«Nurses
don't think that the movement is over"
INDUSTRIAL action has been taking the health sector by storm in Europe, the latest example being the recent nurses' strike in France. The strike, which lasted several weeks, mobilized enormous numbers. Taking their cue from the rail strike earlier this year and the student struggles of the winter of 1986, nurses further extended the use of the innovative and independent coordinating structure pioneered in those earlier
Marle-Claude Jeannot is a laboratory technician in the public health service, and a member of the medical-technical Coordinating Committee.
fightbacks.
Danlèle Abramovic is a nurse in the public health service, and member of the
Problems raised by the
National Bureau of the National Nurses' Coordinating Committee.
nurses' strike include how to
Patrick Alloux is a hospital worker at the Evry hospital, member of the Nurses
Aides and Hospital Trainees' Coordinating Committee, and a member of the relate to the other categories
LCR (Ligue Communiste Révolutionnaire, French section of the Fourth of health workers, the role played by trade unions and negotiations with the government, and what the next stage of struggle will be.
The strike concluded with three of the major trade-union federations in
France signing accords with the government. Nurses, only five per cent of whom are members of any union, feel bitterly betrayed.
Gaëlle Lucy and Marc
Renard interviewed three of the strikers on November 7
10 in Paris.
International).
H OW DID the nurses' strike
come into being? Why now? PA: This is a sector which hasn't gone through major social struggles, and which also did not experience May '68. The current explosion of struggles can therefore be seen as a kind of "delayed May '68" in the health sector. At Evry hospital, we handed out information on the nurses' struggle in Britain, which struck a real chord.
On March 25, the nurses' professional organization, UNASIIF (the National Union of Nurses' Associations), called a rally in front of the Ministry of Health which drew 3,000 people. Some hospitals were represented, and we found it possible to gather together and form a coordinating body. That's how the coordinating committees came into being. The radicalization at
Evry hospital was influenced by an earlier dispute at the SNEMA industrial plant. The hospital was nearby this firm, and many nurses either had friends or relatives who worked there. The demand for a 1,500FF (about $250) raise to "catch up" with inflation seemed natural to the nurses. This radicalization at Evry also made a mark on the movement since it was here that the first departmental coordination was set up.
DA: The ideological dimension of this conflict should be highlighted, as it is basically a women's struggle. The social upheaval of nurses is also a revolt against everything represented by the history of the job. The profession was started by nuns doing "good works". This also explains the weight of a particular ideology on this milieu — charity, devotion, a calling, the do-
----- pull-quotes on this page -----
C CRUX ON
November 28, 1988 • #152 International Viewpoint cile execution of any doctor's orders or whims and so on. So this is a break with what hospitals have been like for decades. That's why you see slogans like Ni bonnes, ni nonnes, ni connes ("Neither maids, nuns, nor fools") at demonstrations.
The winter 1986 student movement has also had a lot of influence, even on structural forms and self-organization. The arrival of young people in hospitals was a turning point. Already on March 25 nurses' schools went into action around UNASIIF's call. All these young people, many of whom are not in unions, weren't affected by the weight of tradition in the way that their eld• Did the May '88 elections, with the triumph of a left government, play any role in this radicalization?
DA: Not really, because the first mobilizations began under a right-wing government. You have to remember that the anesthetists' struggles had been going on for over 18 months, affecting the whole sector. For the other serious reason for the movement, you have to look at the decline in the numbers of health workers in the last five years. We no longer have the time to stop and talk to patients, to catch our breath or rest, to go on vacation even. The catalyst for the movement was the decree that downgraded the nursing profession.
PA: Two things are intertwined. Technological change in the sector, along with the arrival of new work-methods that cause nurses to be more and more technical and to have fewer and fewer personal links with the patients. Today, this role is filled by nurses' aides. In fact, part of nursing training and even one of the motivations for choosing the profession is this aspect of relating to sick people. The second element was the fact that people are fed up with continuing austerity policies. • You spoke about changing work methods. What have these changes in the health system been in the last few years, and how have they affected the position of nurses?
DA: In the beginning nurses only cared for the sick, but little by little they began to do things like take blood which formerly only doctors did. So they began to have more technical tasks and need more training. The state diploma for nurses is only twenty years old. Earlier, no qualification or diploma was required for nurses. Those who started off as nurses' aides could become nurses. Today almost everyone has a baccalaureat (the diploma awarded after successfully passing one of a set series of in-depth examinations after secondary school) and is becoming more and more technical. The machines have also evolved. They are more complex; you have to know how to use them; and we also need more computer skills now than before. • So the status and wages no longer correspond to the qualifications
DA: Qualifications are higher, but the wages have stayed the same. There has been no reevaluation. The ideology of charitable works is responsible: it is indecent to talk about money when it concerns the health of patients, isn't it... • Has the idea that nurses' wages are only "pin money", since 92% of them are women, helped to make it possible to impose such a low wage rate?
DA: That's the only way to explain why the people who did this job did it for only 6,000 francs (about $950) a month. Let's not forget that originally, this was a Catholic milieu conditioned by the weight of religion, the family and so on. Many nurses were married to doctors, and many became nurses in order to marry doctors. But that is no longer the case with the arrival of young women in hospitals. They question everything. Forget about cleaning and "pin money," forget about charity — this is their job. Forget about them accepting low wages because they've studied and they're skilled. It's a new generation that will no longer accept bad working conditions in the name of • Is it also the product of the women's movement of the 1960s?
M-CJ: Of course, even if explicit references to feminism are not always present. Many young women say "either we win some of our demands, which will improve our working conditions, or we quit doing this job. We love our work, but there is no reason to have to choose between raising kids at home or working in conditions like that. " The average age of those who are active in the movement or the leadership is around thirty. So, there are nurses who have worked several years, and some young recent graduates.
DA: The men who are in the leadership, especially those with trade union experience obviously find it easier than us to speak, intervene in discussions, debate and so on. But two of the male nurses in the Coordinating Committee have a certain understanding of what it is like for women, and they have helped us to overcome this. They have pushed us some to make us speak. It's true we're not used to it! Even me, and I'm a union activist, I don't speak
This is changing, but it's not yet the revolution! We're not really used to constructing a speech, and we tend to leave speaking to the men, especially if they articulate what we're thinking in a more organized way. On the other hand, when there are sexist remarks, we put them in their place.
There is a real awakening of a feminist consciousness in the profession. It is an underground process that we are not in control of but which will have a lot of effects later. Many women are beginning to question their relationships. It's the first time in many relationships that the woman is out fighting while the husband is home taking
FRANCE care of the kids...and there are husbands who've had a hard time accepting this. But now that women have seen that it is possi ble, they won't go back. • How did the Coordinating Committee come together? How is it structured?
PA: About twenty establishments met after the March 25 demonstration, and five people were designated to make up a bureau of what later became the regional coordinating committee for the Ile de France [Paris region]. The June 14 Coordinating Committee meeting brought together 80 hospitals in the Paris region.
DA: It was this group which called the first regional demonstration on September 29, asking those outside of Paris to hold local demonstrations and to build for the September 29 mobilization. Afterwards we continued to work through this structure, with a Paris bureau, and then a national one. The bureau thinks about the forms of actions and proposes them, but everything has always been, and will continue to be, decided by the coordinating committees, first locally, then in the regions with representatives from all the hospitals, and now at the national level via regional delegates. • But how do the coordinating committees function at the local level. Are decisions taken by general assemblies?
DA: Yes, there are general assemblies at the hospitals, which in turn elect delegates to regional or national coordinating • How do the other categories in the health sector organize?
PA: Nurses' aides are a bit of a special case. Numerically, this is the largest category in the hospital system, because there are about 480,000 nurses' aides and hospital trainees. As with nurses, they are about 92% women. This group entered the strug gle following the example of the nurses. Their coordinating committee was formed on September 29 after the first nurses' demonstration. Today there are 220 collectives and a national bureau.
Whatever comes out of the nurses' movement, the struggle will continue among the nurses' aides because nothing has been settled for them. Their place in terms of the restructuring and standardizing occurring at the European level has not been defined at all. No clarification as to the future of the profession; no real national degree, only a certificate of qualification. What's more, this profession is more often confronted on a day-to-day basis with sickness, death, insanity and suffering, because it is this category that most commonly takes care of old people until their death in retirement homes aides will undoubtedly adopt more radical forms of struggle than the nurses. They are more closely linked to the tradition of the workers' movement, and unionization is more common among them than among the nurses. And above all, this
International Viewpoint #152 • November 28, 1988
FRANCE is the category that is the most oppressed and has the longest tradition of struggle.
M-CJ: As concerns the paramedical profession, physical therapists, laboratory and x-ray technicians and so on, their organization is older. There has been a functioning coordinating committee of physiotherapists for two years now. The lab and x-ray technicians have come together and formed a medical-technical coordinating committee which became national a week ago. We also function through general assemblies and a national bureau.
In our category, we've also faced changes in working conditions: much specialization, adaptation to new techniques, new apparatuses, thus higher qualifications which aren't taken into consideration in our wages. • The widespread fragmentation is therefore quite important, but what links are there between the coordinating committees of these different categories?
DA: Links are pretty difficult to establish, because the nurses' were sure at the beginning that given the breadth of their movement, they could win all of their demands alone and they didn't see any need to ally themselves with the other categories. So it was rather hard to get across the idea that other coordinating committees had the right to exist, and that we could do things together while retaining an independent profile as nurses. This is changing, but only slowly because some nurses think it would be better to act alone.
PA: This sector is being cut to the bone by capitalist restructuring, and in each category a reappraisal of professional identity is taking place. The fragmentation we're seeing here is somewhat similar to what we saw in the workers' movement at the turn of the century. Each category is also fighting for its professional identity in this restructuring.
The fight around status waged by the nurses and the struggles of the medicaltechnical corps or medical secretaries is headed in the same direction. One part of the personnel wants to unify the movement. But in the first stages, it is undoubtedly necessary for all of these sectors to go through the experience of this form of struggle, even if this means failure at the beginning, in order to understand the limits of that sort of struggle. But nothing is settled, and the nurses' struggle as well as those of other categories will get going again. • The level of union membership is very low throughout this sector. How are union activists received?
DA: Not only is the percentage of unionization tiny — 5% — but anti-union sentiments are widespread among nurses. It is true that unions have hardly displayed their advantages in health. That said; I am in a 12 union and I came onto the Coordinating • Committee as a union militant. And the
Coordinating Committee quite rightly calls itself "union, non-union - associated, non-associated".
Those among us who are in unions have proved through practice that being in a union brings something to the movement. Especially since we met in the headquarters of a regional union in the CFDT (Democratic Confederation of French Workers) and they lent us their whole infrastructure for putting out leaflets and so on.
People were able to see that unions had their use. But the majority of nurses remained quite skeptical and distant in relation to unions. Fear of manipulation is • What are the relations like with the major groups of affiliated trade unions?
DA: Not great, that's for sure! Three of the big union organizations, the CPDT, the CFTC (French Confederation of Christian Workers) and FO (Workers' Force) never wanted us to participate in negotiations at the same time as them. Moreover, they signed the accord with the minister of health, Claude Evin, despite the call not to form the Coordinating Committee, which represents the vast majority of nurses.
The CGT (General Workers' Confederation) refused to sign the accord. It must have understood that this is a movement that would go far and could be useful to it. The CGT therefore tried to worm its way into the movement. But I don't think it has really allowed itself to have a real participation. In the general assemblies, the CGT members only tried to get the slogans of their own unions passed at all cost without participating in the real debate. There has also been some sheer clumsiness on their part. For example, on the November 3 demonstration Henri Krasucki (general secretary of the CGT) tried to march at the head of the contingents, although it was the EMERGENCY? AN ...HANG -ON, I'M COMING..
Coordinating Committee that initiated this demonstration. He was therefore called to order by the nurses who forced him back to his place, at the very end of the march! • How did negotiations with the government unfold?
M-CJ: At the start of the movement, Evin was very firm. The day of the first demonstration, he declared that there was no question of meeting the Coordinating Committee and recognizing it as the leadership of the movement, refusing to see the breadth of the movement. One week later, he had to retreat and meet with the Coordinating Committee. Otherwise it would have been unacceptable to the nurses that he meet and negotiate with the unions when the Coordinating Committee has led the movement! However the union organizations also did their best, hand in hand with the government, to make sure that the Coordinating Committee was not associated with the negotiations.
DA: No one wanted to recognize us, and . the unions, apart from the CT, were adamant that we not be considered and recognized as speakers and allowed to participate in the negotiations. We decided to send a delegation to go and pick up the government's proposals and come back to the rank and file, as that was where these decisions should be made. This method really bothered the government, undoubtedly it didn't fit in with the way it has worked with the
We got the impression that we were being taken for a ride by the government, which heard us out without taking any account of our demands. The most flagrant example of the government's incomprehension is the attitude of Prime Minister Michel Rocard, who proposed that nurses would have access to the medical profession after twenty years on the job...that's the least of our worries!
PA: There were two phases, at the beginning, the government didn't believe that the movement could continue to grow in strength. Taking its cue from Mitterrand's approach at the beginning when he assured the nurses of his compassion and understanding, the government thought that the whole thing would wind down after the first
The government's attitude changed when the rolling strike was called. It realized then that this was a real social conflict to be managed.
M-CJ: October 3 came to mark the real turning point in the dispute. The size of the demonstration gave not only the nurses but also the other categories in the Health Sector a real boost. But from another point of view; I got the impression that until then; the nurses thought they were going to win easily, because the movement was strong, it had the population's support, and it was a "nice" movement. The government, moreover, also displayed a condescending sympathy towards the movement, and believed it could get clear by negotiating with the un-
November 28, 1988 • #152 International Viewpoint ions. Rocard was telling us, "You've had your fun, now get back in line." That was yet another underestimation of the movement.
PA: Starting from then, Rocard took the matter in hand and met the Coordinating Committee at 3:00 in the morning. No doubt his idea was to have an overnight negotiating session at Matignon [the seat of executive government in France] and "solve the problem". But he had nothing to offer! • Wasn't not extending the struggle to the other categories one of the weaknesses of the movement?
M-CJ: It was really a problem after October 13. If there had been a real willingness on the part of the nurses to extend the movement and to work with the other categories, if there had been a clear call around this, the movement could have taken a different turn after October 13, especially as other categories were all in motion then.
PA: After October 13, the government was also afraid that the movement would spill over into the rest of the public sector. From that point on, it did not hesitate to rely on classic methods, trying to divide the Coordinating Committee and split the movement by sending general information files to the press to expose the "Trotskyist plot", to start a press campaign saying that the LCR was manipulating the nurses. • How did nurses react to these accusations?
DA: The great majority of nurses weren't fooled. These theories of "Trotskyist plots" came to light when the government didn't want to give up any ground and people understood that there was a plot...by the
M-CJ: I think that when the press says things like that, women get the idea that they're being taken for idiots. They elected a bureau, they are always discussing orientations, they have confidence in the people they elected, they know they are in control of their movement...and then the press tells them that they're being manipulated.
DA: Within the Coordinating Committee, certain people tried to settle scores with members of the LCR [Ligue Communiste Révolutionnaire]. Pascal Diaz who is a member of the LCR and one of the spokespersons of the Coordinating Committee made a statement that was quite clear, saying, "I don't care if the Ligue is accused, but in that case everyone must give their political identity." This made even the most recalcitrant shut up, because if the comrades from the LCR have never hidden their political leanings, that's not true of everyone. However, this reopened the debate over the inter-category liaison committee. Those who were against enlarging the struggle to include other categories through such committees attacked members of the LCR, saying, you have up your sleeve? You want to pull off something uniting the categories.
CLAMPS!
That's not in your mandate," and so on.
PA: A minority in the Coordinating Committee was opposed to this extension and tried to hinder it in any way they could. These are the same people who have been pushing for the acceptance of joint discussion commissions with the ministry, and for us to have almost permanent links with • How can the movement organize itself for the long term? What will be Its structures now? What will become of the coordinating committees?
DA: The National Coordinating Committee that met the day before yesterday, on November 5, was very clear. There were two proposals on the floor, one for creating an independent union, and one for continuing the Coordinating Committee in the form of a legal association. The latter proposal was adopted with 268 for; 22 against, and 97 abstentions. The nurses insist on this structural form. But as to whether the local bodies will stay in place, it's difficult
PA: On the one hand, nurses don't think that the movement is over, and therefore don't want to get rid of the Coordinating Committee as a tool, on the other, there is an understanding that the sector has to arm itself with an instrument other than the traditional union organizations. The latter are seriously discredited by their divisions, their inefficiency, their impasse, and because they signed the accord with the government, in spite of the wishes of the nurses. This is reflected in the vote around setting up an independent union, ceived 31 votes in favor, 135 against, and 224 abstentions.
M-CJ: Keeping the Coordinating Committee is doubly justified: the movement isn't finished, not one problem has been solved and the struggle continues. It is un-
FRANCE doubtedly the first time that at the end of such an extensive strike, the movement was still able to turn out 40,000 people in the streets, as was the case on November 3! Besides, the Coordinating Committee neither betrayed nor deceived us during the course of the movement. It was tested, showed its strength and its ability to mobilize. • This tool must also help get beyond the fragmentation into categories. How are discussions around this dev-
PA: It's one thing to have 100,000 in the streets, but another to find yourself, after weeks of dispute having gained nothing. So, there is a reaction of turning toward the other categories. In fact, a section of the nurses has understood now that they cannot achieve anything on their own. Thus, I think the situation is partially beginning to
DA: In any case, a balance sheet of the movement must be drawn up, of its limitations and weaknesses. It would certainly be simplistic to say that if we had broadened the movement to include the other categories, we would have surely won. But many nurses will now ask themselves why we didn't win, although we all came out. • But were there demands that could have been called narrowly prof-
DA: No! Everyone always said, "the others can structure themselves too, but outside of us, apart from us." We confined ourselves to taking up nurses' demands and saying that each category should take up
M-CJ: Nurses took the downgrading of their status badly, and were infuriated by the gap between their $950 monthly wage and their qualifications. But if you confine yourself to defending wage demands based only on this injustice, then you leave the other categories out, even though paramedics have the same level of studies and qualifications. • Given the unification projects around status in terms of 1992 Single Europe Act, do you think we can look forward to a Europe-wide struggle in defence of health services?
DA: Undoubtedly it's necessary, but very difficult. Nurses are in struggle all over Europe, but demands don't always correspond. Spanish nurses, for example, went on strike because baccalaureat-level studies were going to be made a requirement.
In France, the movement also took off because we were afraid that, with the standardization of 1992, we would see our work devalued. So it's difficult to standardize struggles! But we have to talk about it. We received messages of solidarity from everywhere in Europe, and the Coordinating Committee has voted to organize an inTention My Day vent for 13 1989.*
----- photo credits and running heads -----
Catherine
International Viewpoint #152 • November 28, 1988
BRITAIN
TIS DIFFICULT to exaggerate the impact of this result. The SNP increased its share of the vote to 48% from 10% in the 1987 general election, while Labour fell to 36% from 65%. At least one-third of Labour voters switched to the SNP, with many more not voting.
Suddenly, Labour feels insecure in its Scottish strongholds. Until last week, Labour held 50 out of 72 seats in Scotland and the SNP only 3. If the Govan swing is repeated elsewhere, all Labour's seats in Scotland would fall to the SNP.
The result also threatens the Labour leadership's strategy for winning the next general election. Labour leader Neil Kinnock has concentrated on winning the so-called yuppie vote in the south of England. To this end, he has moved his policies to the right in search of "new realism". He has particularly opposed any attempt to have Labour back extra-parliamentary or illegal action. He has cynically derided calls for mass action around the miners, local govemment or the poll tax. The underlying assumption is that Labour's core vote is safe: there is no threat to the left.
The SNP result changed all that. The SNP campaigns for a nuclear-free Scotland, Scotland out of NATO and a campaign for non-payment of the poll tax. On all these issues, it is to the left of Labour. Indeed, the SNP has been taken over by ex-Labour politicians, and generally portrays itself as a "socialist party", at least in central Scotland. Labour can no longer rely on Scottish seats, and without these it cannot form a British government.
Inquiries set up to study
Labour's defeat