Nurses and other caregivers at the Berlin Charité, the largest university hospital in Europe with 13,200 employees, are beginning an indefinite strike today. More than 96 percent of the workers—who are members of the ver.di (Vereinte Dienstleistungsgewerkschaft – United Services Trade Union)—voted in favour of the stoppage, which is over understaffing and what workers call “unbearable” working conditions.

A break with the ver.di union and its local group at the Charité, which is closely connected with the Left Party, is a precondition for a successful struggle. The union has every intention of using the strike to let off steam while it collaborates with management to impose further cost-cutting measures as it has for over 20 years.

The nurses’ main demand is improved conditions. The Charité no longer hires permanent employees and the allocation of workers is dependent on the budget available to each department or ward. Patient care is continuously sacrificed to the drive for profit as gaps are filled with temporary agency staff and it is often the case that only one trained nurse is left responsible for an entire ward during the night.

Workers complain they are under tremendous time pressure and cannot appropriately care for patients. Often they are contacted in their free time to cover emergencies and large amounts of overtime are commonplace. Along with care responsibilities, there is not only an increased quantity of documentation to be completed, but also a growing number of tasks taken over from doctors. Maintaining adequate break times is out of the question.

As a letter from nurses in the child and maternity wards pointed out, “With chronic understaffing on every shift, current patient care, including the psycho-social care of parents and relatives, is in our view an extremely dangerous form of care. In addition, extra assignments and tasks cannot be completed properly. The unbearable conditions on our ward also result from, among other things, the high rate of sickness. The reason for this is the drastic increase in the physical and psychological burden.”

The Charité is typical of the conditions throughout the healthcare system, where personnel and supplies have been cut continuously since the 1990s in a campaign to privatise and reduce costs. According to ver.di, the shortfall of nurses across the country is currently estimated at 70,000 full-time positions.

This was accelerated with the “reform” of state healthcare insurance in 2000, which established a so-called results-based and rewards system. Payments to hospitals from the insurance system were no longer determined by the actual medical costs but on statistical categories known as diagnosis-related groups (DRG), which set a flat fee depending on the diagnosis. The explicit goal of this was to compel hospitals to compete against each other to cut costs, reduce hospital stays and accelerate privatisation.

The next major attack followed in 2005 with the replacement of the collective agreement for federal workers (BAD) by the collective agreement for public services (TvÖD). This was connected to major cuts in wages and benefits for public employees in Germany’s individual states, including hospital workers. In opposition to the downward spiral, not only in pay, but also working conditions, 20,000 doctors at the Charité conducted one of the most determined struggles in the post-war era, which lasted three months in early 2006.

None of these attacks could have been implemented without the active support of ver.di and Left Party. These organisations are composed of people who have turned the practice of deceiving workers into a professional occupation. Their comfortable positions in the political structures of the Charité rest on their ability to force through every new attack while making a show of protest.

In early 2003, as part of its coalition with the Social-Democrats (SPD) in the Berlin state government, the PDS (as the Left Party was then called) pulled Berlin out of the association of state employers so they could cut the wages of city workers below national levels. At the Charité, workers then labored for years without a contract. At the same time hundreds of millions were cut from Berlin’s university hospitals, mainly by reducing staff costs.

In September 2006, ver.di felt forced to call a strike due to the mounting anger among workers. It confined the work stoppage to only a few departments at the hospital and then shut it down after eight days.

In the same year, the SPD-PDS coalition formed Charité Facility Management (CFM) to outsource non-medical and non-nursing staff, including caterers, cleaners and logistical workers, to low-wage contractors. A strike five years later against the miserable working conditions at CFM was isolated and sold out by the union.

The immediate background to the latest strike is the failure of ver.di’s negotiations with Charité management, which have been ongoing since the beginning of the year. Talks restarted at the end of 2014 after the expiration of a so-called “short contract”, based on an arbitration decision struck in June 2014.

The central component of the agreement was the formation of a “workplace health commission” (GK) to which the employer and ver.di each appointed three members. The commission was allegedly to oversee the appointment of 80 new workers, who should have been hired at the end of last year. However, this never took place.

The commission ver.di representatives include members of the pseudo-left SAV (Socialist Alternative) that works within the Left Party. In 2011, SAV played a crucial role in maintaining the control of the union bureaucracy over the strike, while pitting Berlin university hospital workers at different locations against each other.

SAV assisted the ver.di leadership, Charité management and the Berlin senate in imposing a new five-year contract for 10,000 non-medical workers that includes a strike ban, which is still in force.

Today, ver.di, the Left Party and SAV are again playing a double game.

While Charité management has taken firm measures against workers, including seeking a strike-breaking court injunction on Thursday, ver.di is collaborating with management and the state government to prepare further rationalisation measures.

The SAV is seeking to maintain control over growing discontent by using radical-sounding phrases at so-called days of action, which are no more than fruitless protests and publicity stunts.

To prevent the defeat of this fight hospital workers must draw the lessons of the past and take the conduct of the struggle out of the hands of ver.di and its SAV and Left Party apologists. If the Charité workers are not to be isolated, worn down and defeated then workers must expand the walkout to other hospitals and workplaces. For this, independent forms of organisation must be created to bring together train drivers, childcare workers and postal workers to lead a joint struggle against the sabotage of all these struggles by ver.di.