examinations, medical examinations, home care, health education and other preventive work, therefore, they cannot conduct exclusively outpatient reception of patients and are not entitled to a reduced 33-hour working week.

In this regard, part of the working time of doctors as part of the provision of primary health care to the population, evenly by day of the week, is allocated to these types of work, based on the 39-hour duration of their working week.

A doctor - a dentist-surgeon, a doctor - maxillofacial surgeon of medical and preventive organizations, institutions can be assigned a 33-hour working week, if their official duties do not provide for other work, namely: conducting advanced training classes medical staff, participation in medical examination, other sanitary and preventive work, organization of treatment at home. Doctors - dentists-surgeons and doctors - maxillofacial surgeons working in hospitals are set a 39-hour work week.

Summarized accounting of working hours

In accordance with the current labor legislation, in organizations where, due to working conditions, the daily or weekly working hours established for this category of workers cannot be observed, it is possible to introduce a summarized accounting of working hours. The procedure for introducing the summarized accounting of working hours is established by the rules of the internal work schedule organizations.

Medical organizations with hospitals provide medical care to the population regardless of the time of day and days of the week, therefore, in the internal labor regulations, medical workers are established with a summarized record of working hours or shift work for them to be on duty in the evening and at night, on Sundays and holidays in accordance with the approved work schedule.

In the case of summarized working time, the duration of working time should not exceed the normal number of working hours for a specific accounting period of time. The normal number of working hours for the accounting period is determined based on the weekly working hours established for this category of medical workers. For employees working part-time (shift) or part-time working week, the normal number of working hours for the accounting period is reduced accordingly.

The use of summarized working time is based on the fact that the duration of the working week established by the current legislation is provided by the schedule on average for the accounting period. Scheduled daily and weekly working hours may deviate to a certain extent from the established standard of working hours. In this case, the emerging defect (processing) must be corrected in the established accounting period (month, quarter, and other periods). The number of working hours according to the schedule must be equal to the number of working hours according to the established norm for this period. The accounting period cannot exceed one year, and for the working hours of employees employed in work with harmful and (or) dangerous working conditions - three months (part 1 of article 104 of the Labor Code of the Russian Federation).

Organization of shift work

Article 91 of the Labor Code of the Russian Federation obliges the employer to keep records of the time actually worked by each employee. In relation to medical organizations, the employer ( chief physician) or a person authorized by him is obliged to maintain work schedules for medical workers.

In medical organizations with hospitals, employees alternate shifts evenly and, as a rule, the transition from one shift to another is made every week at the hours determined by the shift schedule. As for the employees of outpatient medical organizations, they move from shift to shift every other day.

The rational organization of outpatient care for the population largely depends on correctly drawn up schedules, which are an integral part of the work plan of the polyclinic and its structural divisions. They regulate the time of the beginning and end of daily work, the number and duration of work shifts, their alternation and the calendar of days off for medical personnel. Schedules are drawn up for a specific accounting period according to structural divisions, groups of personnel (medical, middle, junior, etc.) and for each position occupied (main, combined and replaced, part-time) separately.

The duration of the shift (duration of work during the day) on different days of the week may deviate from the established length of the working day, but the sum of the duration of all shifts per month must necessarily correspond to the monthly balance of working hours. The duration of one shift should not exceed 12 hours. The duration of the break between shifts cannot be less than twice the duration of the working shift. The number of days off per month for each employee must correspond to the number of days off provided for by the calendar. The schedules must reflect the recorded types of work performed by the doctor: reception at the clinic, including dispensary, home visits, and other preventive work.

Shift schedules are communicated to the employee. As a rule, not later than one month before its entry into force.

Changing clothes before and after the end of the working day (shift) is not included in the calculation of working time.

Breaks for rest and meals

In accordance with Art. 108 of the Labor Code of the Russian Federation, during the working day (shift), a medical worker must be given a break for rest and meals lasting no more than two hours and at least 30 minutes, which is not included in working hours. However, in those jobs where, due to working conditions, it is impossible to provide a break for rest and food, the employer is obliged to provide the employee with the opportunity to rest and eat during working hours. The list of such works, as well as places for rest and eating, are established by the internal labor regulations. This rule also applies to medical workers with both 6.5-hour and more reduced working days.

Example

For medical workers working at ambulance stations (departments), where to install exact time for eating and rest is impossible, the internal labor regulations set an approximate time, for example, from 13.00 to 16.00. A similar approach is used in the internal labor regulations and for ambulance drivers.

Working hours on the eve of non-working holidays

According to Art. 95 of the Labor Code of the Russian Federation, the length of the working day or shift immediately preceding a non-working holiday is reduced by one hour both for employees with normal working hours and for those who work under reduced working hours (including medical workers), regardless of the reason for its reduction. However, it should be remembered that the duration of work at night (including for medical workers who have a reduced working time) is equalized with the duration of work during the day (i.e., the duration of work (shift) at night is not reduced by one hour) in cases where this is necessary due to working conditions, as well as for shift work with a six-day work week with one day off. The list of these works may be determined by a collective agreement, local normative act.

If a non-working holiday follows a day off, then the working day preceding this day off is not subject to reduction. If the week falls on a pre-holiday day, the working hours for that week are adjusted accordingly. This rule applies to both the five-day and six-day working weeks.

The main form of compensation for processing on the pre-holiday day in continuously operating organizations and certain types work, where it is impossible to reduce the duration of work (shift), is to provide the employee with additional rest time. Compensation for such processing should be provided for in the shift schedule. If in the organization this issue is not regulated by the shift schedule or the collective agreement, then additional rest time is provided by agreement of the parties. Replacing processing with payment according to the norms established for overtime work is allowed only with the consent of the employee.

Duty of medical workers, including at home

The labor function on duty of medical workers, performed outside the normal working hours, is similar to the labor function on duty of medical workers performed according to the schedule.

In accordance with the norms of the Labor Code of the Russian Federation labor function employee must be specified in the employment contract. Any work that is in addition to it must also be reflected in the employment contract. Based on this principle, it can be concluded that additional types of work specified, in particular, in subparagraph "g" of paragraph 2 of the Decree of the Ministry of Labor of Russia dated August 30, 2003 No. 41, can be formalized either as a combination of professions (positions), or as part-time work, for example, internal, if there are positions in the staff list of a medical organization.

As mentioned above, the duty of medical workers is a specific job and, of course, must be formalized within the framework of an employment contract. In this case wage for duty should also be included in average earnings medical workers.

However, it must be borne in mind that, in accordance with the Labor Code of the Russian Federation, any additional work or type of work is performed only with the consent of the employee himself. For example, the question is often asked about the legitimacy of involving doctors from outpatient departments of hospitals, dispensaries, maternity hospitals, etc. to be on duty in hospitals. Such duties are possible only with the personal consent of the employee himself and if such functions are recorded in the due duties of the medical worker.

As for the involvement of medical workers working in hospitals on duty in a hospital, such functions should also be taken into account in official duties worker.

The head of a medical organization may, within his authority, approve the workload rate for an employee.

In 2013 in Art. 350 of the Labor Code of the Russian Federation, amendments were made that establish that in order to implement the program of state guarantees for the provision of free medical care to citizens in an emergency or emergency form, medical workers of medical organizations, with their consent, can be placed on duty at home.

TO this species activities, medical workers were involved earlier, however, the corresponding norm was canceled in 2008, since it contradicted the current labor legislation, and until 2013 there was no legal definition of the concept of home duty in the legislation.

But no one canceled the specifics of the activities of medical workers, and the medical organization was obliged to provide emergency medical care to citizens and ensure the smooth operation of the organization on weekends and non-working holidays, at night, including the elimination of accidents, etc. Therefore, in 2011, an order was issued by the Chairman of the Government of the Russian Federation to the Ministry of Health and social development RF develop project federal law on amendments to the Labor Code of the Russian Federation, which fixes the specifics of the work of doctors and paramedical personnel when they are on duty at home.

In Art. 350 of the Labor Code of the Russian Federation defines duty at home - this is the stay of a medical worker of a medical organization at home waiting for a call to work (to provide medical care in an emergency or urgent form).

In addition, it is established that when taking into account the time actually worked by a medical worker of a medical organization, the time on duty at home is taken into account in the amount of 1/2 hour of working time for each hour of duty at home. The total duration of the working hours of a medical worker of a medical organization, taking into account the time of duty at home, should not exceed the norm of working hours of a medical worker of a medical organization for the corresponding period. Particular attention should be paid to the fact that shifts are introduced only with the consent of the employee.

Peculiarities of the regime of working time and accounting of working time when medical workers of medical organizations carry out duty at home are established by the order of the Ministry of Health of Russia dated April 2, 2014 No. 148n “On approval of the Regulations on the peculiarities of the regime of working time and recording of working time when medical workers of medical organizations perform duty at home”.

For medical workers on duty at home, the rules of the internal labor schedule establish a summarized record of working time.

The start and end time of duty at home is determined by the work schedule approved by the employer, taking into account the opinion of the representative body of employees.

In the event of a call to work of a medical worker on duty at home, the time spent on providing medical care and the time spent by the medical worker from home to the place of work (place of medical care in emergency and urgent form) and back is taken into account in the amount of an hour of working time for each hour of medical care and the medical worker's movement from home to the place of work (place of medical care in emergency and urgent form) and back. At the same time, the time of duty at home in the accounting period is adjusted in such a way that the total duration of the working time of a medical worker of a medical organization, taking into account the time of duty at home, taken into account in the amount of one second hour of working time for each hour of duty at home, does not exceed the norm of working time of a medical worker of a medical organization for the corresponding period.

The procedure for recording the time spent by a medical worker from home to the place of work (place of medical care in an emergency and emergency form) and back is established by a local regulatory act in agreement with representative body workers.

The employer is obliged to keep records of the time the employee stays at home in the waiting mode for a call to work, the time spent on providing medical care, and the time the medical worker travels from home to the place of work (place of emergency and emergency medical care) and back if he is called to work while on duty at home.

Example

The doctor has a reduced working time of 39 hours per week. In a medical organization, a work schedule has been established for him, which provides for the provision of medical care at the workplace for 29 hours a week and duty at home (the doctor must be ready to be called to workplace) for 20 hours a week. In total, the working hours will be 49 hours per week. At the same time, 20 hours of time spent on duty at home is counted to the doctor as half an hour for each hour of duty (including night duty), i.e. the duration of the recorded working time in total will be the same 39 hours as in the normal mode of operation. If, during the duty at home, the doctor was called to work for 3 hours, then the remaining time on duty at home is reduced by 6 hours, so that the amount is 39 hours.

The trade union of healthcare workers of the Russian Federation took an active part in the working group under the committees of the State Duma on labor, social policy and the disabled, health protection in the preparation of the draft law. The trade union suggested setting medical workers, with their consent, on duty at home outside the working hours established for a particular employee, and the duration of this duty should not exceed the monthly norm of working hours for the accounting period established by the employee. In addition, the Trade Union offered, in case of calling a medical worker on duty at home, to work, the time spent on providing medical care, and the time spent traveling from home to the place of work and back, to pay in the amount of at least a double part of the salary ( official salary), calculated per hour of work, taking into account all established monthly allowances and surcharges. However, the proposals of the Trade Union did not find support among the deputies and representatives of the ministries of health and finance of the Russian Federation.

After amending Art. 350 of the Labor Code of the Russian Federation, with their consent, medical workers can be placed on duty at home in the form of staying at home awaiting a call to work (for providing medical care in an emergency or urgent form) within the normal working hours.

When taking into account the time actually worked by a medical worker, the time on duty at home is taken into account in the amount of 1/2 hour of working time for each hour of duty at home. As a result, medical workers in this situation actually work in the extended working hours, which is contrary to labor legislation in terms of observing the norm of working hours.

These circumstances entail the unwillingness of workers to carry out duty, thereby increasing the tension of the psychological climate in teams, medical workers refuse to be on duty within the normal working hours.

In order to generalize the established practice of implementing Art. 350 of the Labor Code of the Russian Federation regarding the implementation by medical workers of duty at home, the Central Committee of the Trade Union monitored the registration and payment of these duties.

The monitoring results showed that due to insufficient staffing of medical personnel (as well as a lack of positions) to carry out duty at home within the established norm of working hours, as provided for in the law, is quite problematic, and in some cases impossible (this was indicated by 20 regional organizations of the Trade Union). At the same time, the practice of registration and payment of duty at home is not uniform.

The existing system of duty at home within the limits of working time is actually voluntary-compulsory in nature, and in the presence of only one or two specialists, it turns into round-the-clock duty. In most cases, home calls are carried out outside the norm of working hours, while payment is carried out either as overtime work, or as part-time work, or in the form of compensation payments. At the same time, the heads of medical organizations are placed in the strict framework of Art. 99 of the Labor Code of the Russian Federation, which provides for restrictions on involving employees in overtime work - 120 hours. In practice, the time of work carried out in the form of duty at home significantly exceeds this norm.

In this regard, the Central Committee of the Trade Union again appealed to the Health Protection Committee of the State Duma of the Federal Assembly of the Russian Federation with a proposal to return to the discussion of the issue of implementing Art. 350 of the Labor Code of the Russian Federation regarding the implementation by medical workers of duty at home.

Hello dear friends. Today we will consider what is the duration of the working hours of medical workers according to the law. The main document establishing the duration of the working time of all physicians is Decree of the Government of the Russian Federation No. 101 of February 14, 2003.

The amount of hours worked per week depends on the group to which the employee belongs. There are 4 groups of health workers, the length of hours worked which varies depending on the presence of dangerous, harmful conditions in the workplace. Let's take a look at these groups.

Basic moments

I would like to note right away that the division into these groups was made on the basis of the Labor Code of the Russian Federation. The smallest group is the health care workers servicing the radio manipulation equipment with gamma radiation: 24 hours a week or 4.8 hours (4 hours 48 minutes) per day with a 5-day week.

They are engaged in gamma therapy and gamma irradiation using special techniques. This is a profession that is very hazardous to health, so this group of doctors also has the right to an increased duration of the next vacation, preferential retirement experience and additional payment for harmful conditions.

Second group

The next group of doctors should work 30 hours a week, or 6 hours a day with a 5-day week. This group includes the following employees:

• Institutions involved in the treatment of tuberculosis, including all workplaces that have contact with patients for this type of disease.
• Morgues, prosectoral and pathological-anatomical laboratories - all employees who have the opportunity to contact with corpses.
• Expert groups that carry out activities that confirm the presence of TB disease in patients.
• Forensic examinations that come into contact with corpses and their parts.
• Services that collect and store cadaveric blood.
• Units that carry out contact with X-rays (fluorography), radioactive substances used in gamma examination.

Third group

In this group of doctors, the reduction in working hours is 33 hours per week, or 6.6 hours (6 hours 36 minutes) per day with a 5-day week.

All doctors involved in primary and secondary admission of patients in polyclinics, employees of physiotherapy departments servicing devices at an ultrashort-wave frequency of more than 200 W, and all dentists, except those involved in jaw or dental surgery, are related to it.

Other

The fourth group includes the majority of health workers involved in the reception and treatment of patients. Their working week is 36 hours or 7.2 hours (7 hours 12 minutes) per day. These are doctors, nurses and orderlies (except those involved in statistics and archivists):

• Organizations that treat infectious and dermatovenereological diseases.
• Leprosoriev.
• Organizations providing treatment, maintenance and examination of patients with AIDS and HIV-infected.
• Laboratories that come into contact with the blood of AIDS patients and HIV-infected people.
• Psychiatric, neurosurgical and narcological organizations conducting examination and treatment of patients with these diseases, in addition social organizations to help the homeless.
• All children's medical organizations that are engaged in the maintenance of disabled children, children with mental and nervous diseases and mentally retarded.
• Physiotherapy services serving hydrogen sulfide and sulfur baths, mud peat and ozokerite clinics that have contacts with hydrogen sulfide and sulfur dioxide, preparing mud baths and cleaning after them.
• Expert groups who have contact with patients who have signs of mental illness.
• Ambulance stations and other types of urgent care, also involved in the delivery of mental and infectious diseases to special hospitals.
• Sanitary-epidemiological and anti-plague organizations.
• Blood transfusion stations.
• Organizations engaged in the rehabilitation of drug addicts and alcoholics.
• Services in contact with radioactive liquids and X-rays.

Some exceptions

As you can understand, for health workers in clinics, hospitals and sanatoriums, kindergartens and schools, if they do not fall into the above groups, the working time is within 39 hours per week or 7.8 hours (7 hours 48 minutes) per day with a 5-day week.

When a health worker falls into one of the groups that have the right to reduce working hours under the Labor Code of the Russian Federation (disabled people under the age of 18, etc.), then his working day corresponds to the duration in this group.

For women workers in the countryside, the established working week is 36 hours, regardless of the work performed, unless they belong to groups with a shorter working day.

We consider the schedule

Some difficulty is caused by issues of paying part-time jobs and overtime hours on schedule. Health workers are allowed to work part-time in the amount of half the monthly rate.

It must be borne in mind that if a physician has a norm, for example, 36 hours a week, then half the rate is 18 hours and no more. If there are unoccupied vacancies, it is allowed to combine one more full-time position.

When organizing round-the-clock duty, a schedule is drawn up that takes into account the monthly norm of hours, which can be specified in the production calendar or calculated independently.

For example, with a 36-hour work week, the monthly rate will be 172 hours, and the round-the-clock schedule will look like this:

1st worker

2nd worker

3rd worker

4th worker

5th worker (replacement)

1st worker

2nd worker

3rd worker

4th worker

5th worker (replacement)

Where 12 is the day shift, 12 is the night shift. A replacement worker (fifth) is usually needed in the absence of the main worker (another vacation, sick leave). If all the workers are in place, he has a shortfall to the norm of hours.

All changes within the medical institution regarding working hours are made by order 2 months before the start of its action with the simultaneous execution of the corresponding change to employment contract worker.

Compared to the Soviet period, there were no special changes in the length of the working day for medical workers, only new positions and professions were added to the lists. The only deterioration was the restriction of payment for night hours (from 22-00 to 6-00) to 20% of the tariff, salary.

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Question: Based on the Decree of the Russian Federation of February 14, 2003 No. 101, Appendix 2 establishes a 33-hour working week for employees of dental institutions. But in this list there is no position of a dentist-surgeon and honey. sisters. On the basis of what document is the working time for these positions determined?

Answer: In accordance with Article 350 of the Labor Code of the Russian Federation, a reduced working time of no more than 39 hours per week is established for medical workers. And further it is indicated that, depending on the position and (or) specialty, the working hours of medical workers are determined by the Government of the Russian Federation. The duration of the working hours of medical workers is regulated by the Decree of the Government of the Russian Federation of February 14, 2003 No. No. 101 "On the duration of the working hours of medical workers, depending on their position and (or) specialty." Decree of the Government of the Russian Federation No. 101 consists of three annexes, each of which grouped lists of positions and (or) specialties of medical workers and the corresponding number of working hours per week, more than which medical workers falling under the scope of one or another application cannot work. Thus, Appendix No. 1 contains a list of positions and (or) specialties of medical workers for whom a 36-hour work week is established. Appendix No. 2 contains a list of positions and (or) specialties of medical workers for whom a 33-hour work week is established. This list includes medical workers of medical and preventive organizations, institutions (polyclinics, outpatient clinics, dispensaries, medical centers, stations, departments, offices); physiotherapeutic medical and preventive organizations, institutions, departments, offices; dental treatment and prevention organizations, institutions (departments, offices). Appendix No. 3 contains a list of positions and (or) specialties of medical workers for whom a 30-hour work week is established. This list also includes medical workers performing work related to radioactive substances and sources of ionizing radiation.

According to Decree of the Government of the Russian Federation of February 14, 2003 No. 101, the working hours of the following medical workers of dental clinics (departments, offices) is 33 hours a week:

• Dentist;
• Dentist-orthopedist;
• Dentist-orthodontist;
• Children's dentist;
• Dentist-therapist;
• Dentist;
• Dental technician (except dentist-surgeon, oral and maxillofacial surgeon).

Articles referred to in this paragraph dentists-surgeons are also not included in other annexes of this Decree that establish other reduced working hours. Thus, the duration of the working hours of dentists-surgeons is, in accordance with Art. 350 of the Labor Code of the Russian Federation 39 hours a week. Similarly, the issue of other positions and (or) professions of medical workers in dental clinics (departments, offices) should be resolved. So, if any positions and (or) professions of medical workers engaged in their labor activities in a dental clinic (department, office) are not in appendices Nos. 1-3 of the Resolution, then for this category of workers, working hours should be established in accordance with Art. 350 of the Labor Code of the Russian Federation, that is, 39 hours a week.

"Accounting in medicine" No. 1, 2007

DI. ROMANOV, Lawyer of CJSC "Legal Support Group"

Due to its specificity, the activities of medical workers are classified as a separate category. And the norms of working hours for them are different from the usual ones. They are defined in government lists depending on the position or specialty held by the employee. But there are specialties that are not included in these lists. What should be followed in such cases? Consider how these issues are regulated by law.

Legislative regulation of norms

The maximum working hours established in Article 350 of the Labor Code of the Russian Federation (hereinafter referred to as the Code) is 39 hours per week for any healthcare worker. This length of working time is characterized as reduced. Whereas the normal length of the working week in accordance with Article 91 of the Code for all employees, with the exception of those specified in chapter 55 (military, medical and creative workers) is 40 hours per week.

However, the Labor Code establishes only the maximum length of working hours. And specific norms depend on the positions and specialties of health workers. Their lists are given in Decree of the Government of the Russian Federation of February 14, 2003 No. 101 (hereinafter referred to as Decree No. 101). It indicates for which specialists and for which positions this or that duration of the maximum working time per week is established.

Working hours

For medical workers of middle and junior level working in infectious diseases hospitals, skin and venereal dispensaries, leper colonies, medical institutions for the prevention and control of AIDS and infectious diseases and similar establishments, a 36-hour working week is established (Appendix No. 1 to Decree No. 101).

A 33-hour work week, according to Appendix No. 2, is provided for doctors of medical and preventive organizations who conduct exclusively outpatient appointments. Also for doctors and paramedical personnel, physiotherapeutic treatment and prevention organizations working full-time on medical ultrashort-wave frequency (UHF) generators with a power of over 200 W, dentists of various specializations (except for a dentist-surgeon and a doctor-maxillofacial surgeon).

Heads of tuberculosis treatment facilities and heads of departments are ordered to work 30 hours a week. The same time is allotted for the work of junior and middle-level doctors of anti-tuberculosis organizations and some others (Appendix No. 3). The list of positions of medical workers who have a 30-hour work week is supplemented by the order of the Ministry of Health of the Russian Federation dated May 30, 2003 No. 225.

Medical workers whose work is associated with radioactive substances and sources of ionizing radiation are supposed to work no more than 24 hours a week (clause 1 of Resolution No. 101).

What if this or that position (specialty) is not included in the specified Lists?

In such cases, Article 423 of the Code gives the right to be guided by the normative legal acts of the former USSR insofar as it does not contradict the current labor legislation. We will turn to them.

"Former" norms allowed for use

If any position or specialty is not in the above documents, then the resolution of the Council of People's Commissars of the USSR dated December 11, 1940 No. 2499 and the order of the People's Commissariat of Health of the USSR dated December 12, 1940 No. 584 "On the duration of the working day of medical workers" will help determine the permissible working hours. In them, medical institutions are divided into groups according to specialization, and each group has its own standards.

So, for doctors and paramedical staff of the following medical institutions, the norm is set - 6.5 hours a day:

Hospitals, maternity hospitals, clinics, clinics and other inpatient medical institutions;

Specialized sanatoriums, dispensaries, stations and blood transfusion points;

Outpatient clinics (with the exception of doctors engaged exclusively in outpatient admission of patients);

Health centers and first aid posts, stations and points of emergency and emergency medical care;

Sanitary and epidemiological institutions;

Medical, feldsher, obstetric and nursing general and specialized offices;

Women's and children's clinics, orphanages, orphanages, children's rooms and rooms for mother and child;

Institutions of forensic medical examination;

research institutes and laboratories, etc.

A 6-hour working day is established for doctors, paramedical and junior medical workers, as well as cleaners of the wards of the following medical institutions:

Sanatoriums, hospitals for patients with open forms of tuberculosis;

Hospitals, departments of hospitals and barracks for contagious patients;

Psychiatric hospitals provided direct service to patients;

X-ray therapy rooms;

Mud, sulphurous and hydrogen sulfide baths (baths and nannies);

Anatomical institutes, provided that they work exclusively in prosectors and morgues (junior medical workers);

Disinfection facilities, etc.

5.5 hours a day are supposed to work for doctors of outpatient clinics engaged exclusively in outpatient admission of patients, medical labor expert (VTEK) and medical consultation (VKK) commissions.

In addition, you can use the following rules:

It can be seen from the above documents that the more dangerous the work for health, the shorter the established working hours.

Features of the application of norms

What you need to pay attention to.

Application of old rules. If you had to use the decision of the Council of People's Commissars of the USSR. No. 2499 and the order of the People's Commissariat of Health of the USSR No. 584, it must be taken into account that the norms of working hours are set for the day. Article 104 of the Code does not directly provide for such an accounting period as a “day” in the case of a summarized accounting of working time. It indicates "month, quarter and others", but "no more than a year." At the same time, the working day is mentioned as an accounting period in Article 102 of the Code. Therefore, the use of such a unit of accounting for working hours is possible, but in practice this will cause some inconvenience. We will have to additionally conduct daily monitoring of compliance with the relevant standards. To avoid this, when creating staffing it is still better to use the modern names of positions and specialties of health workers specified in Decree No. 101 (of course, if there is an alternative in choosing a name).

Overtime work. As mentioned above, the maximum 39-hour work week is set for all medical workers. The norms for certain categories are even lower. And work in excess of these standards will be overtime work (Article 99 of the Code) with all the ensuing consequences. In particular, the need to comply with the procedure for engaging in overtime work and paying for overtime work in an increased amount (Articles 99, 152 of the Code).

Daily rate. One more point should be taken into account. Decree No. 101 establishes the length of working hours per week. It is logical to assume that to determine the daily norm, the number of hours must be divided by five working days (or by six if the week is six days). However, the daily rate calculated in this way can be extended if necessary. Here you can apply the provisions of Article 94 of the Code. In which it is indicated that for employees with a 36-hour working week, the duration per day (shift) cannot exceed 8 hours, and with 30-hour or less - 6 hours.

EXAMPLE

The therapist carries out treatment with a gamma drug in a specialized institution. Working hours - "five days" with two days off. Working time per week is 24 hours. Thus, the duration of the day shift is 4.8 hours (24:5). Due to production needs

up to 6 hours. However, then in a week the actual working time (30 hours) will exceed the established maximum norm - 24 hours. It will turn out processing in 6 hours.

In such a situation, you can choose one of the options:

Arrange processing as overtime work in the manner prescribed by Article 99 of the Code;

Establish a working regime with irregular working hours in accordance with Article 101 of the Code;

Reduce any other working day by a number of hours equal to the processing time (then it will be flexible working hours in accordance with Article 102 of the Code) so that the weekly rate does not exceed 24 hours.

In addition, the employer has the right to reduce the working week to 4 days. Then the weekly rate will be met (4 days x 6 hours = 24 hours a week).