An account of workplace organising in a privately run hospital in Germany in 2007.
The healthcare system is in upheaval. For years public sector provision has been cut back and private companies are pushing in and expanding. The effects are seen not only in the quality of care for patients but also in the increasingly bad working conditions for workers, The rapid growth of the private sector in German healthcare is shown by the fact that one out of every 4 hospitals here is now under private control.
Effects of privatisation
Privatisation in the public sector always means job cuts, intensification of work, the introduction of new methods of work and wage cuts. About 80% of the costs of running a hospital are wages so if the companies want to make a profit, they need to cut here. There are many similarities in what they do. They leave employers federations and break old contracts1
about wages and conditions, they employ new workers on worse wages and conditions, sometimes they set their own pay levels. They will cut or abolish yearly bonuses, introduce so called performance related pay and lengthen the working week, without of course any corresponding increase in pay. In order to drastically reduce sickness levels, case management systems designed to scare workers off have been introduced. These include home visits and calls, and so called "return from illness" discussions. Last but not least, the screw is further turned by reducing the staffing levels. Short term contracts are not renewed, people who leave are not replaced. For the workers who stay this means much harder work - they have to do the same work in the same time with less people. If necessary, qualified workers are replaced with less or unqualified staff. Agency staff are also increasingly used.
Ready to Struggle
In January 2007, members of the FAU in Hannover who worked in the Healthcare sector, formed a new industry syndicate - der Gewerkschaft Gesundheitsberufe - (Union of Healthcare Workers - GGB Hannover. The GGB stands up against the privatisation of public parts of the healthcare system, against the rationing of healthcare services and against the worsening of conditions for workers. The GGB's declared aim is to develop a health care system based on solidarity rather than just sitting back and taking the attacks of the government and employers - public or private.
Our Everyday Reality
The Wahrendorff hospital in Sehnde - Ilten near Hannover has always been privately run. It is one of the largest privately run psychiatric hospitals in Europe with 222 full time beds, 55 part time beds, 660 residential places and 785 workers.
Dr Wilkening, a Consultant for Psychiatry and Neurology bought the bankrupt hospital for a 7 figure sum in 1993 from the Wahrendorff family.
Until the 13th of December 1992 staff were covered by a contract called the PKA which covered private hospitals in the German state of Niedersachsen (Lower Saxony) - the liquidation administrator had decided to leave the employers federation and break the contract. The new owner, a self-declared opponent of unions didn't rejoin. Lacking a new contract the old agreement applied for new workers up 'til 1998. From 1999 only new individual contracts were given which no longer followed the old PKA contracts.
New employees were then force to negotiate their wages etc. individually with the management, they were robbed of the ability to collectively pressure the management.
In 2003, some workers were given contracts with a wage cut of some 800 euro a month before tax. One care assistant had to apply for income support to top up the wage, a nurse was meant to be happy with just 1,185 euro per month. The reasons for these wage cuts were flimsy - the workers were awarded back pay by an industrial court. The court's judgement didn't change the fact that everyone had to keep on going to court to force payment of parts (supplements etc) of their wages. Wilkening always paid only the exact amount ordered by the court - and after the cases he never updated the wage payments to include the tribunal decisions.
At the end of 2004, a new contract for 2005 onwards had been signed by 95.7% of the workforce. This included longer working hours (up by 1.5 hours a week to a 40 hour week) and a wage freeze. 'Performance related' pay was also introduced. Beforehand, Wilkening had made clear that he could rule out sackings on economic grounds, but he offered to delay these until the end of 2008. The Christmas bonus was set at a half a month's pay,2 but in 2004 Wilkening tried to wriggle out of paying any of it. After complaints from staff, he offered vouchers instead - these saved him money on tax, and social insurance payments. The vouchers could be cased in at petrol stations, at a travel agent as well as within the clinic - e.g. at the in house canteen and garden center.
To deal with the high level of staff sickness at the hospital, the management set up a system of case management. The staff turnover at the clinic is high - qualified care staff in particular leave. The intensity of work for individual staff is very high ... some have developed psychiatric illnesses themselves.
Anti - Union
The attempts by union officials from the services union 'ver.di'3 (and its predecessors ÖTV and DAG) were always half hearted. In reality, their reliance solely on membership drives and casework based on individualised complaints put a brake on union activity. They certainly never tried to get the membership active or be confrontational with the bosses.
The efforts of a small but determined ver.di union group at the hospital - made up of up to a dozen of the 200 members - couldn't change things. A lot of people were very unhappy but many didn't have the confidence to take a stand. A climate of fear reigned. If someone 'went too far' they'd either be transferred or given a disciplinary warning. Wilkening had challenged the unions, and everyone who wanted to get organised, from day one. Union leaflets would be ripped down from notice boards. At union meetings, people would attend who nobody knew. 4 Most employees relied on the activity of the Work's Council and signed away their personal responsibility.
The Work's Council was exposed to heavy attacks. After '94 its members faced regular warnings and (attempted) sackings. 4 militant members of the ver.di group on the Work's Council had 10 sacking attempts directed at them - although 9 of these were quashed by industrial tribunal. There were a further 3 attempts to remove members from the Works Council. A former personnel manager (Eicholz) gave evidence in February 2007 to the Industrial Court in Hannover where he made clear that fabricated evidence was used as the basis for dismissal proceedings.
In elections to the Work's Council at the end of 2005 some 70% of the staff supported the more militant list - 'Courage' - which got 9 of the 13 seats - the other 4 went to the pro management group 'Future Dialogue' - which included some union members as well.
At first the GGB rejected the system of Work's Councils as it is in Germany. 5 However in this case the GGB was the view that it was an act of solidarity to support fellow workers who were getting fired purely for union activities. The more militant members of the Work's Council tried to keep the rest of the workforce fully up to date with what was happening in the hospital - the pro management faction tried to stop this. Over time, the GGB realised that the reformist union ver.di began to lose its credibility with its own members, also amongst Work's Council members, because it left them in the lurch to sort out their own problems.
The GGB saw that through supporting these workers who were being disciplined, it had a real chance to spread anarcho syndicalist ideas amongst the workforce. It wanted to make clear that hitting back against management attacks is only possible through using workers one real weapon - their solidarity.
Our Challenge to the Hospital Management
We wanted to break once and for all the dynamic that management was always on the attack. So on March 14th 2007 some 20 union activists from ver.di, the local DGB (German Trades Unions Federation) and the Hannover FAU picketed the AGM of the Hospital which was being held at the Luisenhof hotel in central Hannover. Our protest against the anti union practices at the hospital surprised the 75 invited guests who came from political or hospital management backgrounds. The guests' reaction to their unexpected welcome at the hotel ranged from pure ignorance to a noticeable surprise and uncertainty. Passersby and workers from neighboring shops came and asked us why we were there.
The next day the GGB began an international protest campaign to further raise pressure on the hospital management. About 80 protests letters followed in the next month. These letters to the hospital management came from anarcho-syndicalist, syndicalist and class struggle unions from around the world - it was an unprecedented example of international solidarity for a workplace in Germany.
It went way beyond local and workplace groups of the German FAU-IWA. Letters came from numerous union branches of
- the french Confederation Nationale de Travail (CNT-F) and
- the spanish Confederación General del Trabajo (CGT-E), as well as
- the Anarcho-syndicalist Federation of Croatia,
- the Eleftheriaki Syndikalistiki Enosi from Greece (ESE),
- the Federation Democratique du Rail Syndicat des Cheminots Marocains from Morocco (FDR),
- the OZZ Inicjatywa Pracownicza Poznan from Poland (IP),
- Industrial Workers of the World in Australia (IWW - ROC),
- the International Solidarity Commission of IWW,
- the Libertarian Movement of Cuba (MLC),
- the National Garment Workers Federation (NGWF) of Bangladesh,
- the Norwegian Syndikalistik Forbund (NSF-IWA), 32
- the Priamia Akcia from Slovakia (PA-IWA), 33
- the REPERG from Guinea,
- the Siberian Workers Union (SKT),
- the Malmö local group of the Sveriges Arbetares Centralorganisation from Sweden (SAC),
- the algerian Syndicat National Autonome des Personnels de L'Administration Publique (SNAPAP),
- the british Solidarity Federation (SolFed-IWA) and
- the Workers Solidarity Alliance New York from the USA. (WSA).
The letters demanded that the hospital management stop attacking union activists and to withdraw the sacking notices issued against militant members of the Work's Council.
Other protests came from Mexico, Slovakia, from the Spanish Confederación Nacional de Trabajo (CNT-E-IWA) and from Germany - amongst others from the DGB - transport workers unions TRANSNET. GLAMROC (the IWW in German speaking parts of Europe also sent its solidarity to the GGB in Hannover. The support of many web pages played a big part in making the dispute known internationally. This included various union sites in Germany as well as the site of the CNT-F, the Unione Sindacale Italiana in Italy (USI-IWA), the IWW, the PA-IWA and the REPERG. There were also newspaper reports in 'Direkte Aktion' from the German FAU, 'Combat Syndicaliste' (CNT-F), 'Industrial Worker' (IWW), 'vers beaux temps' (Hannover), and 'Neues Deutschland' as well as interviews on the FAU Dresden's radio programme 'Das Syndikat ist nicht die Mafia', on coloRadio, an independent radio station in Dresden.
The protests left a definite impression, not only on the affected workers, but also on the hospital management, whose lawyer raised them more than once at the court.
Moving towards a workplace group.
After the success of the solidarity letters, the GGB Hannover leafleted the workers at the hospital on May the 5th 2007. In the leaflet they were urged to take their rights as employees seriously and to show solidarity with each other. One aim of this was to form a militant workplace group.
The leaflets were simultaneously distributed in both parts of the hospital, other Hannover FAU members helped make this possible. Later in May we posted letters directly to the workers on the wards and residential units. The publicity work is meant to spread news about the situation at the hospital as widely as possible. The GGB's activism is in for the long haul. It is orientated on the concrete problems - there are always new ones to add. Overtime the GGB Hannover has found sympathisers within the workforce. Our aim is to build upon these and to form a workplace group at the clinic.
Heiko GGB Hannover,
- 1Translators note: these are like national pay scales in the UK or industry wide awards in Australia
- 2 Translators note: these are traditionally a full month's pay
- 3 Translators note: newly amalgamated
- 4 Translators note: presumably private detectives employed by management
- 5 Translators note: these Work's Councils are a consultative mechanism set up by law and are seen as a method to co-opt struggles and undermine even moderate unionism, they are a major feature of industrial relations in so called 'Rhineland Capitalism' and have been expanded across the EU.