Tens of thousands of doctors drew attention to their precarious situation on Thursday with a nationwide warning strike. Around 4,000 took part in the central rally on Frankfurt’s Römerberg. Almost 500 municipal hospitals throughout Germany were on strike, except for Hamburg and Berlin.
The doctors’ warning strike reveals a striking contradiction. Thousands of doctors made it clear that after two years of the pandemic they are working at their limit and are no longer prepared to carry on like this. They are demanding fundamental changes in a health system that is itself ill and going more and more to the dogs.
However, it is clear this is not the fight their trade union, the Marburger Bund, is waging. The Marburger Bund is a conservative professional organisation. It refuses to fight for fundamental changes to the dire conditions in hospitals and the health care system more broadly alongside other sections of the working class. On the contrary, it is trying to settle the conflict with the municipal employers as quickly as possible.
The conditions facing health care workers are part of a broader destruction of wages and working conditions impacting nurseries and schools, aviation, basic industry and virtually every other sector. To wage an effective struggle, doctors must break out of the straitjacket imposed by the unions and forge links with workers in federal and local governments and the state.
Like nurses, teachers, bus drivers and auto workers, doctors must build independent rank-and-file committees against the “profits before lives” policy of the ruling class. These committees should reach out to other sections of workers to carry out the broadest possible mobilization in defence of health care. Workers must fight for health care system in which it will be possible to work in a humane way that is safe, reasonable, healthy and employing cutting-edge science and technology.
The posters carried by the participants in the Frankfurt demonstration were a testimony to the enormous anger felt by doctors in the face of conditions that have dramatically worsened over the two years of the pandemic. One poster read, “In hospital: exhausted and badly paid!” Others read: “Doctors fight against 70-hour week,” “Work until you drop,” “You burn us out,” “Work-work balance?,” “Fair time recording: enough is enough!,” “Work until the doctor drops,” or: “Without doctors’ health—no healthy patients.”
Other slogans were: “No one is asking for champagne, just 2 weekends off,” “Yes, I am overworked—the hospital doesn’t care,” or: “...and who will look after you in the next pandemic?!”
A young couple, Waleed and Nisreen, emphasised, “For us, working conditions are most important. We have to be healthy ourselves to be able to take care of people,” Waleed explained. “Nisreen is having a baby now, and we are both doctors and we are wondering how we will do it. As a person and as a doctor—how do we go on?” Nisreen pointed out that it was simply impossible for young parents to work through three weekends a month. She also said she was afraid of contracting coronavirus.
“Medical workers are the cardiac mainstays of society,” Waleed continued. “To me, the pay scale is just unfair, if you take into account the training and compare us to other professions for a change.” But what was most important to them both, he said, was to see a rapid improvement in working conditions: “The situation has worsened in the last two years. Doctors are treated so badly—something simply has to change.”
Hanno from Braunschweig explained that doctors in municipal hospitals were mainly concerned with a clear limitation of night duties, on-call duties, and rest periods. “We are demanding fair working conditions,” Hanno explained. “It must be guaranteed that each of us gets at least two weekends off a month.”
Recently, a survey of 3,300 doctors by the Marburger Bund found that workloads had increased significantly for 71 percent of respondents during the pandemic. Ninety-one percent of clinicians felt regularly exhausted by their work; 31 percent said this was “always” the case, and 60 percent that it was “increasingly” the case.
“We are concerned about our working conditions,” said Kent, who had come with a group of colleagues from Bremen. “They are so bad that we hardly get any new recruits at the hospitals. When I’m on duty at the weekend, I work through from Friday morning to Monday morning. I’m on call then, but for me that often means working through.”
His colleague Ekhard explained: “The employers don’t allow us the rest periods. If it was not possible to rest during the night and we go home after working through the night, this is deducted from our salary.” He added, “The medical profession is the only profession where you earn minus hours through overtime, which you then have to work off at the weekends. This is modern slavery, nothing else.”
On the coronavirus pandemic, doctors reported, “Right now, we have extremely high absenteeism. A third of the staff is missing because of the Omicron variant. They all have families; they have children at home who can’t avoid getting infected at school. But at the hospital, staffing is so thin there is no cushion. Then beds are closed, wards are closed, and treatments are cancelled.”
The Marburger Bund has been negotiating with the VKA about the conditions of almost 60,000 doctors in municipal hospitals since 14 October 2021. No progress has been made in four rounds of negotiations and two exploratory talks. VKA chief negotiator Wolfgang Heyl described the financial costs of this as “unbearable.”
However, the demands raised by the Marburger Bund in no way address the explosive situation. It is only calling for reliable rest periods, a general limitation of on-call duty to a maximum of twelve on-call shifts and two guaranteed weekends off per month. In addition, it calls for a 5.5 percent increase in salaries under conditions where inflation had already reached 7.3 percent in March. The 2020 contract already mandates two free weekends, but this does not reflect the reality.
Susanne Johna, national chairperson of the Marburger Bund, criticised the VKA’s “attitude of refusal” in Frankfurt. But this is merely a cover. In the fact that the union is fully prepared to reach a rotten agreement with the municipal employers. Moreover, the Marburger Bund is working to maintain the isolation of doctors and is fundamentally unwilling to extend the fight to other sections of workers.
When the contract was terminated on 30 September 2021, thousands of nurses at the Charité and Vivantes hospitals in Berlin took industrial action last autumn. Across the country, workers in other sectors of the public sector repeatedly took to the streets to fight against exploitation and wage theft. But in this situation, the Marburger Bund refused to mobilise doctors alongside their colleagues.
At the end of November, the unions Verdi (public service), GEW (education) and IG BAU (construction) agreed to a foul sell-out that condemned over a million workers nationwide to forego any wage increase for 14 months, until 1 December 2022 (!).
The WSWS wrote: “The unions deliberately isolated the strikes in hospitals, schools, and government services. The protests they organized were token events aimed only at letting off steam. The union leaderships are in cahoots with the employers, are often members of the same political parties, and regularly exchange well-paid positions in the union bureaucracy for senior government posts, and vice versa. The COVID-19 pandemic has exposed as never before the subordination of the unions to the capitalist drive for profits at the expense of any consideration for public welfare.”
The same is true of the Marburger Bund. We urge health care workers who want to fight to contact the WSWS about building a rank-and-file committee at your workplace.