Women Doctors Uncover Gender Pay Gap at Children’s Hospital

Landspítali national hospital

Three paediatricians at Landspítali, The National University Hospital of Iceland, uncovered a gender pay gap at the children’s wing, Vísir reports. The women’s pay has since been adjusted accordingly and they’ve been given back pay to correct the injustice.

The three paediatricians, all women, started investigating salaries in the wake of the Women’s Strike last October. They utilised a clause in legislation that allowed them to access the salaries of all specialist doctors at the children’s and women’s wing and discovered that the men received higher pay, irrespective of qualifications.

Women’s experience not valued

According to collective bargaining agreements, doctor pay is mostly determined by education and the length of their careers. In addition, administrators can make a subjective choice on additional pay, taking into account factors such as subspecialties, administrative experience, and research and teaching history. A memo on how these factors should be evaluated was published in 2016, but was not used when the women were hired that same year.

A small gap remains

The women published an article in The Icelandic Medical Journal exposing the pay gap after appealing to a public committee on equality. Hospital administrators corrected their pay accordingly. Furthermore, the hospital looked into the wage setting of all specialist doctors at the hospital and found a 1.4% bias towards men. The hospital has had an equal pay certification since 2020 and a goal of keeping the gender pay gap under 2.5% at any time.

“I will never again believe that wage setting is fair,” said one of the doctors, Helga Elídóttir. “I’ll need to look for myself.”

Euthanasia Bill Presented in Parliament

landspítali hospital

Five MPs from the Reform Party have presented the first ever bill in Alþingi, Iceland’s Parliament, concerning euthanasia, Morgunblaðið reports.

Katrín Sigríður J. Steingrímsdóttir, a reserve MP for the Reform Party, presented the bill on her colleagues’ behalf. “I think most of us have experienced having loved ones with terminal illness and dealing with pain,” she said, adding that euthanasia, or the assisted termination of life, should be one option of many. “I think this option should be available for people in this situation, as this is a matter of personal freedom and a humanitarian issue at the same time, and I think it’s very important that Alþingi has the chance to have experts submit reviews on this issue.”

Guiding light of liberal politics

Katrín Sigríður added that the people affected by the issue need someone to fight for their rights and that she wanted to introduce the subject during her temporary service in Alþingi as a reserve MP. “Euthanasia has been a cause close to my heart for many years, so I wanted to champion it,” she said. “A subject like euthanasia is at the core of my politics, combining liberalism and a humanitarian view, which is my guiding light politically.”

Doctors could opt out

Euthanasia is legal in many European countries, such as the Netherlands, Switzerland, Luxembourg and Germany. Katrín Sigríður said that her bill is based on the Dutch law and that there are many ethical questions that need to be answered. “That’s why I thought it important to add a clause to the bill allowing doctors to opt out of providing this assistance and that they would be in their right to choose whether to help with euthanasia or not,” she said, adding that she wanted to respect people’s convictions if they objected on religious or moral grounds.

Staff Shortages Impact Mothers’ Safety, Midwives Say

The vast majority of midwives in Iceland say mothers’ safety has been put at risk due to staff shortages. Almost one-third of midwives have considered leaving the profession altogether within the last two years. Too much strain, staff shortages, and dissatisfaction with how the shortening of the work week has impacted shift work are all named as key reasons.

The data is from a recent survey by BHM which was commissioned by Icelandic Association of Midwives last month. According to the survey, 85% of midwives say the safety of mothers has been put at risk at some point in the past six months due to staff shortages, and 48% of them say that such incidents happen more often than before.

More strain on shift workers

When asked to consider the last six months, 85% of midwives say they have encountered situations where staffing was not sufficient to ensure minimum safety requirements for patients. This percentage is lower among midwives who work daytime hours (72%) and higher among those who work shifts (93%). Notably, 39% of shift workers stated they have often encountered such situations within the past six months.

Dissatisfaction with impacts of “shortened” work week

Three-quarters of midwives stated that the level of strain they experience on the job is “high” or “very high,” and 70% say that strain has increased over time. These figures are higher among shift workers than daytime workers.

When asked how their working conditions had changed with the shortening of the working week, 54% of midwives working shifts in the public healthcare system believe that working conditions have worsened as a result, while only 30% believe that working conditions have improved. There is great satisfaction with the shortened work week among midwives in daytime work, while dissatisfaction among shift workers is mainly related to a system that financially incentivises them to take more evening and night shifts, as well as the negative effect on work flexibility.

Staff shortages and strain have been an issue across Iceland’s healthcare system for years, including among nurses and in emergency care.

Never More Strain on Hospital, Chief Physician Says

Emergency room

New rules took effect today at Iceland’s National University Hospital of Iceland due to increased strain and an outbreak of respiratory infections. Mask use is once again mandatory for outpatients and visitors, and visiting hours have been reduced. Chief Physician of the Infectious Diseases Ward Már Kristjánsson told RÚV it is “the most strain that we have ever seen the hospital under.”

Mandatory mask use

Mask use is mandatory in all interactions with patients as of today, January 4. Inpatients are not required to wear masks, but outpatients and their chaperones are required to do so. Visitors and others entering the hospital are also required to wear surgical masks. In departments where COVID-19 outbreaks occur, staff are required to wear fine particle (FFP2) masks.

Visiting hours have been shortened and will be between 4:30 and 7:30 PM on weekdays and 2:30-7:30 PM on weekends. The hospital recommends guests come one at a time and wash their hands upon entering the hospital.

Exceptions may be granted

Sibling visits to the children’s hospital are only permitted in consultation with the children’s ward staff. Exceptions to all of the new infection prevention regulations can be granted by department or shift managers.

Read more about the National Hospital’s persistent problem of patient flow.

Icelandic Doctors and Nurses Sign Ceasefire Petitions

Nurses Hospital Landsspítalinn við Hringbraut

Over 400 Icelandic doctors have signed a petition calling on the Icelandic government to denounce Israel for its attacks on Gaza and demand an immediate ceasefire, mbl.is reports. A separate letter from Icelandic nurses with the same demands has 254 signatures, RÚV reports. The letter outlines the deaths and destruction of infrastructure caused by Israel’s attacks in Gaza and call the situation a humanitarian crisis.

“In the past few weeks, Israel has carried out extensive attacks on Gaza in revenge for a terrorist attack which was carried out in Israel. Israel’s attacks have killed at least 10,569 Palestinians, including at least 4,324 children. The attacks have also caused tremendous destruction of Palestine’s infrastructure, which is at the point of collapse. Israel has cut off all water, electricity, and food supplies to residents of Gaza and is significantly restricting all aid from Egypt. A serious humanitarian crisis is happening that must be responded to as quickly as possible,” the opening of the letter from Icelandic doctors reads.

Demand Icelandic government puts pressure on Israel

The letter outlines the impact of the attacks on healthcare services in Gaza, including the killing of healthcare staff, destruction of hospitals, clinics, and ambulances. “The healthcare system in Gaza collapsed a long time ago,” it reads, in part. “Hospitals in Gaza cannot fulfill their role.”

“We the undersigned send this letter with the sincere wish and demand that the Icelandic government responds to the serious events that are now happening and demands a ceasefire,” the letter continues. “The government should put pressure on Israel to stop the continuing attacks on innocent residents of Gaza and on healthcare services in the area and condemn [Israel’s] actions.”

Locals in Iceland have held regular protests calling on the government to denounce Israel’s attacks and pressure for a ceasefire. A protest in support of a ceasefire will be held outside the US Embassy in Reykjavík today at 5:00 PM.

Healthcare and Education Services Especially Impacted by Women’s Strike

women's day off iceland 2018

The Women’s Strike scheduled for tomorrow, October 24, is expected to have a significant impact on services offered throughout Iceland.

Women and non-binary persons all over the country will put down their paid and unpaid work for an entire day and thousands are expected to participate in the strike to show solidarity.

Companies and institutions have made plans to deal with the temporary labour shortage, but some services may be disrupted.

Healthcare and education affected

Fields in which women form the majority are expected to be especially affected, such as healthcare and education.

RÚV reports that 5,493 of the total 6,856 employees at Landspítali, the National University Hospital, are women. This represents 80% of the entire workforce.

Runólfur Pálsson, director of Landspítali, stated to RÚV that operations tomorrow will be scheduled in such a way as to allow as many as possible to participate in the strike.

“Of course, we will continue to provide all emergency services, urgent tasks, and necessary surgeries,” he stated. However, he stressed that the nature of healthcare work means that not all can be absent from work. He instead encouraged those who do not or cannot participate in the strike to take pictures of themselves at work so that others can express solidarity with them.

Schools throughout Iceland are also expected to be affected by the strike. According to the Icelandic Teachers’ Union, women make up 94% of preschool teachers, 82% of primary school teachers, and 62% of secondary school teachers.

Katrín goes on strike

Prime Minister Katrín Jakobsdóttir has also expressed her solidarity with the Women’s Strike, stating that she will be laying down her duties tomorrow, October 24.

She stated to Vísir: “I will be putting down my work to show solidarity with women. It is an incredible situation in the year 2023 that we still have gender pay gaps, that we haven’t achieved full equality, and that we are still dealing with gender-based violence.”

Stating that these issues have long been a priority for her government, she continued: “We are seeing the gender pay gap decrease, and we have also taken significant actions to address gender-based violence.”

Katrín also called for others to take part in the strike as well.

Publish a list

Organizers of the Women’s Strike will also be publishing a list of employers who obstruct women’s participation in the strike tomorrow.

Sonja Ýr Þorbergsdóttir, chairperson of BSRB, a federation of public labour unions, is one of the organizers of the Women’s Strike. She stated that they hope to ensure that as many people are able to participate as possible. To that end, they have created a document that allows workers to report workplaces discouraging participation in the strike.

Sonja stated to Vísir: “We hope to establish initial contact with these employers and encourage them to support women and women’s participation in this important fight for gender equality.” She continued:  “Many of the submissions also come with accounts of injustices within workplaces, so we thought that we might even take it a step further and publish the names of those employers who do not intend to support this struggle for equality.”

Workplaces and institutions can be reported anonymously here.

Women in Iceland first went on strike in 1975. Some 90% of Icelandic women took place in what was called Women’s Day Off and equal pay legislation was passed in parliament the following year. Other labour actions have occurred in 1985, 2005, 2010, 2016, and 2018. Tomorrow will be the seventh Women’s Strike.

Read our archival coverage of the 1985 Women’s Day Off.

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Minister Advocates for Fiscal Restraint in Iceland’s New Budget

Prime Minister Bjarni Benediktsson

In a budget briefing yesterday, the Finance Minister highlighted increased government earnings while advocating for fiscal restraint to counter inflation. He revealed a multifaceted approach for the upcoming year, which included streamlining state institutions for targeted savings of ISK 17 billion [$129 million / €119 million], revising road taxes to account for the surge in electric vehicles, and adjusting income tax brackets, all against a backdrop of a projected state treasury deficit and rising healthcare costs.

Cautious optimism tempered by financial and demographic challenges

During yesterday’s press conference on the state budget, Finance Minister Bjarni Benediktsson underscored the significance of acknowledging a marked increase in government revenue, which had surpassed earlier projections. He advocated for continued fiscal discipline to mitigate rising inflationary pressures. The goal was to prioritise investments in infrastructure and basic services like the National Hospital and housing. He also revisited plans to streamline state-run institutions, targeting savings of ISK 17 billion [$129 million / €119 million] for next year.

On transportation, Bjarni stressed that the rise in electric vehicles, facilitated by government incentives, had negatively impacted fuel tax revenues. He announced plans for a “new, simpler, fairer, and more transparent system” based on road usage. “It’s time for electric vehicles to participate in maintaining the road network,” he added.

As noted by RÚV, the draft budget reveals a projected state treasury deficit of ISK 46 billion [$344 million / €320 million], primarily due to interest expenses outpacing interest income. However, core operational revenues anticipate a surplus of ISK 28 billion [$209 million / €195 million]. Self-sustaining state entities project a modest surplus in core operations but face a deficit once interest is considered.

Healthcare spending is set to increase significantly, up by ISK 88 billion [$658 million / €612 million] since 2017 and ISK 14 billion [$105 million / €97 million] compared to last year. Factors like tourism, population growth, and an ageing population are cited as key drivers.

An 8.5% adjustment in income tax brackets by year’s end is expected to reduce the average income tax by about ISK 7,000 [$52 / €49]. Bjarni also noted the reimplementation of the overnight stay tax in 2024 – revoked in 2020 due to the pandemic – extending it to cruise ships.

Total state expenditure for the next year is estimated at ISK 1,480 billion [$11 billion / €10.3 billion]. The budget draft shows a 22.3% increase in financial costs and a 14.8% rise in hospital services. Funding for innovation has decreased the most, by 9.7%, followed by a similar reduction in foreign affairs.

Overall, the budget suggests a cautious optimism tempered by financial and demographic challenges.

Briefly on the budget: According to constitutional provisions, disbursements from the state treasury can only be made if authorised in the annual budget or a supplementary spending bill. The budget undergoes a rigorous legislative process: the Minister of Finance introduces the draft budget to Parliament during its first autumn session, typically held on the second Tuesday in September. Following this, the draft undergoes three rounds of parliamentary debates before it is usually finalized and approved in December.

Rise in COVID-19 Cases in Iceland

Confirmed COVID-19 infections have been increasing in Iceland over the past four weeks, Chief Epidemiologist Guðrún Aspelund told RÚV. “We’re talking about going from around 10 cases per week to around 30,” she stated. Guðrún says seniors and those with underlying health issues will be offered COVID-19 booster shots this fall.

The numbers Guðrún cites are numbers of COVID-19 cases confirmed via PCR tests in hospitals and they do not give a complete picture of the spread of COVID-19 in the general population. “There are lots of people who don’t have to seek out healthcare services, who are home, test at home, or are just sick at home. Hospitals test those who go in and those inpatients who have symptoms. That’s where we’re getting these notifications from,” Guðrún explained.

At-risk groups offered boosters this fall

While COVID-19 vaccinations are available at health clinics in Iceland, there has been no ongoing vaccination campaign. Those in at-risk groups will be offered booster shots this fall. “There will be clearer guidelines on that in September, it would be at the same time as the flu shot. There we’re targeting, as was stated in the guidelines that were released last spring, the 60+ demographic, and then at-risk groups and also healthcare staff who are more exposed.”

Risk of Overdose Rises Following Closure of Iceland’s Only Safe Injection Site

Iceland’s only safe injection site, a temporary project operated by the Icelandic Red Cross, shuttered on March 6. A Red Cross employee told RÚV such sites decrease the risk of overdose among intravenous drug users in addition to saving funding within the healthcare and social service system. Over 100 individuals used the safe injection site within the last year, many of them unhoused, during over 1,200 visits.

Ylja, as the safe injection site was called, opened in May of last year and was a temporary pilot project operated by the Icelandic Red Cross. Like safe injection sites abroad, Ylja offered a safe environment for those 18 years of age and older to inject intravenous drugs under the supervision of trained nurses, who ensured sanitation, safety, and infection prevention practices were followed. Safe injection sites are a harm reduction service that can prevent overdose and death among users of intravenous drugs. They can also connect clients to other essential services they may require.

Assists a marginalised group and saves public funds

“We need housing and the funding to pay for it, in order to operate a safe injection site. There is a lack of political will to approve it,” stated Marín Þórsdóttir, the department head of the Icelandic Red Cross’ capital area department. In 2015 and 2022, the Icelandic parliament shelved bills to decriminalise drug possession for personal use. Minister of Health Willum Þór Þórsson promised to submit a new, revised bill last autumn but has yet to do so.

Marín adds that with Ylja’s closure, the Red Cross loses staff that is specialised in harm reduction, primarily nurses. While operating a safe injection site requires considerable funding, Marín says it ultimately saves public funds. “We are tending to a very marginalised group that receives little service, experiences perpetual discrimination in society, and it’s just savings, both within our healthcare and social services system by having a safe injection site and assisting people with harm reduction resources.”

Read more: In Harm’s Way

Economic and social factors appear to impact drug use in Iceland, according to the research of Dr. Arndís Sue-Ching Löve, an assistant professor at the University of Iceland. Her studies show that cocaine use decreased in Iceland during the COVID-19 pandemic, but increased again last year to around pre-pandemic levels. The increase may be partially explained by increased prosperity: a similar pattern was seen before the banking collapse in Iceland.

Which languages are required to work as a nurse in Iceland?

Nurses Hospital Landsspítalinn við Hringbraut

For some years now, there has been a shortage in healthcare professionals in Iceland. In fact, despite the relatively high standard of public healthcare, Iceland has some of the lowest ratios of nurses and general practitioners to the population in Europe, meaning that working in healthcare in Iceland is a high-demand field.

Partially in response to these staffing shortages, previous requirements to speak Icelandic have been lifted in the last years. There are, however, some things to keep in mind.

The Icelandic Directorate of Health issues licenses to practice as a registered nurse in Iceland. On the application for applicants who have studied in an EEA country or Switzerland there is no specific requirement regarding language requirements. However, the applications are only available in Icelandic and English on their website. Applicants who have studied in countries outside the EEA or Switzerland are required to submit a course syllabus, or a detailed description of the classes concerned, in Icelandic and English.

In addition to that, individual employers can require job applicants to speak Icelandic. It varies between hospitals and institutions. If you have specific questions, it’s best to refer them to the employer in question.

If you are interested in a career in healthcare in Iceland. you may find the following resources helpful: