The four-month strike by 700 nurses and case workers at Henry Ford Health’s Genesys Hospital in Grand Blanc, Michigan has entered a new and dangerous stage. Hospital management has sent a threatening letter telling strikers that the hospital is now posting their positions.

The threat of permanent replacement represents an intensification of the strikebreaking operation mounted by Henry Ford Hospital while the Teamsters union bureaucracy continues to isolate the struggle and refuses to mobilize the broader strength of healthcare workers across Michigan.

In early December, striking nurses reported receiving the letter from Henry Ford Genesys management informing them that the hospital had begun posting their positions and that there was “no guarantee” they would regain their former jobs if they did not return to work.

Local media coverage summarized the message bluntly: the hospital is “posting their positions, with no guarantee of returning to their previous roles,” an unmistakable warning that their jobs could be permanently filled by new hires.

The text of the letter states in part:

We have posted positions across all shifts and welcome anyone committed to patient care. We will support and protect those who choose to return, as well as new nurses joining our team.

At the end of the strike, nurses who have not returned will have recall rights, but not bumping rights. Those returning will be placed into available roles based on seniority and qualifications. Nurses who permanently filled positions during the strike will remain in those roles.

At the same time, Henry Ford Health has unilaterally implemented its “final” contract offer after declaring an impasse in negotiations, announcing publicly that the new wage and benefit terms apply to “all registered nurses, including new team members, RNs who have remained on the job through the ongoing strike, and striking nurses who might want to return.”

Management has also stated that it will “re-extend” job offers to candidates who had previously declined posts at Genesys, which, in combination with the letter to strikers, demonstrates that the hospital is actively recruiting replacements while threatening to strip current nurses of their positions. Striking nurses have reported that a handful of union members have returned to work.

The strikebreaking by Henry Ford Health is taking place under conditions where the strike remains confined to Genesys Hospital and has been systematically isolated by the Teamsters apparatus. For 16 weeks, the Teamsters bureaucracy has refused to mobilize a broader strike by healthcare workers in the region, even though the central issues—unsafe staffing, below-inflation pay and chronic overwork—are shared in every healthcare workplace.

Earlier in the walkout, the Teamsters capitulated to management’s order to dismantle picket encampments and remove tents and burn-barrels that provided minimal shelter.

This pattern has continued as the hospital has escalated its offensive. While Henry Ford deploys highly paid travel nurses and now threatens to permanently replace strikers, the Teamsters have limited their response to legal maneuvers and press releases, including unfair labor practice charges that, as workers have seen in struggle after struggle, do nothing to alter the balance of forces on the ground.

No serious effort has been made to mobilize the 10,000 newly unionized Corewell Health East nurses—represented by Teamsters Local 2024—whose own contract fight involves attacks on pull pay and student loan programs and who confront the same issues of understaffing and corporate cost-cutting.

In the face of the escalating pressure, nurses and case workers on the picket line remain deeply opposed to management’s attempt to impose substandard conditions and are determined to win binding, enforceable nurse-to-patient ratios.

One nurse told reporters from the World Socialist Web Site, “I am not going back in this building unless we get what we want. What we want is reasonable, safety. I will stand out here even if I have to get another job.”

Speaking on a picket line rally held that week she said, “We had community support, it was very nice. It was a cold, cold day and extra windy, but we still had quite a few. There were probably about 30 UAW guys who came,” from General Motors plants.

“We are fighting for all nurses; something has to change. There is big-time burnout among healthcare workers.”

Another long-time Genesys nurse said, “I just want safety. If you create a safe environment, you create a better work environment, a hospital where people want to come and be treated.

“Our goal is to get concrete staffing ratios and accountability. The big guys at the top have little knowledge of what is happening on the local scene.

“There are nationally recommended staffing ratios that have been put together over years based on evidence-based procedures. There is no excuse for hospitals not to follow them.

About the propaganda being directed at striking nurses by Henry Ford Health she commented, “Often, when corporations are trying to achieve something that doesn’t have community support, they will try to falsely portray themselves in a better light than what exists in reality.”

She added, “Safety is not a lot to ask. It is a human right. You can’t tell us the wealthy don’t have the money” to fund universal health care, she added. “The corporations are awash with money. It is a national problem, in every hospital. You have to keep standing up for what is right. I have been very happy to see the amount of community support we have been receiving by people saying ‘yes’ to healthcare workers.”

Julie, a nurse for 20 years at Genesys, said, “We feel very supported. Some people from the UAW came out last week. I am really surprised that Henry Ford didn’t have more union hospitals to begin with. We fought 21 years for this contract that we’ve had. And then they just came in and they just annihilated it. And we have no pensions, no healthcare after we retire.

“We need other workers to come out with us ... because your voice is louder when there’s more numbers. You know, if Corewell went out, I think that’s about 10,000 nurses.”

Martha, a nurse for 10 years at Genesys, said, “Our insurance premiums doubled in the contract Henry Ford brought us recently that we rejected. The conditions we are facing are the same as nurses across the country. It’s everywhere. It’s not about pay.

“We only care about staffing, about having a safe number of patients so we can give really quality care. But it is true that families can’t live off just one salary anymore, so there is a financial pressure. I know a lot of nurses who have kids coming out of college who are struggling to find work.”

Francesca, a nurse for 15 years at Genesys, also said, “It all got so much worse with COVID. A lot of nurses retired or just walked. Then the hospital realized we could work without enough nurses, without the supplies we needed, without proper infection protocols and they just kept doing it to us. The demand on the nurse today is higher than it ever has been, and they want to just add on more patients, which is not safe at all. It’s not just this hospital. It’s every hospital.

“It’s not an accident that we are short staffed. Henry Ford and all these hospitals, they want to make more money. It’s supposed to be a non-profit. And where did the COVID money go? They built new parking lots, got new signs, built new buildings and meanwhile they take away our basic supplies like wipes.”

Throughout the strike, nurses have repeatedly emphasized that safe staffing is a matter of life and death for patients and for their own physical and mental health. Local union officials themselves have acknowledged that Henry Ford has refused to move “since day one of the strike” on mandatory nurse-to-patient ratios, while continuing to insist that current staffing policies are adequate.

The hospital’s reliance on travel nurses, who are reportedly being paid around $100 an hour—far more than the Genesys nurses earn, and with housing and other benefits included—has only deepened the anger of the rank and file, who see in this not a lack of money, but a conscious decision to starve permanent staff while opening the door to strikebreakers.

From the beginning of the walkout on September 1, the strike has been driven by deep-rooted anger over systematic understaffing, unsafe patient loads, stagnant wages and the deterioration of working conditions since Henry Ford Health took control of Genesys.

Over the past 16 weeks, there has been a steady escalation in management’s strikebreaking tactics: from the early deployment of travel nurses and efforts to limit picketing, to the removal of picket line infrastructure, and now to the unilateral imposition of a contract and threats to permanently replace strikers.

In November, Henry Ford publicly announced it was declaring an impasse and would move to enforce its “last, best and final offer” over the heads of the strikers, an offer that includes a net 8.6 percent wage increase that does not keep pace with the real rise in the cost of living. At the same time, the corporation boasted that it had maintained operations throughout the strike, thanks in large part to the use of contract nurses and the refusal of the Teamsters leadership to mobilize broader industrial action that could shut down the hospital’s revenue stream.

The threat letter and the aggressive posting of positions mark a further qualitative step in this offensive. It is a warning that Henry Ford is prepared not only to ride out the strike but to attempt to break it by replacing a significant section of the workforce. Henry Ford Health is betting that the combination of economic hardship, isolation and the union’s passivity will eventually force nurses back on management’s terms.

The central lesson of the past four months is that the tremendous determination of the Genesys nurses and case workers cannot secure victory so long as their fight remains confined within the framework set by the Teamsters bureaucracy. The union has neither the intention nor the strategy to wage a serious struggle against Henry Ford Health and the broader corporate and political forces backing it; its role has been to police the strike, enforce legal restraints and prevent the emergence of a wider movement of healthcare workers.

Given that tens of thousands of nurses in Michigan are facing similar attacks, including the 10,000 Corewell Health East nurses whose negotiations with management have already produced major conflicts over pay, staffing and benefits and who could, if mobilized in a joint offensive, transform the situation overnight.

To break out of this isolation, Genesys workers need to form their own rank-and-file committee, democratically elected from the shop floor and independent of the union apparatus. Such a committee would take control of the struggle out of the hands of officials who tell nurses to obey strikebreaking orders and instead organize to expand the fight: appealing directly to Corewell nurses, other Henry Ford workers, and health care workers across Michigan and nationally for coordinated action, including joint strikes and mass demonstrations.

It would insist on non-negotiable demands rooted in the real needs of workers and patients—mandatory, enforceable nurse-to-patient ratios, substantial across-the-board wage increases that beat inflation, protection against victimization and permanent replacement, and full staffing of all units—and reject any attempt by management and the union to impose a sellout agreement that leaves the underlying conditions intact.

The strike at Henry Ford Genesys is part of the struggle by the entire working class against the capitalist system and the control of the healthcare industry by powerful financial interests that are focused on one thing: profits. The struggle for a healthcare system that is operated to provide for the needs of the public requires that the hospitals, clinics, health insurance companies and the pharmaceutical monopolies be placed under the control of the working class and operated based on socialist policies.

What is needed now is a conscious turn to a new strategy, one that unites the struggle at Henry Ford Genesys Hospital with the broader movement of healthcare workers and other sections of the working class, and that strips control of society from the financial oligarchy and places power in the hands of the workers who create all the wealth in society.