Australia: The way forward for New South Wales nurses

Tens of thousands of nurses in New South Wales (NSW), Australia’s most populous state, carried out their first statewide strike in almost a decade last week. They are taking a stand against longstanding staff shortages, high patient-to-nurse ratios, a punitive pay cap and dire working conditions, exacerbated by the COVID-19 pandemic.

The strike proceeded in defiance of a ban issued by the state Industrial Relations Commission (IRC), expressing the workers’ determination to fight for their conditions and wages, in opposition to decades of funding cuts to the public health system.

The NSW Nurses and Midwives Association (NSWNMA) has previously used IRC rulings as justifications to call off planned strikes at the last minute. The fact that it did not do so in this instance was solely because the trade union feared a massive backlash from workers that it might not be able to control.

Striking nurses in Sydney, February 15, 2022

The Socialist Equality Party (SEP) welcomes and fully supports the entrance of nurses into struggle. They are taking a stand, not only for themselves and all health staff, but for the working class as a whole. Their action expresses a broad sentiment of opposition and anger.

The crucial issue, however, is how this fight is to be developed. The SEP warns that not a single step forward can be taken within the straitjacket of the NSWNMA. The union’s perspective is clear. At the strike rallies last week, it sought to suppress any discussion of the political issues nurses confront; directed them to make plaintive appeals to the right-wing NSW Liberal-National government, and said nothing about further action.

As it has been for the past four decades, the union’s aim is to prevent the emergence of an independent, political movement of nurses and other health staff. The NSWNMA, like its union counterparts, functions as a police force of governments, imposing on workers increasingly unsustainable demands. The unions are tied by a thousand threads to the Labor Party, which has played a central role in the protracted assault on healthcare, and they defend the profit system, which is the source of these ongoing attacks.

The SEP urges nurses to begin the widest democratic discussion on the issues they confront and how their struggle can be advanced, free from the interference of the NSWNMA leaders, who instructed staff last week not to speak to “protest groups” or political tendencies advancing an alternative to the union leadership. The SEP proposes that nurses establish their own rank-and-file committees, independent of the unions, to unite health workers across the state and nationally, in a fightback against the onslaught on public health and for all of their social rights.

On the crucial issue of the day, the pandemic, the NSWNMA is at one with the government and the ruling elite. The union has supported the profit-driven “reopening” drive throughout the COVID crisis, including the official abandonment of public health measures in December and the open adoption of a “let it rip” program, which has resulted in an unprecedented coronavirus surge that has overwhelmed the hospitals.

Last month, the NSWNMA backed changes to “close contact” rules which forced potentially infected nurses and health staff to remain on the job. It appeals to state Premier Dominic Perrottet, the architect of the surge, to “come to the table,” and is aligned with Labor, which is responsible for the “reopening” no less than the Liberal-Nationals.

As is the case internationally, these “herd immunity” policies are dictated not by science, but by business interests. Nothing can be allowed to disrupt corporate profit-making activities and the drive to keep workers on the job so they can be exploited, even mass illness and death. Over the past two months, capitalist governments everywhere have dropped any pretense of trying to mitigate the worst effects of the pandemic.

Instead, their perspective is to declare COVID “endemic” and insist that the population must “live with the virus.” In practice, this means continued mass transmission, which will result in infection wave after wave and the emergence of new variants, potentially vaccine-resistant and even more virulent.

It must be stated bluntly: health workers cannot have decent conditions in this official scenario of a forever pandemic. Their working conditions and their very lives will continue to be a nightmare. Already, an estimated 115,000 health workers around the world have died from COVID. In Australia, tens of thousands have been infected. An untold number have become severely ill or have died. The governments and the health unions must know the figures, but they have kept workers in the dark.

The fight for conditions and for pay rises is inseparable from a struggle against the “let it rip” pandemic policies and the adoption of scientifically-grounded measures aimed at eliminating the virus.

But the union is intensely hostile to this position, as was demonstrated by the fact that it barely mentioned COVID or the “herd immunity” program during last week’s strike. To do so would raise the need for nurses and other health workers to take up a political struggle against the very governments and official parties to which the union is tied.

Who is responsible for the healthcare crisis?

The pandemic did not begin the crisis in Australia’s healthcare system. It has exacerbated immense problems that have existed for years. Likewise, the role of the unions over the past two years, in backing the official COVID policies, is not an aberration but a deepening of longstanding tendencies.

When the pandemic began, Australia had one of the lowest ratios of hospital beds, including for critical care, per capita, in the OECD. This was only the sharpest expression of a dire situation that included chronic understaffing, insufficient resources and gruelling conditions, including major overtime pressure.

Who is responsible? The governments and the health unions! For decades, Labor and Liberal-National governments, state and federal alike, have not only refused to boost funding to public healthcare, but cut the system back. In NSW, this process was spearheaded by the last state Labor government, in office for almost 20 years. In Victoria, it has been overseen by a Labor administration for the past decade.

At the federal level, the previous Rudd-Gillard Labor government sought to open public health up to the full force of the market. This included initiatives such as expanded “casemix,” allocating funding on the basis of procedures performed at competitive costs, and the National Disability Insurance Scheme, which has effectively privatised much of disability care.

The health unions, including the NSWNMA, have worked hand in glove with all these governments. This has included the imposition of one sell-out industrial agreement after another.

In NSW, for instance, the last strike action by nurses was in 2013. All the issues of today, from staffing shortages to wage suppression, were present. The action was limited to a single day, nothing was resolved, and the union did not even issue a media release on the issue of ratios until April 2014.

Since then, the NSWNMA has prevented any further statewide action, ramming through successive industrial awards that delivered nothing to workers, perpetuating stagnant wages and ensuring the hospital staffing crisis has continued. The union has shut down strikes over the privatisation of hospitals while promoting illusions that the election of a Labor government would reverse decades of attacks on the public health system.

This is the role of the unions everywhere. Amid the globalisation of production in the 1980s, and demands from international capital for ever-greater productivity, the unions took their nationalist and pro-capitalist program to its logical conclusion. They became an arm of industrial management committed, not to fighting for limited gains on behalf of workers, but to forcing them to accept the dictates of big business for unending cuts to wages and conditions.

The need for rank-and-file committees

Around the world, the pandemic and the pro-business restructuring that has gone along with it is spurring working-class struggles, including in healthcare.

The experience of workers everywhere is that they can only begin a genuine industrial and political struggle by breaking out of the framework of the unions and the apparatus of suppression they defend, including the Industrial Relations Commission and Fair Work Australia.

Nurses must form rank-and-file committees so they can link up with other sections of workers who face identical issues, including paramedics, aged care staff and doctors, all of whom were excluded from last week’s strike. Such committees are the only means of challenging the union’s attempts to divide workers up, profession by profession and state by state, the better to betray them.

Rank-and-file committees can serve as a forum for democratic discussion among nurses and other health workers about all the issues they confront. They can formulate responses to the latest government and hospital management dictates from the standpoint of what is in the interests of workers themselves. And amid the ongoing pandemic, they can function as safety committees, fighting for full PPE, infection controls and other crucial measures to protect healthworkers from the virus.

The SEP calls for rank-and-file committees as part of the fight for an independent political movement of the working class. Struggles are emerging among rail workers, who confront the same pay cap as nurses, as well as teachers, who have been forced by the unions into COVID-infected classrooms, port workers and many other sections. In every instance, the unions are limiting them to isolated and sporadic industrial action while holding backroom talks with governments and the employers to force through sellouts. The alternative is to unite the various struggles into a single mass movement.

Nurses and all workers face political issues. The fight for pay and conditions is intimately connected to the struggle against the pandemic policies. It is possible to eliminate the virus and end the pandemic. But this requires scientific public health measures, including shutdowns of non-essential production, with full compensation for affected workers, and remote learning.

Capitalist governments have refused to follow the science, instead subordinating everything to the wealth of the billionaires and the largest corporations. The fight to end the pandemic is thus a fight against capitalism itself. So is the struggle for decent wages and safe conditions. Nothing will be won by begging governments that are preparing new austerity offensives to pay for the vast debts they have accumulated the past two years in handouts to the banks and big business.

The SEP puts forward a socialist perspective, which insists that society must be organised to meet the needs and social interests of the majority, the working class, not private profit. We fight for workers’ governments, which would place the banks and the major corporations under public ownership and democratic workers’ control. Such governments would end the vast funding to the military and to subsidies for the rich, and redirect trillions of dollars to public health, education, welfare and other crucial areas.

The SEP urges nurses and all other health workers to contact us today and begin a discussion on this perspective.