The overwhelming majority of nurses in Portugal’s National Health Service (SNS) went on strike for five days last week, defying demands by the Socialist Party (PS) government to call it off.
The government claimed the action was illegal because the nurses’ unions had not given the statutory 10 days’ prior notice. The authorities’ intransigence forced the union to call another three-day walkout next month.
Despite the government’s threats, some 85 percent of the 70,000 nurses in the country took part in the strike, bringing services to a halt. José de Azevedo, president of the Union of Nurses (SE), speaking during a demonstration outside the S. João Hospital in Porto, told reporters, “The strike is going well. … Everything that is scheduled is closed. Paediatrics, psychiatry and the emergency room, emergency intensive care units, have no minimum services.”
Around 3,000 nurses, dressed in black and wearing t-shirts with the word “Basta” (Enough), took part in a demonstration in the capital Lisbon on September 15. Well-attended protests and picket lines were held in other cities and towns across the country.
The nurses’ demands include an end to the 11-year pay cap, an increase in wages and a 35-hour working week for all nurses—especially those who work in specialist areas. There are around 2,000 such nurses who do not have any pay progression and some 16,000 non-specialist nurses who have the level of skills and training that could already qualify them as specialists.
Nurses earn only around €1,200 (US$1,450) a month regardless of their skills and whether their contracts are 35, 40 or 42 hours a week. Many are forced to work unpaid overtime by the hospital authorities, amid a dire shortage of nurses in Portugal.
This shortage was highlighted by Ana Rita Cavaco, the head of the nurses’ regulatory body, the Nurses’ Order, who declared, “I am not going to comment whether the strike is illegal or not, but I support the nurses.” Cavaco said Portugal needs at least 30,000 extra nurses to fill the gaps, and that over the five years preceding 2016 nearly 13,000 nurses had migrated to Switzerland, Sweden, Germany, France and the UK.
Maria, a Portuguese nurse who now works in a large National Health Service hospital in southern England, told the WSWS, “In Portugal, nurses are on strike for the last months [strikes have taken place in 2014 and 2016] because the pay cap has been on for 11 years. So, it seems like we are doing the same in England and Portugal.”
In England, nurses and other public sector workers have been subject to a seven years wages cap since 2011, resulting in wages dropping by between £6,000 and £9,000.
“The media in Portugal,” Maria continued, “does not give us any support because it would give the cause some strength. They are saying that ‘the nurses want to get more money than the doctors and if nurses get what they want we have to give them 126 million euros’. This is the same argument of the government.”
She continued, “If someone follows the media line, it is our fault that we are poorly paid! In Portugal, the media never show you that nurses are fighting here in the UK. Many don’t trust the media. They are giving the news in a twisted way, and they closely collaborate with the government. This makes us sick.”
Commenting on French President Emmanuel Macron’s plans to rewrite the country’s labour code, aimed at smashing the social gains of the working class, Maria said, “In Portugal that has happened already. Four years ago, they changed the law so that it’s easier to get employees dismissed with no legal compensation to be paid. The employers can simply dismiss you now. There are thousands of workers who are on Green Receipt [bogus self-employment] jobs. It means you don’t have any job security. You have to work under precarious working conditions and whatever meagre wages are forced on you by the employers.”
Maria added, “My colleagues in Portugal are saying that they were afraid of taking action for so long, because there was lot of pressure in hospitals. If you complain about your working conditions and patient care, then the hospital authorities will tell you, ‘okay then you go and work somewhere else’. There is lot of fear over the last five years. They are abusing and intimidating the nurses.”
Asking whether anything had changed since the PS came to power in 2015, Maria said, “No, nothing has changed. Working conditions are getting worse and worse. Nurses are earning a little bit more than during the previous government, as there are some changes to taxes, but not much. The main thing is some of our colleagues are still doing 40-42 hours. Our specialist nurses, despite having more experience, skills and responsibilities, get the same amount as general nurses. They are revoking their own specialist qualifications now.”
Describing working conditions among Portuguese nurses, Maria said, “You don’t have the right to leave the hospital even though you have finished your shift. If someone is absent they force you to stay, saying that if you leave we have many others to have your job. Nurses are doing thousands and thousands of unpaid hours because they are being coerced to do so.
“I worked in a major hospital in Portugal. There is a lack of equipment and essential resources in wards. Sometimes there aren’t enough towels to wash patients. I remember occasions when we didn’t have gloves to put on. Often, you have to look after 30 patients only by yourself. Last news I heard was one nurse for 46 patients. It is happening all the time.”
Maria’s experiences in Portugal and the UK are a product of the counterrevolution launched against the social position of the working class by the ruling elite internationally since the 2008 global financial crisis. As in other countries, successive Portuguese governments have cut expenditure on health and boosted private profit-making.
According to the Organisation for Economic Cooperation and Development, Portugal has seen a 2.4 percent reduction in health spending over the last seven years. Charges have been introduced and increased for virtually every area of health provision, including for over-the-counter drugs, vaccines, medical certificates, use of hospital emergency departments, GP visits, primary care services, and diagnostic and therapeutic services.
The PS came to power as a minority government in 2015 promising to “reverse austerity”. This fraud was legitimised by the Left Bloc (BE) and Communist Party (PCP), which claimed that, in return for its support, the PS could be pressured to oppose the “troika”—the European Commission (EC), International Monetary Fund (IMF) and European Central Bank (ECB). They claimed such pressure would result in social measures, including wage rises and a reversal of increases in working hours imposed by the previous Conservative government.
The callous treatment of the nurses, who have fought for years to improve their pay and conditions, is an indictment of the “socialist” government—and its pseudo-left and Stalinist apologists—who defend the capitalist state.
The BE attempted to distance itself from the latest actions of the PS government that it keeps in power and apologises for.
BE leader Catarina Martins pleaded with the PS government to recognise that “it is necessary to value the work of nurses in Portugal”. Martins declared that the 2018 State Budget (Orçamento do Estado, OE), which the BE and PS are negotiating, should mean a “recovery for the SNS” and more nurses.
Martins criticised the minister of health, Adalberto Campos Fernandes, saying, “The position of the minister who devalues the claims [of the nurses] that all of us in the country realise are essential does not help a negotiation process that is essential. The OE is not a substitute for negotiations and a spirit of negotiation between the Government and nurses in this country.”
Fernandes’s “devaluation” of the nurses’ claims thoroughly exposes BE’s contention that the 2018 OE gives an opportunity to raise wages and create jobs. During the OE negotiations between the PS and BE, Prime Minister António Costa made it clear that expenditure “has to be controlled.”