The strike by nurses at North Rhine-Westphalia’s university hospitals is of great political significance. They are fighting back against intolerable working conditions, which have been further exacerbated by the ruthless “profits before lives” policy during the pandemic. Instead of easing the burden on workers and compensating them for horrendous inflation, the federal and state governments are making billion-euro gifts to the super-rich and spending €100 billion on deadly weapons.

Under these conditions, nurses can assert their elementary rights to a reprieve from intolerable working conditions and adequate pay only through a broad mobilisation of the entire workforce. Workers in day-care centres who are also striking for relief and higher wages, the many workers in industrial plants who face wage theft and mass layoffs, must support hospital workers and conduct a common struggle.

This requires a break with the public service union Verdi, which is doing everything it can to isolate and sell out the nurses’ strike, as happened before in Berlin. In the US and many other countries, nurses have organised themselves into independent rank-and-file action committees that are taking the struggle into their own hands. We call on all employees of the university hospitals in North Rhine-Westphalia (NRW) to set up their own action committees and join forces with their international brothers and sisters.

Hospitals and care facilities are where all the ills faced by workers around the world are concentrated. That is why the NRW strike enjoys broad support among working people, even though the establishment politicians and the media are trying to block it out and talk it down.

Even before the pandemic, the privatisation of hospitals and the accompanying orgy of cuts led to untenable working conditions. “It’s not the strike, but the normal state of things that is endangering patients,” one nurse told broadcaster WDR. A nurse in a paediatric intensive care unit illustrated this in Essen by saying that emergency staffing during the strike currently required more nurses than hospital management usually provides during normal operations. “Emergency staffing has been set by our employer at four nurses,” the nurse said. “Last month, we worked 12 shifts with a staffing of three.”

With the pandemic, these conditions became simply intolerable. Nurses have been hit hardest by policies that have placed profits before lives and only ever limited the pandemic enough to keep hospitals from completely collapsing. As a result, staff have had to work at their limits for two-and-a-half years now, and many have fallen seriously ill or even died. Because of poor working conditions and completely inadequate pay, there is severe understaffing everywhere. And this is deliberate. With every understaffed shift, with every employee who physically collapses afterwards, the companies make a profit.

After all this, workers are now confronted with severe real wage cuts. Far from being rewarded for their superhuman efforts during the pandemic, caregivers are facing de facto pay cuts. The billions gifted to the banks and corporations during the pandemic have fuelled inflation, which is becoming even more ferocious with the economic warfare measures against Russia. The 7.9 percent official inflation rate is a serious underestimate because food prices have risen by as much as 20 to 50 percent.

While workers' wages are being cut in this way, the government is spending €100 billion more on weapons and armaments. Workers, on the other hand, are constantly told there is no money.

In this frontal assault on the working class, through which hospital employees are doubly and triply affected, the trade unions and especially Verdi stand on the side of the government and corporations. The unions are doing everything they can to isolate the emerging struggles and let them come to nothing. Verdi has just recently sold out the struggle of workers in social and educational services.

In the NRW nursing strike, Verdi is concentrating everything on the demand for a “reprieve collective agreement,” as already exists in a similar form in Berlin at the Vivantes and Charité hospitals. This means that the sellout is already pre-programmed: In Berlin, hospital management and the Senate (state executive) are always finding new loopholes to bypass the collective agreement. A few days ago, Berlin nursing staff highlighted that conditions on the wards have not improved in any way with their “Walk of Care” and by holding new warning strikes.

At the same time, by focussing on the “reprieve” agreement, Verdi is seeking to distract from the wage reductions it organised at hospitals last year. In the last collective agreement, the union imposed a zero increase on nurses until December of this year, despite hospitals facing collapse and the burdens of the pandemic. From January 2023, wages rise only by 2.8 percent, which under conditions of horrendous inflation amounts to a substantial real-wage decrease.

Every health care worker knows that falling wages are the main reason for understaffing, along with increasing workloads. To bring about real relief, staffing levels would have to at least double, and wages would have to increase by at least 20 percent just to compensate for inflation. Under these conditions, the whole “reprieve collective agreement” that Verdi is now negotiating is not worth the paper it is written on. It serves only to suppress workers’ anger and to continue the policy of cuts.

To wage a fight for real improvements in care, for higher wages and better working conditions, nurses must take the negotiating mandate away from Verdi and build independent rank-and-file action committees that take the struggle into their own hands. They must establish contact with Health Care Workers Rank-and-File Committees in the US and other action committees and coordinate the struggle internationally. To that end, the International Workers Alliance of Rank-and-File Committees (IWA-RFC) was formed a year ago.

Hospital workers need to orient themselves to the many other working class struggles breaking out everywhere. Industrial workers are resisting mass layoffs and wage theft, educators are resisting vile working conditions and starvation wages. These struggles must be united and organised independently.

Such a fight inevitably raises political questions. The struggle for higher wages and better working conditions cannot be separated from the struggle against rearmament and war, against the “profits before lives” policy in the pandemic, and against the handing over of billions to the banks and corporations. It inevitably raises the question of whether the needs of working people should take precedence over the profit interests of the rich. In order to implement a health care system that is oriented toward the needs of patients and workers, a socialist perspective is needed. This is what the Sozialistische Gleichheitspartei (SGP, Socialist Equality Party) is fighting for with its sister parties of the Fourth International around the world.

Get in touch with the SGP! It supports the building of independent action committees and helps to establish contact between workers internationally.

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