Mass protests against untenable conditions in the Polish health care system

On Saturday, between 30,000 and 40,000 doctors, nurses, caregivers, pharmacists, physiotherapists, hospital technicians, paramedics and many other professional groups from all over Poland protested in front of the Ministry of Health and the Polish Sejm, the parliament, in Warsaw for higher wages and better working conditions. The protests, which were held under the slogan “Białe miasteczko 2.0” (White City 2.0), continued on Sunday.

Demonstrators carried banners with slogans such as “Take it [the money] from the politicians and give it to the health workers!,” “The pandemic of the shortage of nurses and midwives has been going on for many years,” “Welcome to the hospital, we are closing soon,” “The patients are victims of the system,” “The system is finished,” “We want to [be able to] provide care in Poland,” “We die 20 years earlier than other Poles” and “We demand decent wages.”

The demonstrators also held a minute’s silence for the over 500 health care workers who have died in the pandemic from the coronavirus. Quite rightly, they blamed the miserable working conditions and the lack of personal protective equipment for the many who have died.

The Polish health care workers are demanding an increase in pay to the Organisation for Economic Co-operation and Development (OECD) standard. In many cases this is tantamount to multiplying their salaries, because a large proportion of health care workers often earn only a few thousand złoty a month. For example, nurses earn on average of 3,000 złoty net per month, which is about US$780; paramedics and laboratory diagnosticians earn even less on average.

Their demands also include an increase in health care spending from the current 6 to 8 percent of the gross domestic product; an alignment of the number of employees in the health care system with the average OECD level, especially taking into account the fact that many employees of the Polish health care system are elderly; more and better medical services from state funds; and a qualitative increase in medical, nursing and therapeutic care, as well as access to modern forms of laboratory and imaging diagnostics.

The protest has met with widespread support on social media. A dentist posted on Twitter: “Too many medical professions are undervalued. It’s time to change that! As for dentists, we must stop being pushed into the private sector. Adequate dental care is needed by ALL, not just those with fat wallets.” A patient also said on Twitter that she supported the protest because “everyone in health care deserves decent pay and good working conditions.”

While the mass protests in Poland have been largely hushed up in the international and especially the German press, just 250 kilometres away in Berlin, over 2,000 Charité and Vivantes hospital workers have been on strike since Thursday. They are facing problems similar to those of their Polish colleagues.

The protests come amid the developing new wave of the pandemic, driven by the highly contagious Delta variant and the full reopening of schools and workplaces across Europe and the US. Case numbers are also rising dramatically again in Poland. There were 530 new cases on Saturday and 476 on Sunday; case numbers have been rising by 40 percent each week. So far, only a little over 50 percent of the population has been fully vaccinated.

Poland, like all of Eastern Europe, has been hit particularly hard by the pandemic, mainly because of the disastrous consequences of the restoration of capitalism. Although its population of just under 40 million is half that of Germany, Poland has confirmed almost 3 million cases of the coronavirus, compared to around 4 million in Germany. Given the massive lack of testing, even this is a clear underestimate of the true case numbers. The death rate is 198.6 per 100,000 population, almost as high as in the UK and the US (around 201 per 100,000).

The miserable conditions in the health care system are a major reason for the high death rate. The already massively understaffed and underpaid medical staff are confronted with mass infections, especially in working-class regions like Silesia. At the same time, entire towns did not have a single respirator. While the EU average is 10 nurses per 100,000 residents, Poland has only 5. Only in Romania and Bulgaria are the averages worse. According to trade union representatives who spoke at the demonstration on Saturday, 270 hospitals should actually be closed due to acute staff shortages.

The scale of the protests speaks volumes about the explosive mood among workers. The paramedics had been protesting since June against the miserable minimum wage of around 900 euros, among other things, with sickouts. About half of all paramedics in the country took part in the protests, so that the number of available ambulances dropped by 25 percent at times.

The government reform passed on July 1 was the famous last straw that broke the camel’s back. The reform provides for massive salary cuts and a postponement of the previously announced increase in total health care expenditure to 7 percent of the gross domestic product. In Poland, health expenditure is centrally controlled and allocated by the state through the National Health Fund. Originally, the government claimed to reach this level in 2024 but has now postponed the deadline to 2027. With its current 5.4 percent, Poland is one of the worst performers in comparison with other OECD industrialised countries (9 percent), as well as within the EU (10 percent).

The PiS (right-wing Law and Justice Party) government has taken a highly provocative stance towards the workers. Negotiations between the unions and Health Minister Adam Niedzielski broke down after the ministry rejected the demands as “theatrical” and refused to allow Prime Minister Mateusz Morawiecki to participate.

According to PiS calculations, the demands required additional spending of over 100 billion złoty (about 22 billion euros), almost double the previous budget of about 120 billion. Instead of brusquely rejecting the old lie that there is “not enough money,” the committee’s spokespersons demanded more precise information about the basis of the calculations, because only then, they explained, would there be a basis for talks.

The umbrella organisation of the medical unions, the Trade Union Forum (FZZ), warned after the failure of the negotiations on Friday of an “escalation of the social conflict, a deepening of serious personnel problems and ultimately to a total breakdown of the entire system.” In line with the national protest committee, FZZ is now calling for direct talks with the prime minister and the handing over of negotiations to the “Rada Dialogu Społecznego” (Social Dialogue Council), a permanent corporatist body made up of representatives of the government, employers associations and trade unions.

In order to control the growing anger among workers, at the beginning of August six trade unions, together with the supreme medical association, the family doctors’ association “Porozumienie Zielonogórskie” and four other medical professional associations, formed a national protest and strike committee.

In the face of growing militancy and anger among workers, the right-wing PiS government, which is deeply hated by large sections of the population and has recently plummeted to 26 percent in opinion polls, finds its main support in the trade unions. The National Protest and Strike Committee has already made it clear that it wants to end the protests as soon as possible and return to the negotiating table despite PiS’s continued provocative stance. On Tuesday, the specially appointed deputy health minister wanted to meet with the protest committee. However, the meeting did not materialize in the end. The prime minister explicitly refused to meet with the committee.

Most of the trade unions are closely allied with the liberal opposition party (PO), whose representatives feigned support for the protests on social media. In reality, all capitalist parties in Poland are responsible for the current health care disaster, which is a direct result of the restoration of capitalism 30 years ago and decades of cutbacks. Whatever the tactical differences between the PO and the PiS, both speak for the interests of the Polish bourgeoisie and upper middle classes, who fear nothing more than a working-class movement in Poland and across Europe.

The struggle for better conditions in the health care sector cannot be waged within the framework of the trade unions and the established bourgeois parties. Workers need new independent organizations to link their struggles internationally and assert their interests against the bourgeoisie. The International Committee of the Fourth International supports the building of an international alliance of action committees that are independent of the trade unions and under the direct control of workers. Workers in Poland who want to take the initiative themselves in building such committees should contact us today.