Hundreds of thousands march in Madrid against health cuts

Hundreds of thousands of people demonstrated in Spain’s capital Madrid Sunday, in defence of public health care and to oppose its dismantling and privatization under the right-wing Popular Party (PP) regional government of Isabel Ayuso.

Organizers say 670,000 people took to the streets, while the government gave estimates of around 200,000. It was by all accounts one of the largest protests in Spain’s capital over the past decade.

Trains, subways and buses were packed, as tens of thousands moved to join the different columns of protests going from points across the capital to the main demonstration in the centre. Under the slogan, “Madrid rises up to defend public health,” nurses, doctors and health workers were joined by whole working class families, with children and grandparents, from across Madrid. Well-known film director Pedro Almodovar attended, telling El País “the question of public health care is absolutely transversal and affects everyone.'

Aerial photos showed major roads like El Prado, Castellana, and Alcalá entirely jammed with masses of people. Protesters chanted “Quality public health,” “Cutting back on health is a criminal act,” “Not one euro more for the private health sector” and “Ayuso resign!”

The protest also included a minute of silence for the thousands of people who lost their lives in Madrid senior care homes during the pandemic.

The protest is part of rising global opposition to the capitalist offensive against public health care, as the ruling class privatises, dismantles and sacks thousands of health workers, while providing trillions of euros in bank bailouts since the COVID-19 pandemic and NATO’s war on Russia in Ukraine began.

This is discrediting governments across Europe and provoking explosive struggles. In the UK, 300,000 UK nurses voted to strike for a pay deal of inflation plus five percent, the largest ballot by the Royal College of Nursing (RCN) in the union’s 106-year history. In the US, 33 medical groups wrote a letter to the Biden Administration to carry out urgent collective action to address the evolving crisis, in which “Emergency departments (EDs) have been brought to a breaking point.”

The region of Madrid is Spain’s most densely-populated region, with 6.6 million people. While it is the richest, it has the lowest health expenditure per capita in Spain, at €1,171/inhabitant, compared to the average of €1,478. It is normal to wait 4 to 8 months to see a specialist doctor and an entire month to get an appointment with a general practitioner.

The combination of a ‘let it rip’ strategy against COVID-19 along with the privatisation and dismantling of services has provoked a catastrophe. According to Eurostat, the region has seen its life expectancy drop more dramatically than anywhere else in Europe—from 85.8 to 82.3 years.

Anger among health workers has been building for years. Ayuso ran last year on the slogan “Communism or Liberty,” opposing public health measures against COVID-19 as “communist” and calling for the defence of “liberty” by ending social distancing and allowing mass infections.

Close to the neo-fascist Vox party, with whom she made a parliamentary alliance, Ayuso is notorious for pursuing a health policy of “social murder.” She provoked protests in the autumn of 2020 by demanding a back-to-school policy despite heavy circulation of the virus, saying: “It is likely that practically all children, one way or another, will be infected with coronavirus.”

She issued protocols with criteria to exclude nursing home residents from being transferred to hospitals at the peak of the COVID-19 pandemic, leading to tens of thousands of deaths. She even gave contracts to bring masks from China to a friend’s company, for which she ended up paying a commission of about €300,000 to her own brother.

The health crisis has only intensified over the past months. Emergency wards have been overwhelmed as primary care and local emergency services were rapidly dismantled. This April, Ayuso sacked 6,000 health workers who signed a COVID contract in March 2020. Most of them were doctors, nurses, assistants and laboratory technicians.

Over the summer, under mounting anger, Ayuso was forced to announce the reopening of primary care emergency services that had been closed during the pandemic. Then, in early October, she suddenly announced the reopening of 78 continuing care points—41 old SAR (Rural Care Service) and the 37 old SUAP (emergencies located in health centres)—with half the personnel. Doctors were therefore forced to work for 50 percent more hours a year.

This sparked mass anger among health workers, who launched mass sickouts, partial strikes and protests. Walkouts had started in the region the week before, with a strike called for next Monday for nearly 5,000 Madrid doctors. Ayuso reacted by denouncing health workers as “privileged and self-interested” and imposing 100 percent minimum services, aiming to break the strike.

Responsibility for Ayuso remaining in power and implementing her murderous agenda lies squarely with Podemos and the Spanish union bureaucracy. Just weeks ago, on October 22, a demonstration of more than 35,000 people marched in Madrid against Ayuso’s plans. This was ahead of the strike in primary care emergency rooms.

Terrified of rising opposition, the main health unions—the Spanish Trade Union of Nursing Professionals (SATSE), the Podemos-linked Workers’ Commissions (CCOO) and the social-democratic General Union of Workers (UGT)—signed an agreement with Ayuso, calling off the strike. This betrayed the health workers’ main demands.

Workers reacted with a mass sick-out. The same unions that had previously agreed with Ayuso suddenly shifted and, working with neighbourhood associations and medical social movements under their control, launched Sunday’s protest.

Over the years Podemos has played a key role in demobilising opposition to Ayuso. Indeed, the Socialist Party (PSOE)-Podemos government worked hand in hand with Ayuso and Vox in Madrid to implement the EU’s “herd immunity” policy, which has cost over 160,000 lives in Spain. Now, amid a new wave of COVID-19, the government is dismantling testing and data reporting as part of its new strategy of simply ignoring the pandemic.

In autumn 2020, the government threatened to deploy 7,500 soldiers against protests targeting the “restricted mobility” order imposed by Ayuso in the working class districts of Madrid amid the resurgence of COVID-19. The order, worked out between the Madrid regional and the PSOE-Podemos national government, required workers and youth to continue reporting to work and school. It imposed lockdowns only in working class areas.

Amid this devastating exposure of Podemos and the unions, the pseudo-left is intervening to prop them up. Revolutionary Left, formerly affiliated to the Committee for a Workers’ International (CWI), is calling on “the leaders of the CCOO and UGT, and of the parliamentary left, of Más Madrid and UP [Podemos]” to “abandon their completely failed strategy of demobilization to guarantee social peace.” Instead they should lead “mass mobilization in the streets and militant and combative strikes.”

In a similar fashion, the Spanish affiliate of the International Marxist Tendency calls on the “trade unions, neighborhood associations, social movements, as well as the left-wing parties and their activists, to join forces to broaden their demands beyond the health issue: in social care, education, urban planning, housing, etc. and launch a first day of general strike in the Community of Madrid for 24 hours, with massive mobilizations in all neighborhoods and cities.”

Workers and youth must be warned. Such a perspective can only lead to a dead end. The great task facing workers in Spain and internationally is to prepare a rank-and-file insurrection against the diktat of the bureaucracies and impose a scientifically-based fight against COVID. This necessarily involves the formation of rank-and-file committees, independent of the union bureaucracies, to organise and expand workers’ struggles against Ayuso and the PSOE-Podemos government and the financial markets.