Protests in the health sector: putting “national unity” into question

August 8th and subsequent weekends throughout the month saw thousands of UK health workers take to the streets of major towns and cities protesting angrily against low pay, high tuition fees, increased and open-ended workloads and shift hours, lack of Personal Protective Equipment (PPE) against the spread of Covid-19, systemic under-funding and the government’s presentation of their ‘heroic sacrifice’ as a deadly burden happily shouldered.

In previous periods, such expressions of militancy by groups of workers attempting to defend their living and working conditions may have appeared routine, ‘par for the course’. However, in the context where workers are showing small signs of emerging from a global retreat in combativity and consciousness in recent decades (1) – and in particular, against the backdrop of the ‘national unity’ demanded by governments in the face of the Covid crisis – these expressions of class struggle are noteworthy.

Largely organised at local level by nurses, care home workers and other health sector staff but coordinated and corralled by union committees and Labour Party fringe groups, staff spoke at dozens of demonstrations including Leeds, Liverpool, Manchester and Glasgow of the stress induced watching colleagues and patients die (over 540 health care staff at this point had perished), of not knowing if they were themselves infected or transmitting disease to their families; of the struggle to survive facing training debts of up to £60,000 or even £90,000 and of trying to live on real wages which in many cases had fallen 20% over the last decade, despite strikes by 50,000 junior doctors in 2016 and a three year pay ‘deal’ for other staff in 2018.

Above all they were and remain furious to have been excluded from pay ‘rewards’ granted in July by the government to some 900,000 ‘key’ public sector workers including members of the armed forces, civil servants, elements of the judiciary and senior doctors for their part in the ‘battle’ against Covid, but ignoring nurses and care workers. We’ll return to this aspect below.

The ad-hoc nature of the protests – the fact workers didn’t wait for ‘their’ unions to give voice to the evident anger – was further emphasised by parades of largely home-made placards bearing statements such as : “Heroes to 0%” (ie: heroes to zeroes) , “Claps don't pay the bills,” “Pay NHS a fair wage - you owe us”, “Some cuts don't heal,” “Stop clapping start talking” and “A nurse is for life, not just for Covid19.” The protests – 100 workers in Cambridge, 100 in Bournemouth, 2000 in London and so on around the country – attracted predominantly young workers who’d never demonstrated or entered a proletarian struggle before,  together with a few ‘old hands’ reaching the end of their service who wanted to show solidarity with colleagues facing increasingly intolerable pressures. Mostly, they’d used social media such as Facebook groups of health workers with titles like NHS workers say NO! To public sector pay inequality, which claims 80,000 Facebook members, NHS Pay 15 which demands a 15% pay rise (a call echoed at an August 26 demonstration by workers from Guy’s and St Thomas’ hospitals in London), and Nurses United UK, in order to rally support. Union banners were largely notable by their absence, although there was no shortage of ‘radical’ political groups arguing that demonstrators should aim to make the unions ‘fight better’. Such ideas are likely to have an echo because, as far as we know, none of the ad hoc groups directly challenged the unions or trade unionism.

Rejecting social peace and sacrifice

For months, health workers have been lectured about how they were part of a ‘national effort’ - including army units and the recruitment of thousands of ‘volunteers’ (at a time of increasing ‘zero hours’ contracts and the spectre of mass unemployment!) – putting their lives on the ‘front line’ of the ‘war against Covid’, doing ‘whatever it takes’. That appeared to include working endless overtime, forgoing holidays and instructions about PPE (or the lack of it) which changed from day to day. So the angry demonstrations, albeit on a small and limited scale, showed a real resistance to the state’s pressure to work longer for less ‘for the national good’.  They attenuated the attempt to invoke the ‘war-time spirit’ of ‘we’re all in it together’. In doing so, they mirrored the struggles by millions of others around the world attempting to collectively oppose the increasing exploitation - and often, repression - demanded by capital. Some examples:

• On the African continent, health workers’ strikes have been documented in, among other countries, Kenya, Egypt, Zimbabwe, Nigeria, Ghana and Sierra Leone, with protests in Lesotho and Malawi. “South Africa has seen by far the largest number of strikes and walkouts, where the government plans to cut nurses’ wages as part of a broader plan to cut the public sector wage bill before turning to the IMF for a loan.” (2)  Striking nurses have been threatened with ‘disciplinary’ actions with some themselves hospitalised by rubber bullets and stun grenades;
• In India, in June and July, staff at two hospitals in the capital, New Delhi, protested against a lack of PPE and the dismissal of 84 colleagues for raising safety concerns. These were a prelude to August’s two-day nationwide strike embracing at least 21 states and an estimated 3.5 million workers from different sectors of the economy, spearheaded by some 600,000 members of the all-women Accredited Social Health Activists, “workers who travel to low-income, rural areas to provide essential health care” … (3)
• In California, USA, “hospital revenue has fallen more than a third since the beginning of the pandemic, and the losses have forced health care workers to take pay cuts or even furloughs to compensate in some cases.” (San Francisco Chronicle, July 20). A strike by 700 health care workers at Santa Rosa Memorial Hospital protesting an inadequate supply of protective gear, benefit cuts and “unsafe staffing levels” was just one regional reaction.

Indeed, “In at least 31 of the countries surveyed by Amnesty International, researchers recorded reports of strikes, threatened strikes, or protests, by health and essential workers as a result of unsafe working conditions. In many countries, such actions were met with reprisals from authorities,” (4)

• In Russia, doctors complaining about a lack of PPE were charged under ‘fake news’ laws and faced fines and/or dismissal;
• In Malaysia, “police dispersed a peaceful picket against a hospital cleaning services company ... and charged five health care workers for “unauthorised gathering”;
•  In Egypt, “nine health care workers… were arbitrarily detained between March and June on vague and overly broad charges of ‘spreading false news’ and ‘terrorism’.

Manoeuvres Against the Working Class

But outright reprisals and repression are not the main means used by the ruling class to impose their ‘states of emergency’ on the working class. In the old centres of capitalism – in Europe, the US and elsewhere – the general tendency is a political game of divide and rule, aimed one way or another at making health workers a ‘special case’, at sowing divisions between them and at dividing them from their class brothers and sisters in other industries.

• In Belgium, ‘Emergency Powers Decree No 14’ envisaged forcing private and state health and other employees into unpaid overtime without time off in lieu. These clauses were dropped after opposition from angry workers but it was the trade unions which strengthened themselves by taking over the fight, threatening strikes which never materialised, while all other conditions of work continued to deteriorate;
• In France the recently trumpeted ‘Ségur de la Santé’ plan to ‘reward’ health sector workers in fact divides private from public staff, envisages a decrease in rest times between shifts and is a further step in the dismantling of responsibilities shouldered by the state regarding health provisions; (5)  
• In the UK, the above-mentioned pay award was an evident kick in the teeth for nurses but it also had the intended effect of dividing junior from senior doctors, nurses from other public sector workers, etc.

The tendency to see the health sector as the be all and end all of the struggle – the curse of corporatism which crippled the miners’ and steel strikes in the UK in the 1980s – is one real weakness expressed by the August protests in the UK, even if one meeting raised a chant of “the firemen deserve a pay rise too”.  Another is the inclination to blame the Tory Party for ‘privatising the health service’ when in fact all parties everywhere have for decades been paring down to the barest minimum the health services provided to ensure the expanded reproduction of capital and the labour power required for this purpose. It was the last Labour government’s embrace and expansion of the Private Finance Initiative which truly put the ‘NHS up for sale’ and eroded workers’ conditions.

The militancy shown in the UK (6) and elsewhere over the summer is in marked contrast to the prevailing atmosphere of fear and uncertainty generated by the Covid crisis and the mass layoffs and lockdowns which ensued, factors which reinforced the pre-existing lack of confidence in the class. The struggles provided a welcome reminder that the working class has not been crushed by exhaustion nor the siren songs of self-sacrifice. The necessary politicisation of that struggle - the recognition of what historically the working class is and what it can and must become – remains to be re-appropriated by the majority of the proletariat.

RF,  10/9/2020

(1) See “Report on the class struggle: Formation, loss and re-conquest of proletarian class identity” https://en.internationalism.org/content/16707/report-class-struggle-formation-loss-and-re-conquest-proletarian-class-identity

(2) World Socialist Website, July 7, 2020, https://www.wsws.org/en/articles/2020/07/17/afri-j17.html

(3) Workers’ World, August 13 https://www.workers.org/2020/08/50567/

(4) https://www.amnesty.org/en/latest/news/2020/07/health-workers-rights-covid-report/

(5) See Révolution Internationale, https://fr.internationalism.org/content/10227/segur-sante-nouveau-coup-porte-a-classe-ouvriere

(6) Other sectors in struggle during the spring and summer included university lecturers and bitter protests by British Airways employees with thousands sacked and others re-hired on lower wages and inferior terms and conditions. For further coverage of worker’s strikes and resistance earlier in the Pandemic, see “Despite All Obstacles  the Class Struggle Forges Its Future”, https://en.internationalism.org/content/16855/covid-19-despite-all-obstacles-class-struggle-forges-its-future