Protests multiply in the Polish healthcare system
Protests in the Polish healthcare system have entered their fourth week. On September 11, during the initial protest, 40,000 workers from all sectors of the health care system took to the streets in Warsaw alone. This was triggered by the government’s announcement to postpone the increase in the health budget and not to increase spending to 7% of GDP until 2027. On September 17, the corresponding law was passed in the Sejm ( parliament). According to this, the budget is only expected to increase by 85 billion zlotys (around 19 billion euros) over a six-year period, an almost insulting sum given the catastrophic conditions of the healthcare system and the pandemic.
The Polish healthcare system is known for its low wages, severe staff shortages and miserable working conditions. For example, nurses earn an average of 3000 net zlotys per month, or about 659 euros. Many employees, especially physicians, depend on having multiple jobs, both to make ends meet but also to maintain basic services in many areas.
Paramedics, in particular, who have been calling in droves for the sick for months, are at the center of the protests. Last Friday, for example, half of all ambulances in Gdansk were not in service due to understaffing. At the same time, the Zielona Góra University Hospital shut down emergency operations for several hours due to lack of personnel. In Poznań, 65%; in Włoclawek, 70%; and in Płock, 80% of the staff were absent, according to spokespersons for the protests, and they are expected to continue until October 10.
The local government then tried to use firefighters and army paramedics as scabs. However, they refused to sign the prepared contracts.
According to Newsweek Polska, Polish paramedics, most of whom have to work 24-hour shifts, work an average of 300 overtime hours per year. The gross hourly wage of a paramedic in Warsaw is only 24 zloty (5.25 euros).
Meanwhile, the protests spread to other areas. For example, medical students and health care trainees announced protests in several cities on October 9 under the slogan “Młodzi z Medykami” (Young people with doctors). In many cases, doctors are also quitting their second or third job in order to reduce their exorbitant working hours. This has led to the closure of services in many places, including the Institute of Psychiatry and Neurology in Warsaw.
About 60 percent of all Polish doctors work in more than one institution full time. The sad record holder is said to be a doctor from Łódź who worked 620 hours per month. Exhaustion and lack of concentration due to chronic fatigue pose a huge danger not only to patients. For example, a 39-year-old anesthesiologist from Wałbrzyc who, according to colleagues, had worked 96 hours a week for lack of staff, died at the end of August.
In the meantime, the justice employees, who had also already demonstrated in September against their low salaries and high workload, have also set up a “red city” next to the former “white city” of professionals. health.
The dire conditions of the Polish healthcare system are a direct result of the restoration of capitalism by the leaders of Solidarity and the former Stalinist regime. The deregulation and privatization that followed was further exacerbated when Poland joined the EU in 2004. Even before the coronavirus pandemic, life expectancy differed by around 10 years between Western and Eastern Europe.
In addition to poverty wages, the health system suffers from a serious staff shortage. For example, according to the Supreme Medical Association, more than 10,000 doctors left the country between 2004 and 2017 alone. One in four active surgeons is in fact already retired. Due to declining birth rates, migration, and the closure of medical schools and universities, the number of medical students alone fell from 6,310 in 1987 to 2,070 in 2000. By 2020 , the number had risen to over 5,000 for the first time. The health ministry said tens of thousands of additional doctors would be needed to make up for age-related shortages in the years to come.
The situation is just as dire for the approximately 225,000 Polish nurses. With an average age of 53, a massive staff shortage means it is already nearly impossible to provide safe nursing care, and here too, tens of thousands of new recruits would be needed each year.
The pandemic has exacerbated all of these problems, which have worsened for decades. To date, more than 75,000 have died from COVID-19 in Poland, including 500 health workers. Still, the wave of the Delta variant is only just beginning to arrive in the country. The Department of Health is now regularly reporting more than 1,000 new infections a day after the infection rate fell to single digits over the summer.
So far, only around 20 million Poles are fully vaccinated, or around 51 percent of the population, while one in four has no vaccine protection. Professor Andrzej Pławski of the Polish Academy of Sciences therefore warns of 40,000 more deaths by the end of the year from COVID-19. Although Health Minister Adam Niedzielski expects 5,000 new infections a day by the end of October, he has categorically rejected the new nationwide restrictions and lockdowns.
Protests for healthcare are growing against the backdrop of a highly explosive class struggle in Poland and internationally. Major strikes by workers in the auto industry, healthcare and railroads have also taken place in the United States and Germany in recent weeks. In Poland, moreover, millions of public sector workers, including teachers and judicial employees, are demanding a 12.5 per cent salary increase.
In addition, given the decision to phase out coal, the struggles of around 100,000 coal miners are imminent. Energy prices in particular have been rising rapidly for months, while the inflation rate is 4%. As social discontent grows, the magazine Polityka recently warned of a “hot autumn” and mass strikes and protests in many industries.
The far-right government of the Law and Justice Party (PiS) has adopted a provocative and uncompromising attitude towards the workers.
To this day, he refuses even to send Prime Minister Mateusz Morawiecki to the negotiating table, as demanded by protesters in Warsaw, and has refused to make any concessions in negotiations with the unions, openly resorting to delaying maneuvers to exhaust the workers. PiS has also taken a strong stance in discussions with public sector unions.
The PiS government is hated by much of the population and is in deep crisis, especially since the mass protests against the new abortion law. In opinion polls, the PiS election alliance, which won an absolute majority in pushing for populist measures in 2015 and 2019, currently only has 35% support. Recently, massive conflicts within the coalition have arisen over disputes with the EU, and rumors of preparations for a “plexit”, or Poland’s exit from the EU, are growing.
In these conditions of growing class conflict and enormous political instability, the unions are the backbone of the Polish bourgeoisie and desperately try to prevent the development of a broad working class strike movement. Despite the openly provocative attitude of the government, the National Strike and Protest Committee, made up of various trade unions and professional associations in the health sector, continues to conduct inconclusive negotiations with the government and intends to continue them at least until October 7.
In doing so, the only concrete action organized by the committee is the “Białe miasteczko 2.0” protest camp in Warsaw (White City 2.0); most of the other actions taken by doctors and paramedics to expand the protests appear to have developed independently of the unions.
There is no doubt that a clearance sale is being prepared behind closed doors. Some unions even launched it. On September 21, for example, the government signed an agreement with the union of paramedics (OZZRM) and the respective employers’ association (SP ZOZ). The heart of the agreement is a 30 percent travel allowance on top of the salary and a minimum wage of 40 zlotys (around 8.74 euros), for some of the paramedics. There were angry comments among those in the protest camp and on OZZRM’s Facebook page. For example, Piotr, a paramedic from Szczecin wrote: “their agreement is worthless” and “the community has been sold”. The Supreme Chamber of Pharmacists has also already reached a separate agreement and also left the protest alliance.
Above all, the unions are systematically trying to prevent the workers’ struggle from spreading either into the health sector or beyond. The trade union confederation OPZZ has so far remained completely silent, although most of the teachers are organized within it. In 2019, the unions, working closely with the liberal opposition party PO (Civic Platform), sold a nationwide teachers’ strike, saving the PiS government from its fiercest threat to date from the working class.
The unions and associations organized within the National Strike and Protest Committee also have a long history of selling out struggles. For example, the nurses and midwives union OZZPiP, like the entire trade union federation FZZ, has close links with the government and opposition parties. Leading trade unionists, such as Lucyna Dargiewicz or Dorota Gardias, stood for election on the lists of the PiS or the former Stalinist Social Democratic Party of Poland (SDPL).
The doctors’ union, PR OZZL, for example, ended its protest, accompanied by hunger strikes, in 2018 for meager concessions, including limiting an increase in health spending to 6% of GDP. here 2024. For the association of protesting doctors “Porozumienie Zielonogórskie,” Marek Twardowski, a representative, even joined Donald Tusk’s PO government in 2007.
To avoid another capitulation, workers in Poland must create new independent organizations and link their struggles across sectors and countries. The International Committee of the Fourth International is fighting to build an International Alliance of Workers of Grassroots Committees (IWA-RFC) independent of trade unions and under the direct control of workers. We call on all of our Polish readers to take up this fight and contact us.