On Thursday afternoon, the Histadrut labour federation called off the nationwide strike of 13,000 support workers at Israel’s public hospitals. This came just three days after the start of the strike over intolerable workloads, massive staff shortages and the dismissal of 200 workers taken on at the height of the pandemic.
The health care workers, who include both Jewish and Palestinian Israelis, have been pushed to the brink. They are also seeking extra payments for dealing with Covid, as cases rise again to levels not seen since April 5, and the implementation of a 20-year-old decision of the finance ministry that recommended pay parity between public and private (insurance owned) hospitals.
Union representatives called off the strike, officially a “45-day suspension”, until the start of the Jewish New Year when the country closes down. This followed a meeting with an aide of Nizan Horowitz, health minister in Prime Minister Naftali Bennett’s right-wing “government of change” that replaced that of longstanding premier Benjamin Netanyahu last month.
There were reportedly vague promises that Horowitz would handle the negotiations on health workers’ contracts with the Finance Ministry and prioritize their demands, with the Civil Service Commission agreeing to “suspend” the 200 job cuts.
Eli Badash, the head of the union representing the striking workers, said the workers would agree to the decision “providing these [200] workers are directly employed by the hospitals, rather than by a contractor who makes money at their expense.” The union is also calling for the implementation of the 20-year-old decision on pay parity.
None of this meets the workers’ demands who face an impossible workload. The union cites the case of one cleaner in a medical centre in Nahariya who is required to clean an inpatient ward of 14 rooms, 15 bathrooms and showers, two offices, a treatment room, a nurses’ station and a sitting area in one six-hour shift. Her supervisor said that could not be completed in 15 hours, let alone six.
All this is done for a pittance. The basic wage for a new housekeeper in a public hospital is $550 a month, while longstanding workers can earn up to $1,320 a month, and with overtime up to $1,764. Israel has one of the highest costs of living and lowest wages among the rich club of 38 OECD countries, of which Israel is a member. The median annual salary of a doctor ranges between $35-40,000, while that of teachers and nurses is between $17-20,000.
It was only when forced that the union called the strike in the first place. Public hospital workers voted for action three years ago, in the run up to a nationwide nurses’ strike over their grueling workload, staff shortages, the low standard of care and a planned pay cut. But the vote was set aside by a court injunction demanding employers and workers negotiate an agreement. Even when the negotiations went nowhere and the National Labour Court cancelled the injunction, the union held off calling a strike, citing the pandemic as a pretext.
The strike had seriously disrupted patient care in at least 20 public hospitals, including general hospitals, psychiatric facilities, and rehab and geriatric centers, as all administrative, maintenance, dieticians, and cleaning and kitchen staff stopped work. It forced the closure of outpatient clinics and the cancellation of non-urgent surgery.
There were reports of surgeons transporting patients to operating rooms and nurses sterilizing critical equipment, serving meals, and removing trash. As garbage and dirty laundry piled up in the summer heat, one hospital official warned that the situation could put patients at risk as infections spread.
The strike won widespread support under conditions where Israel’s health care system has deteriorated dramatically as successive governments have privatized the network, outsourced workers to private contractors and cut funding. Further cuts are planned, and many hospitals are in debt due to the government’s failure to update its system of reimbursement between the health funds and the hospitals. The High Court, in response to a petition from the prestigious Hadassah University Medical Hospital, recently ordered the Health and Finance ministries to register a new budget and new pricing model for hospitals by the end of the summer.
Health care professionals, including dietitians, physiotherapists and occupational therapists, planned strike action on Sunday morning in support of the striking workers. Eli Gabbai, who chairs the Health Professionals Union, said the “time had come for the Finance and Health Ministries to treat with respect these ‘invisible’ workers, who suffer disgraceful work conditions and insulting wages.”
Dr Ze’ev Feldman, the leader of the medical association representing doctors in the public sector, expressed his organisation’s support for the strike, saying that the strikers were left with no choice. He wrote, “Your justified demands have been dragged along for three years, and your fight is all of ours. The health system requires administrative and maintenance staff just as it requires doctors.”
Last May, 600 doctors went on a 24-hour strike demanding job protection in the face of the Netanyahu government’s decision to cut health care funding, already among the lowest in the industrialised countries, in favour of the defence budget to finance the suppression of the Palestinians and Israel’s operations in the region.
The corporatist Histadrut labour federation said that if “the professional staff at the Finance Ministry don’t find a solution quickly to the demands of these ‘invisible’ workers, other sectors can be expected to join the strike.” That Histadrut chief Arnon Bar-David felt compelled to make such an insincere threat testifies to the explosive social conditions in Israel.
Conditions of low wages and appalling workload are replicated across the country. Some 1.5 million workers, out of a 9 million population, are paid the minimum monthly wage of $1,650 for a 42-hour week, significantly longer than in other Organisation for Economic Co-operation and Development (OECD) countries. This has put the Histadrut under enormous pressure to demand an increase to about $1,850 along with a two-hour reduction in the working week as workers struggle to make ends meet.
The cost of housing that 10 years ago sparked protests has risen. It now takes 148 months of salary to purchase an apartment, compared with 127 in 2011, while the amount of public housing has shrunk and rental plans have not helped those in need. With the average monthly rent at about $1,200, 37 percent of an average salary goes on rent.
The Adva Center’s recent report on the pandemic called “The Epidemic of Inequality” concluded that Israel’s richest 1 percent had come out ahead, having received the most of the government’s protection and benefits, including the purchase of $440 million worth of corporate bonds. This is set to be squeezed out of the working population in the new budget. Small businesses, mainly service providers, were the main losers as per capita consumption fell by 11 percent, nearly double the OECD average of 6 percent.
By far the worst affected are Palestinian Israelis, with nearly a quarter reporting in April 2020 that they or family members had reduced their food intake, compared with 14 percent of the general population. As the poorest members of Israeli society, the COVID-19 death rate of Palestinian Israelis aged 60 and older was three times that of that of the ultra-orthodox Jews, Israel’s second poorest group, which in turn was four times that of secular Jews.
The Histadrut’s sellout of the strike comes as health care workers worldwide have struggled to prop up decaying capitalist health care systems that have been looted for decades by the corporations, banks and insurance and pharmaceutical companies, leaving them ill-prepared for a global pandemic. The hospital support workers can only defend their jobs, wages and conditions by uniting with all health care workers across the country and beyond. This requires the formation of rank-and-file committees independent of the corporatist trade unions.