Poland: Health workers in confrontation with Kaczynski government

For the past two months, doctors have been staging strikes at hundreds of hospitals across Poland demanding pay raises, improved working conditions, and, more generally, an overhaul of the country’s decrepit healthcare system.

Recently, nurses have joined in protests for the same demands, demonstrating solidarity amongst healthcare workers. As in the summer of 2006 (see “Poland: Health care crisis provokes strikes and protests”), the crisis of healthcare in the post-Stalinist Polish state has been dramatically exposed for all to see.

Tensions reemerged on May 10 of this year when doctors at some 300 hospitals nationwide carried out a two-hour warning strike. The doctors expressed dissatisfaction with the 30 percent pay raises granted last year by the right-wing Law and Justice Party government of Prime Minister Jaroslaw Kaczynski.

Much of the increase never reached the doctors’ pockets because hospital directors, who received the money, preferred to use it to reduce the enormous debts accrued by many hospitals across Poland. With young doctors earning 1,200 zloty net (US$433) per month, a raise of 30 percent translates to 360 zloty (US$130). This is still far below a living wage in Poland.

On May 15, over 250,000 hospitals and clinics nationwide were hit by a warning strike to demand higher pay for doctors. The doctors demanded that the minimum monthly salary be brought up to 5,000 zloty (US$1,803), twice the national average wage.

The government responded by saying that fulfilling the demand would require an additional 11 billion zloty (US$3.97 billion). It declared that such an outlay was unrealistic because it would raise the national budget deficit to a figure above the limit set by the European Union (EU) as a prerequisite for Polish entry into the Eurozone.

Prime Minister Kaczynski added that satisfying the doctors’ demands would “greatly undermine the credibility of the country in the eyes of its EU partners.”

Poland has one of the lowest levels of healthcare spending in the EU, with public spending on health at about 4 percent of Poland’s gross domestic product (GDP). This is half the EU average.

The government put forward suggestions for a referendum whereby taxes would be raised on the wealthiest Poles to pay for better healthcare, but this proposal was rapidly withdrawn after being roundly condemned by economists.

Indicating that strike leaders are prepared to compromise with the government, Tomasz Underman of the National Doctors’ Trade Union (OZZL) denied on May 24 that the doctors were striking for political reasons. This was a signal to the political establishment that the unions would keep the doctors’ actions within the confines of trade union activity.

Underman went so far as to provide political cover for President Lech Kaczynski when the latter said that doctors would not receive any pay raises in 2007. The strike leader said that Kaczynski was misinformed about the situation in the Polish healthcare sector, and added he was “convinced” that the Polish president would change his position on pay raises in the near future.

A group of about 200 doctors from a major Warsaw hospital took matters into their own hands a few days afterwards by staging a wildcat strike and blocking the street where the hospital is located. The action was taken without consulting the OZZL. Hospital strike committee leader Maciej Jedrzejowski said afterwards that the protest was an expression of the desperation and frustration felt by doctors.

Two days later, Prime Minister Kaczynski suggested that a national referendum on the privatization of healthcare be put to the populace. “The question ... must be put,” Kaczynski told journalists. Meeting the wage demands of the doctors on strike would “be equivalent to ruining public finances, which would be totally irresponsible,” he declared.

Privatisation, which would subordinate the vitally important health system to the profit motive, would mean a profound decline in the quality and efficiency of the healthcare sector in Poland. One need only look at the example of the United States, where private medicine dominates and millions who cannot afford healthcare are left to their fate, to see the barbarity of for-profit healthcare.

However, the OZZL has made clear that it is not opposed, in principle, to privatisation.

The strike entered its fourth week on June 11, having gradually expanded to include 280 of Poland’s 800 hospitals. Forty-six hospitals in the central Lodz province joined the strike, and doctors nationwide announced that they would stop filling out documents for the country’s National Health Fund (NFZ).

More than 100 doctors in the northern city of Slupsk tendered their resignations. The action, according to strike leader Krzysztof Bukiel, did not bring the expected results. The authorities, he said, were behaving as if nothing had happened. “Their only answer is ‘no, no, no,’” he said.

On June 18, nurses began staging protests in solidarity with the doctors. Thousands demonstrated in front of government headquarters in Warsaw.

Two days later miners joined the nurses’ protests in Warsaw. This came after news of a violent altercation between Warsaw police and the nurses, after approximately 4,500 medical personnel set up a roadblock in front of Prime Minister Kaczynski’s office. Police, dressed in riot gear, used force to disperse nurses who had been camping out throughout the night. Four nurses were rushed to hospital after sustaining injuries in the skirmish, and one woman apparently suffered a heart attack.

After the police attack, a poll was released showing that 75 percent of the public sympathised with the plight of the nurses. “I generally agree with the nurses’ strike because they are fighting for their rights,” an anonymous citizen told Polish Radio. He added, “It is a scandal that they earn less than 50 percent of the wage of a cleaning woman. It is really humiliating that educated people in Poland cannot earn enough money to live in dignity.”

The typical wage of a nurse in Poland, approximately 1,100 zloty (US$397) per month, which includes weekends and some overnight shifts without extra pay, is desperately low. Pay for many nurses before the pay raise last year (which has only reached the fortunate ones) was even lower, at approximately 800 zloty (US$289) per month. Such a pay scale for healthcare professionals represents a devastating indictment of the post-Stalinist Polish state, where social parasites such as Jan Kulczyk rake in billions from financial and real estate speculation while people who are entrusted with patients’ lives are struggling to make ends meet.

It was announced on June 22 that striking nurses who had continued to occupy Prime Minister Kaczynski’s premises at the Council of Ministers were refused a face-to-face meeting with Kaczynski in his office. The prime minister called the nurses’ actions “illegal,” but offered to talk with them at the Dialogue Center—an offer unanimously rejected by the nurses’ union, the All-Poland Nurses and Midwives Trade Union. In the meantime, the nurses’ “white city” outside government headquarters had expanded, with nurses setting up some 130 tents.

In recent days, public opinion on the strike has shifted following a campaign by sections of the media attacking the strikers. There were widespread reports that 30 patients at a Warsaw hospital were moved on June 30 because of a hunger strike by doctors. Families were shown shouting abuse at medical workers while patients were being scuttled between hospitals.

In fact, striking doctors have provided reduced care, including emergency services.

The headline of the Polish tabloid Fakt, owned by the German publishing house Axel Springer, asked provocatively on July 2, “Doctors, Has Satan Possessed You?” This followed comments by Prime Minister Kaczynski calling leaders of the doctors’ strike “Satans.”

Another round of negotiations between doctors’ and nurses’ representatives and Polish Health Minister Zbigniew Religa broke off in Warsaw the same day. Prime Minister Kaczynski reiterated that there was no chance of further pay increases in 2007, while confirming earlier statements promising salary hikes for NFZ medical personnel in 2008.

“We are willing to talk about everything,” Kaczynski said, “but not immediately and without thought for economic consequences. We are not going to let them [the doctors and nurses] terrorize us.”

The doctors’ strike is now in its second month, with 300 of Poland’s 800 hospitals affected. It is increasingly clear that the health workers’ strike is the tip of an iceberg of popular discontent in Poland.

Coal miners from the money-losing state-owned Kompanie Weglowa firm are demanding a 30 percent pay raise. Teachers are calling for higher pay, and also for the resignation of arch-reactionary Education Minister Roman Giertych of the far-right League of Polish Families (LPR). Government ministers have warned that doctors could be forced back to work.