On 10 November, the Ministry of Health of the Republic of Lithuania and nine trade union organisations representing healthcare professionals signed amendments to the Lithuanian National Health System Sectoral Collective Agreement.
The agreement provides for increases in the fixed component of doctors’, nurses’ and midwives’ salaries, clarifies certain employee entitlements and introduces additional opportunities to strengthen trade union activities in healthcare institutions.
Lithuanian trade union organisations affiliated with the Lithuanian Trade Union Confederation (LPSK) also played an important role in reaching the agreement. The amendments were signed by Aušra Volodkaitė, President of the Lithuanian Organisation of Nursing Specialists, and Rūta Kiršienė, Chair of the Lithuanian Trade Union of Healthcare Workers. Rūta Kiršienė also headed the trade union negotiating group in talks with the Ministry of Health, representing healthcare workers and seeking better pay and working conditions.
Greater focus on nurses’ pay
Under the signed amendments, the fixed component of doctors’ salaries will increase by 11.1%, while the fixed component for nurses and midwives with higher education qualifications (college or above) will increase by 14.3%.
As of 1 January 2027, the minimum basic salary fixed component for a doctor working full-time will increase by EUR 287.50, or 11.1%, from EUR 2,595 to EUR 2,882.50. The new amount will be calculated on the basis of the 2026 minimum monthly wage (MMW) of EUR 1,153, using a coefficient of 2.5.
Where a healthcare institution applies a coefficient higher than 2.5 to the fixed component of a doctor’s salary, the 2026 MMW will apply only to the coefficient portion of 2.5. Any portion exceeding 2.5 will continue to be calculated using the 2025 MMW.
For a full-time nurse or midwife with higher education qualifications (college or above), the minimum basic salary fixed component will increase by EUR 258.90, or 14.3%, from EUR 1,816.50 to EUR 2,075.40. It will amount to 72% of the minimum basic salary fixed component for doctors, compared with the current 70%.
The minimum basic salary fixed components for other healthcare professionals will be determined as percentages of the minimum basic salary fixed component for doctors. As a result of this amendment, their minimum fixed salary components will increase by 11.1%.
Rūta Kiršienė, Chair of the Lithuanian Trade Union of Healthcare Workers and head of the negotiating group, emphasised that an important outcome of the agreement was the shared commitment of trade unions and the Ministry to finding solutions that benefit the entire healthcare system.
“It is very good that during the negotiations both the trade unions and the Ministry were moving in the same direction, because we need happy employees, satisfied healthcare institution managers and, most importantly, happy patients. It is particularly encouraging that this year greater attention has been paid to increasing nurses’ salaries,” said R. Kiršienė.
Trade union representatives point out that the agreed percentages apply to the fixed component of salaries, not to total remuneration. Therefore, the actual increase in employees’ earnings may vary depending on their pay structure and the particular healthcare institution.
The greatest relative impact is expected to be felt by the lowest-paid healthcare professionals, for whom the fixed component accounts for a larger share of total remuneration. Higher-paid doctors may experience a smaller overall increase in their earnings.
It is also essential to ensure that the agreed increases actually reach employees. Minister of Health Linas Kukuraitis noted that some nurses are still not receiving the fixed salary component to which they are entitled under the collective agreement. According to the Minister, healthcare institutions face financial difficulties in fulfilling all collective agreement commitments, as contracts concluded by the National Health Insurance Fund do not always provide sufficient funding.
Agreement also covers other important employee issues
The amendments address more than salary increases. Provisions on annual leave for public health specialists working in educational institutions have been clarified. In addition, healthcare institutions will be able to negotiate provisions in their own collective agreements on allocating employer funds to support trade union activities.
This provision is important for strengthening employee representation and creating better conditions for social dialogue within healthcare institutions. Strong trade unions and constructive cooperation between employers and employees are essential for addressing issues that matter to the workforce.
Unresolved issues remain on the agenda
Although the agreement delivers significant improvements, the parties were unable to reach consensus on all the issues raised by trade unions.
One of these concerns the salaries of public health specialists. Under the current draft state budget, their pay is expected to increase only in line with the planned 2.5% increase in the basic salary amount. This increase is considered insufficient, and it is hoped that additional funding for these specialists can still be secured during parliamentary consideration of the state budget.
During the negotiations, trade unions also proposed introducing additional salary coefficients from next year for their members working in budget-funded healthcare institutions who had joined a trade union by 1 March 2026. However, as the Ministry of Finance did not provide additional funding, no agreement was reached on this proposal.
Some issues have also been postponed for negotiations on a new collective agreement for 2027. One of these concerns the definition of the term “agreement” in consultation procedures.
Trade unions propose establishing that a decision should be considered agreed only when the other party has given its consent. If the parties fail to reach an agreement, the matter should be referred to the Labour Arbitration Board.
The Ministry’s position is that reaching an agreement means informing and consulting the other party, but does not require obtaining its consent.
Another postponed proposal concerns abolishing the separate fixed salary component standard for dental practitioners, which currently stands at 80% of the minimum basic salary fixed component for doctors.
Trade unions will continue to seek the inclusion of these postponed proposals in the upcoming negotiation agenda. The objective is not only to agree on specific salary increases but also to ensure that all healthcare professionals enjoy appropriate working conditions and receive due recognition for their work.
The healthcare system needs professionals – and they need attractive working conditions
The healthcare sector faces a shortage of workers. Competitive pay is therefore one of the key conditions for attracting young professionals and retaining experienced employees already working in the system. However, salary increases alone are not enough. Appropriate working conditions, opportunities for professional development, workplace safety and respect for employees’ work must also be ensured.
Trade unions believe that achieving these goals requires a long-term commitment from the state, consistent funding for the healthcare system and the political will to address longstanding problems.
The signed amendments to the collective agreement represent an important achievement resulting from trade union negotiations. However, this is not the final goal. Dialogue with the Ministry must continue, and the issues that remain unresolved must lead to concrete solutions.
Only through such efforts can Lithuania build a strong healthcare system in which employees feel valued and patients receive high-quality services.