The Health Trade Union Alliance (HTUA), a combine of several trade unions in the Sri Lankan health sector, announced this week that its members will strike again on March 19 to demand higher allowances. On Tuesday, thousands of health workers held lunch-hour demonstrations called by the alliance outside 17 major hospitals.

The alliance has been forced to announce another nationwide strike in response to the rising anger of its members following a month of fruitless talks between union officials and Health Minister Ramesh Pathirana. The HTUA began these discussions following an invitation from Pathirana after a two-day national strike on February 13 and 14.

In mid-January, President Wickremesinghe increased the disturbance, availability and transport (DAT) monthly allowance paid to government medical doctors from 35,000 rupees ($US108) to 70,000 rupees.

Under conditions where the unions have suppressed workers’ demands for a pay rise, other health workers immediately demanded similar increases in their allowances. The HTUA responded by calling a national strike on January 16, a two-day strike on February 2 and 3, and another walkout on February 13 and 14.

The industrial action, in defiance of the government’s repressive Essential Public Services Act (EPSA), involved over 100,000 health employees, including, radiology and laboratory technicians, pharmacists, nurses, midwives, public health inspectors and entomologists. The government responded by deploying over 1,000 military personnel as strike breakers.

Health Minister Pathirana initiated talks with the HTUA leaders on February 19, promising to appoint a special committee headed by ministry secretary Palitha Maheepala to investigate health workers’ demands. HTUA convener Ravi Kumudesh told the media after the meeting that the alliance was not immediately asking “for the pound of flesh in our proposal.”

The HTUA, he said, took into account the “economic crisis facing Sri Lanka,” the “amount of money available,” “the fact that justice should be done for this injustice caused to the health service as a whole,” and to work out “a solution.” Kumudesh specifically praised the health minister, claiming that he had agreed “in principle” that health workers had been “treated unfairly.”

These comments make clear that the HTUA and the trade unions more generally are assisting in imposing the burden of the Sri Lankan economic crisis on working class. The standpoint of these pro-capitalist bureaucracies is to protect the interests of the Sri Lankan ruling class at all costs, not the jobs, wages and conditions of workers.

Kumudesh is in full agreement with the government’s International Monetary Fund-dictated policies and is ready to betray his members by agreeing to anything proposed by the government. The cutting of real wages and allowances is part of sweeping austerity measures—including privatisation, higher taxes and tariffs, and cuts to public health, education and welfare—deemed necessary to repay foreign debts and boost investors’ profits.

The dilapidated state of Sri Lanka’s health sector, which was exposed during the first years of the COVID-19 pandemic, has further regressed due to the lack of vital medicines and medical equipment, and major staff shortages. Successive Sri Lankan governments have slashed health spending, pushing the island’s free public health service to the brink of collapse, and paving the way for the privatisation of hospitals and other vital health institutions.

Health workers’ low wages have been hit hard by high inflation and harsh Pay-As-You-Earn taxes imposed last year by the government, resulting in drastic reductions in their overall take-home pay and its actual value. Apart from a 10,000-rupee pay rise between 2016 and 2020, health workers have not had a proper wage increase. An insulting 5,000-rupee cost of living allowance paid to all state sector workers did nothing to counteract inflation, which hit 46 percent on average during 2022 and 19 percent in 2023.

Discussions over the past weeks between HTUA bureaucrats and health ministry officials have been held behind closed doors, ensuring that the more than 100,000 members of the union alliance know no nothing about the proposals being discussed.

Upul Rohana, one of the HTUA conveners, admitted during a television discussion that the alliance has not demanded the 35,000-rupee increase in the DAT allowance paid to doctors.

Their proposal, he said, was based on proportional increases, according to the basic salary grades of employees. For example, if a newly appointed doctor with a basic salary of 52,550 rupees gets a 35,000-rupee DAT increase, a health assistant on a basic salary of 22,550 rupees would only get a proportional increase.

The HTUA bureaucracy, like other unions, is committed to the government’s austerity measures and functions as an industrial police force to dissipate workers’ anger by diverting them into fruitless protest appeals to the government.

The Wickremesinghe government has used the draconian EPSA twice against health workers this year. This law bans all industrial action and carries heavy punishments for violating its regulations. These include rigorous imprisonment up to two years and fines up to 5,000 rupees or both punishments, after summary trial before a magistrate. Anyone who induces a worker to take industrial action in a declared essential service faces similar punishments.

Neither the HTUA nor or any other Sri Lankan union has demanded repeal of this law, nor have they opposed the government using the military as strike-breakers.

The EPSA has been used against Ceylon Electricity Board employees who took nationwide action on January 3‒5 to protest privatisation of the institution. The CEB management has interdicted 66 employees, accusing them of violating the anti-strike laws and is preparing to punish them.

Why should health employees, or for that matter the working class as a whole, pay for the crisis of Sri Lankan capitalism, as the government and the trade union bureaucracy propose?

Workers must have the right to democratically decide what sort of salary increase they actually need for a decent living and for other necessities, and fight for those demands. Every section of the working class needs an immediate pay rise to compensate for what they have lost, particularly during past two years when the real value of their wages drastically declined. All wages must be indexed to the cost of living.

Pledges by the HTUA leadership to bail out the government and the capitalist class, and their acceptance of the IMF program, starkly reveal that health workers cannot defend their living standards and basic rights through these pro-capitalist organisations.

Health workers must take their struggle into their own hands through the formation of their own democratically-controlled action committees independent of the trade union bureaucracies, the capitalist parties and their henchmen. No health worker, or any other section of the working class or the rural masses, must be forced to sacrifice their wages, jobs or living standards to bail out the crisis-ridden capitalist system.

What is required is the independent mobilisation of the working class to bring down the Wickremesinghe government and take forward the fight for a workers’ and peasants’ government based on a socialist and internationalist perspective.