Government proposes merit-based pay scale to equalize salaries for contracted and appointed doctors

Paraguay’s government is offering a merit-based salary system instead of the across-the-board pay increase demanded by medical unions.

The proposal emerged from an extensive meeting with the National Medical Union, known as Sinamed, and scientific societies. Ministers of Health, Labour and Economy attended, along with Chief of Cabinet Javier Giménez. The government said its plan addresses four issues raised by medical groups and that three are already moving forward.

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Two thousand three hundred and ninety doctors will join the ministry as appointed staff, and they would already be bringing in their files to join the workforce, God willing, before the end of the year.

Health Minister María Teresa Barán said the government would guarantee supplies of strategic medical materials, introduce payment for work on public holidays from January 2027 and improve job stability for thousands of health professionals. She said 2,390 doctors would receive appointed positions and could submit their files to join the public workforce before the end of the year.

The main dispute concerns salaries. Medical unions want a general increase in the basic pay floor. The government instead proposes to eliminate the current difference between contracted and appointed doctors through an existing career scale. Barán said contracted doctors would ultimately earn exactly the same as appointed doctors under the system.

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What we proposed to Sinamed is to eliminate the difference between a contracted doctor and an appointed doctor. Today, a contracted doctor would earn exactly the same as an appointed doctor and work within that career scale.

The measure would take effect in July 2027 without requiring a competitive examination. It would cover 10,626 doctors, or 90% of the total workforce, with increases ranging from 500,000 to 4 million Paraguayan guaraníes, depending on the case.

Giménez defended the approach as a way to reward training, experience and time devoted to work. The government said the plan would require an investment of about 60 million, financed through an improvement in public spending. The article identifies the funding proposal but does not provide further details.

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We both want doctors to be paid better. The executive’s proposal is simply clear: a merit-based system in which those with better training, more experience or more working hours earn more.