A two-day warning strike has left the Frankfurt University Hospital paralyzed until Friday evening. More than 4,000 non-medical employees are taking part, protesting against staff shortages and catastrophic working conditions. These conditions have worsened during the coronavirus pandemic, with many out sick. Most recently, the state responsible for the university hospital, Hesse, even tried to send nurses still testing positive for COVID-19 back to work.

Cynically, understaffing is seen as a plus in the hospital’s financial calculations—which is why management is trying to retain the status quo. But the employees are no longer willing to put up with the untenable conditions, and the warning strike can easily lead to an indefinite strike.

It is part of a worldwide offensive by nursing staff. There have been and still are nursing strikes in the US, France, Spain and Greece, as well as in Sri Lanka. In the German state North Rhine-Westphalia (NRW), staff at university hospitals have been on strike for 11 weeks, as have the Berlin nursing staff at the flagship Charité and Vivantes hospitals.

Nurses in the oncology, surgery and outpatient care wards told the WSWS of a veritable wave of resignations with more and more colleagues quitting due to pure exhaustion. The situation in these wards is close to spilling its banks, they said.

“My work week is sometimes 72 hours long,” says Carina. “We nurses take over a lot of tasks from the doctors, who are terribly overworked themselves.” In oncology, she says, two registered nurses are responsible for 25 patients.

“We do the work of doctors, but we get paid like beginners,” echoed Stephan, who works in the emergency ward. Shifts are so tightly scheduled, he says, that families and social contacts lose out. “Something has really got to change!”

Nurses were stunned to witness how the government raised “100 billion euro for the Bundeswehr [German armed forces] in the blink of an eye,” as one said, while there was supposedly no money for nursing.

“The exhaustion of the employees is increasing every day,” was the message in a letter signed by 150 Frankfurt employees sent to the hospital management last year. The signatures came mainly from intensive care units that were overloaded with severe coronavirus cases, and still are today. The letter stated that chronic staff shortage is having a devastating effect. “Many complain of sleep disorders or leave the ward crying—this is not an acceptable state of affairs.”

With the fall and winter waves of the coronavirus approaching, driven by the highly contagious BA.5 variant, in July the Hesse state government decided to open the floodgates of mass infection. It has decreed that even infected employees who still test positive for the coronavirus are to return to work. Angela Dorn, the Hesse Minister for Science and the Arts and a member of the Green Party, is the individual responsible. She is also the chairwoman of the supervisory board of Frankfurt University Hospital.

This state policy triggered a wave of indignation that forced its retraction. Infected colleagues must now test negative in order to return to work.

At Marburg/Giessen University Hospital, the second university hospital in Hesse, however, coronavirus-positive nurses can still work shifts. This decision threatens the lives of nurses and patients alike. It is an expression of the profits-before-lives policy of the governing parties.

Two-and-a-half years of pandemic, which bled out the ward staff, ultimately only exposed the grievances that had already accumulated. The introduction of DRGs (Diagnosis Related Groups), which degrade every patient to a “case,” has had a particularly devastating effect. The DRGs determine what therapies, durations, etc., the insurance companies will cover, exerting enormous pressure on doctors and hospital management.

“Since then, there have been massive staff cuts,” one nurse told us. “Patients who in the past would have been nursed back to health are now often discharged too early. This per-case system,” she added, “should be abolished as soon as possible!”

To achieve such goals, however, the struggle must be waged independent of the unions. These organizations isolate every struggle and lock in the reprehensible conditions that are themselves a consequence of the government’s mass infection and war policies. Increased pressure on wages is also a result of inflation and the price explosion that militarism is generating. On all these issues, the unions side with the ruling coalition government and its policy of war against Russia.

The services union Verdi has left both the issues of the pandemic and rampant inflation out of its negotiations. Instead it is focusing solely on the “collective agreement on relief” (TV-E), which has already proven to be a purely cosmetic measure and a distraction in the states of Berlin and North Rhine-Westphalia (NRW).

In NRW, nursing staff struck at the university hospitals for 11 weeks before Verdi stifled it with the TV-E in July. This contract does provide for binding staff-patient ratios on the wards, which, if not met, earn the nurse points, but he or she is only entitled to a relief day after accumulating seven such points.

The main problem is that there is still a staff shortage. So, if someone takes a relief day, his or her colleagues have to cover that person’s workload—a vicious circle that solves nothing. Moreover, the nursing staff will have to wait another year and a half for this system to come into force.

A TV-E had previously been concluded at Berlin’s Charité and Vivantes hospitals. Verdi broke off a strike there last fall after 50 days. That TV-E likewise failed to improve the untenable working conditions.

Verdi’s secretaries and negotiators have decades of experience in keeping worker resistance under control. They are loyal partners of hospital management and the state government. Georg Schulze, who is leading the negotiations in Frankfurt, is not only Verdi’s regional department head, but also deputy chairman of the supervisory board of Rhön-Kliniken, which has taken over the Marburg/Giessen University Hospital. Without people like Schulze, the privatization of state hospitals would never have gone so smoothly. Schulze collected €57,000 in royalties on the supervisory board last year and €122,000 the year before, all in addition to his actual salary as Verdi secretary.

The Frankfurt Verdi secretary for the health sector, Hilke Sauthof-Schäfer, who initiated the warning strike on Thursday, also has years of experience with Verdi labour disputes. She sits on the supervisory board of the Hanau Clinic, of which she was first the works council chairwoman. As a local candidate for the Left Party, she maintains the best relations with the establishment parties, in Hesse especially with the Left, the Social Democrats (SPD) and the Greens.

In the struggle for a high-quality health care system and humane conditions in the clinics, the nursing staff—like the employees of the airports, the schools and daycare centres, and the public transportation system—require their own democratically run bodies that can act independently of the unions.

The Nursing Action Committee, which was formed during the strike in NRW and is a member of the International Workers Alliance of Rank-and-File Committees (IWA-RFC), has set out the following demands for industrial action:

• For each understaffed shift, those affected must receive compensation equal to the wage of the absent worker plus a 50 percent stress bonus! Those who work for two must also be paid for two. Only in such a way the perfidious system can be terminated, with which the hospitals earn at the understaffing.
• Immediate doubling of staff! Each of us knows that adequate care is only possible with a massive increase and a reversal of all staff cuts.
• This is only possible if nurses are finally paid adequately. In view of high inflation, the wage policy of the trade unions means an unacceptable wage loss. To compensate for this and the previous real wage cuts, wages must be increased by at least 30 percent and adjusted to inflation on a sliding scale!
• €100 billion for health instead of for armaments! For years, clinics have been cut to the bone with the argument that there is no money. Now, horrendous sums are being spent to upgrade Germany to Europe’s largest military power. Instead, the money must be invested in fighting pandemics and in the massive expansion of the health care system.
• The system of case flat rates and the associated profit orientation of hospitals must be ended immediately. Privatized facilities must be immediately transferred to social ownership. The health care system must not be run in the interests of a handful of shareholders, rather must be geared to the benefit of the entire population.

Independent rank-and-file committees will provide workers with all the information they need and advance their common struggles across all borders of companies, industries and countries. Get involved in building these workers’ bodies and the International Workers Alliance of Rank-and-File Committees (IWA-RFC) that coordinates them!

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