Around 1,000 Irish junior doctors have voted overwhelmingly in support of strike action to protest long working hours and poor working conditions. Support for the walkout among the members of the Irish Medical Organisation (IMO) was almost unanimous at 97 percent.
The result reflects widespread anger over conditions in the health care system and the government’s austerity programme, which has fallen particularly harshly on the health budget. Some doctors described being forced to work up to 100 hours a week, and shifts of more than 24 hours are a common occurrence. In addition, doctors have been subject to the cuts to pay and other benefits imposed on public sector workers since 2010, and the various new taxes and charges enacted to pay for the bailout of the banks.
The determined drive to slash health care budgets is being enforced by the highest levels of the “troika” of lenders—the European Union (EU), European Central Bank (ECB) and International Monetary Fund (IMF). A leaked document in May revealed that the IMF had assumed virtually full control over Irish health spending, putting in place a procedure that requires the government to report monthly on the health budget. The purpose of this was summed up at a health conference earlier this year by an IMF official who declared that Irish health care workers were “relatively well paid” compared to other countries.
As part of its €85 billion (US$113 billion) bailout programme with the troika, the Irish government has cut public spending by a figure approaching 20 percent of GDP. Health services have been severely affected. This includes an emergency package of cuts for the sector implemented last year to save €500 million in order to comply with troika spending targets for 2012.
Between last year and 2015, 8 percent of the total health budget is to be eliminated, amounting to €1 billion in further cuts. Of the €1 billion in cuts to public sector pay and benefits agreed in the recent Haddington Road Agreement, fully 40 percent of these cuts are to come in health care.
Discussions are ongoing in policy circles about the need to privatise services to slash costs. A recent invite-only conference in Dublin reported on by the Irish Medical Times sought to plan ways to create “sustainable health care for an ageing population in a time of economic crisis.”
The attacks launched so far have already created unbearable conditions in hospitals and other health care facilities. Reports emerged of an epidemic of suicides among doctors earlier this year. At the same time, basic health care services have been eliminated, such as the automatic provision of a medical card guaranteeing free treatment to people diagnosed with cancer.
The government is planning to cut the number of GPs by 7.5 percent, even though waiting lists are rising. This takes place as recent figures show that Ireland has the second lowest percentage of medical specialists per head of population out of 28 countries surveyed. According to the study of mainly European countries, Ireland had only 141 medical practitioners per 100,000 people, which was only more than Turkey.
The IMO is doing its best to restrict the aims of any protest action by doctors, calling on the government to implement the European Working Time Directive, which prohibits a working week of more than 48 hours. The union has also urged the government to put an immediate end to shifts of more than 24 hours. But no demands have been raised by the union on the attacks on pay and undermining of basic services that have seen the health service reach breaking point.
IMO representatives met with the Health Services Executive last week to discuss arrangements for potential strike action. It has been agreed that three weeks of notice will be given before any work stoppage takes place, and the first day of strike action was announced for September 25. Although on this date doctors will strike at all hospitals, thereafter there will be several further days of action at individual locations.
This is a deliberate strategy to dissipate the immense anger among doctors to austerity measures that are putting the lives of health care workers and their patients at risk and creating unbearable working conditions.
Just two months prior to announcing the strike action, the IMO capitulated to the latest round of government spending cuts along with the trade union bureaucracy as a whole. In spite of its initial pose of opposing the Haddington Road Agreement, which was followed by the Irish Nurses and Midwives Organisation (INMO), the bureaucracy accepted €1 billion in further cuts without organising any protest action. They also did nothing to resist the establishment of emergency powers by the government, which allows the pay and working conditions of public sector staff to be altered unilaterally.
Moreover, the union has made no appeal for support to other sections of the working class, under conditions where similar attacks are falling on in every economic sector. Just two weeks prior to the vote of the doctors to strike, workers at Dublin Bus voted down a union-brokered deal that would have imposed cuts to pay and benefits demanded by management. Earlier this year, public sector workers overwhelmingly rejected the latest austerity package before the unions connived with the government to force it through.
The IMO’s unwillingness to initiate any genuine struggle is bound up with its close ties to the political establishment. James Reilly, the current minister of health, who has imposed three brutal budgets on the health sector, including the emergency package of cuts in 2012, is a former president of the IMO. After leading the union between 2004 and 2005, he made a seamless transition into the right-wing Fine Gael party, where he ran as a candidate for parliament in 2007 and has been health minister since 2011.
The drive to slash costs leads in only one direction: to Greece, where there is hardly any access to public health care for vast sections of the population, resulting in the reemergence of previously eradicated diseases and the spreading of infectious conditions.
Health care is a basic social right to which all should be entitled. To take forward a real struggle, doctors must break from the straitjacket of the trade unions and turn for support to other health care workers, patients and the working class more broadly. Action committees must be formed at hospitals and in local communities to take the conduct of the struggle out of the hands of the bureaucracy and to launch a fight against the destructive policies of the ruling elite.