Protests and strikes by hospital workers in Germany

For a long time now, hospital workers nationwide in Germany have been seething over intolerable conditions; expressed in the outbreak of numerous strikes and protests. The situation, which was already hardly bearable due to staff shortages, work pressure and poor pay, has been further aggravated by the pandemic that has now been going on for more than one year with no end in sight.

Last Wednesday, “International Nurses’ Day,” there were protests all over the country, where nurses, other hospital workers and those at care facilities gave vent to their justified anger. “Our working conditions have become unbearable under coronavirus!” declared one care worker at a rally in Hamburg, according to broadcaster NDR.

Due to the government’s murderous “profits before lives” policy, which has already led to more than 85,000 deaths in Germany, hospital intensive care units have been at their limit for more than a year. The already overstretched staffing levels have been further strained by absences due to illness and dismissals during the last months.

In Münster, 1,000 people gathered to demand better conditions in nursing. Among other things, they demanded a 35-hour week at full pay, more security of duty rosters and a starting salary for nursing staff of 4,000 euros a month gross. In the capital, Berlin, several hundred workers from the state-owned Charité and Vivantes hospitals protested.

At Nuremberg hospital, non-medical and nursing staff went on strike for 24 hours last week. The strikers are demanding a significant wage increase. Years ago—as in almost all hospitals—the so-called “service area” was outsourced and transferred to a separate company to circumvent paying wages at the (higher) agreed public service rate. Currently, salaries are only just above the minimum wage of 11.15 euros an hour, which is barely enough to make ends meet. The employer’s current offer of twelve euros per hour was rightly perceived as a provocation by the 800 employees of the service company.

Hospital management immediately rejected the demand for higher wages citing “industry-standard” salaries. Nuremberg’s mayor Marcus König (Christian Social Union, CSU) and Harald Riedel (Social Democratic Party, SPD), responsible for finances, agreed and explained that the demand was not financially feasible.

In addition, there are protests being held against dismissals. At numerous locations, workers at Sana hospitals are protesting against the elimination of more than one thousand jobs at Germany’s third-largest hospital group. Amid the third wave of the pandemic, the group wants to continue implementing its radical austerity measures while driving up profits for shareholders. Except for the cleaning sector, all business areas of the subsidiary DGS Pro-Service GmbH are to be closed. Those affected by the redundancies include ward assistants, the hospital collection and delivery services, porters and security workers. This is not only catastrophic for those being threatened with dismissal but for the remaining staff and the patients, it means increasing work pressure and poorer quality of care.

The importance of sufficient hospital staffing is made clear by a recent study from Australia published in the medical journal The Lancet. A minimum nurse-patient ratio can “save lives and reduce costs,” the authors explained. According to the study, strict minimum nursing levels reduce the number of deaths and readmissions. “These findings are even more relevant in the context of COVID-19, which has pushed already overworked and burnt-out nurses in hospitals to the brink,” said the study’s lead author Matthew McHugh.

While workers are threatened with layoffs, poor wages and working conditions, the health companies are posting record profits. For the big hospital operators like Helios or Asklepios, 2020 was extremely profitable. The German Helios hospitals alone earned 600 million euros before taxes last year, the Spanish hospitals of the internationally operating group also made 400 million euros.

The parent company Fresenius even reported a total pre-tax profit of 4.6 billion euros for last year. CEO Stephan Sturm said that 2020 had been “well managed.” For the shareholders, the highest dividend ever paid by Fresenius was announced, at almost half a billion euros.

To increase this further, plans for more cuts are already in place. According to a report by Zeit Online, Sturm recently stated in regard to Helios that there would be “a targeted reduction in physician capacities” in order “to secure our profitability.” When asked, the group states that it had taken a close look at every department in every hospital, indicating that it is a matter of several hundred jobs in total. Sturm told banking analysts that it could even come to the “sale of hospitals” to further reduce costs.

As the Zeit Online article makes clear, state aid has provided a windfall for shareholders. Thanks to the system of flat-rate payments to hospitals for keeping a certain number of beds free for coronavirus cases, most of the clinics in the group were able to achieve more turnover than had been calculated before the pandemic. The hospital chain received more state aid—740 million euros—than any competitor.

To enforce the dismissals, low wages and poor working conditions, the corporations and governments work closely with the trade unions, whose representatives sit on supervisory boards and similar bodies, support the cuts and sometimes even actively implement them. At the same time, they try to divert any protests against these conditions into harmless channels. This can be seen very clearly in Berlin.

In recent months and years, there have been repeated strikes and protests by workers at the state-owned Charité and Vivantes hospitals. Last Wednesday, hundreds protested in front of the City Hall. The hospitals employ over 36,000 workers across Berlin.

The Verdi trade union is now demanding a “relief collective agreement” for employees in the nursing sector, which should provide for more staff on the wards. The management boards of Vivantes and Charité are supposed to sign an agreement on new staffing levels within 100 days, otherwise, Verdi will call a strike.

Since workers have been demanding more staff for years, it is not surprising that a petition was soon signed by almost 8,400 workers. The petition is to be handed over to Mayor Michael Müller (SPD). The demand for a “relief collective agreement” by Verdi is part of its well-known manoeuvres. In 2016, hospital workers were simply cheated with the “historic” collective agreement for more staff negotiated by Verdi. Even union representatives had to admit time and again that staffing targets were barely met.

By setting a 100-day deadline, Verdi wants to ensure calm in the hospitals and make sure no protests break out in the current tense situation, with enormous pent-up anger among workers. At the same time, the union is working behind the scenes with the SPD-Left Party-Green Party Senate (Berlin state executive) to prepare another sell-out. In this context, it is significant that the person responsible for the catastrophic situation at the hospitals, as well as for the unscrupulous coronavirus policies in the German capital that have cost thousands of lives, appeared at the Verdi rally, health senator (state minister) Dilek Kalayci (SPD).

At the Vivantes facilities, the union is also demanding the public service collective agreement (TVöD) be paid to those working for subsidiary companies. While nursing staff are paid according to TVöD, employees in the areas of cleaning, transport or catering, for example, receive significantly less. Here, too, there have been repeated strikes. Verdi, in close coordination with the SPD, the Greens and the Left Party—Finance Senator Matthias Kollatz (SPD) is head of the Vivantes supervisory board—will do everything to suppress further protests and cement the miserable conditions.

This is exactly what Verdi has done at the Charité service company CFM (Charité-Facility-Management). After the workers there were outsourced 14 years ago and had to put up with low wages, there have been countless strikes and protests. Verdi sold all of them out without achieving any improvements for the workers. After protests grew at the Charité and elsewhere, Verdi and the Senate initiated the buyback of CFM in 2019 and concluded a collective agreement for CFM workers this year.

After a three-month arbitration process under former Brandenburg Minister-President Matthias Platzeck (SPD), a uniform collective agreement was adopted for the approximately 3,000 CFM employees, replacing several different regulations on working hours and wages. The result does not even begin to meet the workers’ demands. Even Verdi negotiator Marco Pavlik had to concede that the agreement was “clearly far away from the level of TVöD.”

In reality, the improvements for CFM workers are minimal, and for some groups the contract even increases their weekly working hours. It is therefore hardly surprising that both the management and the Senate were delighted with the deal. Berlin’s Mayor Müller explicitly praised the agreement as strengthening “workplace co-determination,” i.e., the corporatist role of the unions. Part of the agreement is a slush fund of 100,000 euros per year to “further develop trade union work in the company,” as Pavlik noted. This is to ensure that Verdi retains control despite the lack of support from the workers.

The essentially anti-working class role of the unions can be seen internationally. In the US state of Massachusetts, hundreds of nurses have been on strike for weeks. They face not only the ruthless management of Tenet Healthcare, which has threatened to fire strikers, but also the trade unions, which are isolating the strike, and the Democratic Party. In Connecticut last week, the Democrats, unions and management conspired to reach a rotten deal to prevent a strike by workers from 26 nursing facilities across the state, a deal that did not meet the workers’ legitimate demands.

Bitter experiences around the world show that doctors, nurses and other health care workers must organise independently of the unions in the fight against layoffs, cutbacks, poor wages and intolerable working conditions. They must join together in rank-and-file committees and network internationally. To this end, the International Committee of the Fourth International has called for the formation of the International Workers’ Alliance of Rank-and-File Committees (IWA-RFC) at its online rally this year on 1 May.