The Health Workers Rank-and-File Committee (Australia) is an independent group of health workers across Australia, fighting for unified action through the development of rank-and-file committees, organisations controlled by workers themselves, and for an end to the subordination of healthcare and lives to profit.

Tens of thousands of public sector nurses and midwives in New South Wales (NSW) are set to strike for 24 hours on Wednesday. It will be their third major stoppage this year.

The NSW Nurses and Midwives’ Association (NSWNMA) has called for a 15 percent pay rise, while the state Labor government has not budged on its sub-inflationary offer of just 3.5 percent this year, followed by 3 percent increases in 2025 and 2026.

The Health Workers Rank-and-File Committee (HWRFC) fully supports the strike, and urges other sections of health workers to join and expand this struggle. We warn, however, that not a single step forward can be taken while the action of nurses and midwives remains under the control of the NSWNMA.

The NSWNMA bureaucracy had no intention of calling this strike. They shut down industrial action six weeks ago as an “act of good faith,” in order to enter into behind-closed-doors talks with the Labor government. At the same time, they announced that nurses and midwives would immediately receive a 3 percent “interim” pay rise, backdated to July 1, effectively enforcing the government’s wage offer by stealth.

The union declared that if these talks failed to produce an outcome, then the dispute would be arbitrated by the Industrial Relations Commission (IRC), during which time industrial action would remain suspended. That was another barely veiled attempt to wear down nurses.

That the union has now been compelled to hold another strike is a testament to the determination of nurses and midwives to fight against Labor’s rotten wage offer. But the union is planning to use the strike as a mechanism for workers to let off steam, and to divert the mounting anger of its membership into more futile appeals to the government.

The NSW Labor government, as with its counterparts across the country and federally, is determined to carry out an austerity agenda that include harsh cuts to wages and social spending. The state budget handed down in June included real-wage cuts for the state’s 400,000 public sector workers. Health expenditure is set to rise by just 0.1 percent in 2024‒25, far below the impact of inflation.

This attack is only possible because of the collaboration of the trade unions. In 2022, mass strikes were held by public sector workers across NSW, including nurses and midwives, against cuts to real wages and worsening conditions. However, the NSWNMA, as with other public sector unions, diverted this action into a campaign for the election of a Labor government in NSW, claiming that Labor would boost wages.

The NSWNMA endorsed Labor leader, and now Premier Chris Minns, who had proudly declared that he had “clashed with the nurses’ association over nurse-to-patient ratios” and insisted that any pay rises must be tied to “productivity” gains, that is, cuts to jobs and conditions.

In other words, whatever its posturing, the NSWNMA has worked at every point to subordinate nurses to the big-business Labor government. That is because the union bureaucracy is a privileged layer, hostile to the interests of rank-and-file nurses, and completely tied to Labor.

This shows that to fight back, a new strategy is required, based on a rebellion against the NSWNMA bureaucracy, which has repeatedly cut across the efforts of nurses and midwives to develop a concerted campaign against wage cuts. The HWRFC advocates for, and offers every assistance to workers in, forming rank-and-file committees outside of the control of trade union bureaucrats, to take this forward.

The 15 percent demand the union has endorsed is itself a concession. The NSWNMA bureaucracy arrived at the figure by “finding the savings needed to pay for the pay rise that we have sought,” according to Secretary Shaye Candish.

The amount would be totally inadequate to make up for the soaring cost of living and past losses resulting from previous sell-out deals, which included a pay freeze in 2020 and subsequent sub-inflationary deals.

In April, some 1,200 nurses and midwives signed a petition urging the NSWNMA to fight for a 30 percent pay rise. However, the NSWNMA leadership made clear that even if a majority of workers voted for the demand, the union’s executive council would simply ignore its members’ “recommendation.”

Separately, a campaign supported by some 14,000 workers—almost one third of the workforce—called for nurses and midwives not to renew their professional registration unless the government produced a better pay offer. The NSWNMA refused to endorse this initiative, ostensibly “because it had been generated outside their democratic processes,” according to an organiser of the campaign.

In reality, the bureaucracy, in a completely antidemocratic fashion, is riding roughshod over the demands of health workers. The same is true in every other section of the public sector, in NSW and across the country. The unions are partnering with mostly Labor administrations to enforce the austerity measures demanded by big business.

The common issues facing workers underscore the need for a unified struggle, across the health sector and more broadly. That is what the NSWNMA officialdom is seeking to prevent.

The NSWNMA has presented the low wages of nurses and midwives as a result of misogyny, due to it being a “female-dominated” industry. This is a foul campaign, based on upper middle-class identity politics to divide and conquer workers in direct aid of the government attacks.

It is also based on lies. While 86 percent of nurses and midwives are women, there are 7,000 male nurses and midwives in the NSW public sector who are subject to the same attack as their female colleagues. Moreover, hundreds of thousands of men throughout the public sector also face the same real-wage cut.

The federal Labor government is carrying out an assault on construction workers, a “male-dominated” sector. The construction division of the Construction, Forestry and Maritime Employees Union (CFMEU) has been placed under administration, with a state-appointed barrister granted total control over all aspects of the union with the aim of driving down wages and conditions.

The union is also falsifying the situation of workers in other “female-dominated” sectors, dressing up sell-outs in other industries as victories. NSWNMA Secretary Candish recently declared, “other female-dominated workers such as teachers, early childhood educators and aged care workers are being valued and well remunerated by Labor governments” in other states.

In reality, childcare and aged care workers remain among the most poorly paid workers in the country. In recent weeks, public sector teachers in NSW have seen the Labor government’s offer of 9.5 percent over three-years rammed through.

Related to this is the union’s claim that health workers are doing well in other states. But, while NSW nurses are the lowest paid in the country, health workers across the board are seeing cuts to real wages and face intolerable conditions, including rampant understaffing, increasing overtime, double shifts and unsafe working conditions.

The NSWNMA has made multiple references to nurses in Queensland as having the highest paid nurses in the country. But a recent survey by the Queensland Midwifery and Nursing Union (QMNU) of its members found that 46 percent were considering leaving the profession within the next year, due to overwork and burnout.

The method of isolating workers’ struggles is not unique to the nurses’ union. Despite confronting the same real-wage pay cuts, all the trade unions covering public sector workers have kept their action completely separate.

The Health Services Union (HSU), which covers tens of thousands of health workers in NSW, collaborated with the state government to force through the first year of Labor’s wage-slashing plan, with a 3.5 percent pay “increase.”

New organisations of struggle, rank-and-file committees, are needed to cut through the divisions imposed by the unions.

They are the only means through which workers can develop a democratic discussion, free from the interference of union bureaucrats who act as agents of the government. They are the basis for uniting workers across health and more broadly, including for joint industrial and political action.

Through rank-and-file committees, nurses could develop demands that meet the needs of workers themselves, not what the governments and the unions determine is “affordable.” Among them would be the urgent need for a pay rise of at least 30 percent and a massive increase in funding to public healthcare to end the enormous crisis in the sector and ensure decent pay and conditions for staff and care for working people.

Such demands come up against the domination of corporate profit over every aspect of society, and the austerity imperatives of capitalist governments that answer only to the financial markets. Workers are in a political fight against the Labor government, the union bureaucracy and the entire capitalist system, which is a dictatorship of the banks and the billionaires.

The alternative is a socialist program aimed at establishing a workers’ government that would place the banks, the corporations and healthcare under full public ownership and democratic workers’ control and invest tens of billions in every area of social need, including healthcare and education.

The HWRFC urges nurses and midwives, and all health workers, to circulate our statement and contact us today to discuss this perspective and develop a rank-and-file committee in your workplace.