Markus Salzmann
Health care workers at the state-owned Charité and Vivantes hospitals have been on strike for more than three weeks in the German capital of Berlin. While corporate management and the Social Democrat (SPD)/Left Party/Green Berlin state government, known as the Senate, refuse to make concessions, the Verdi trade union is desperately trying to shut down the strike and codify the constant overworking of staff in collective agreements.
With over 25 days of strike action, the labour dispute at the two hospital groups is one of the longest strikes in the history of the German health care system. Since all campuses of the Charité and eight clinics of the Vivantes group are still affected, thousands of operations and treatments have been postponed or cancelled since the beginning of the strike. Around 1,200 beds are currently out of service and around 2,000 patients are waiting for an operation or appointment for treatment.
Although the strike is extremely stressful for patients and for those employees who are unable to participate because of the need to provide necessary patient care, support for the strikers remains unbroken. The catastrophic working conditions in the clinics, which endanger the health of patients every day, are plain for all to see.
The Berlin strikers are representative of the many hundreds of thousands of health care workers across Germany who are confronted with the same working conditions.
This was recently made very clear in a damning letter from the nursing staff at the Hamburg University Hospital (UKE). In it, two-thirds of the approximately 300 intensive care staff at the UKE described their working conditions and demanded that the legally applicable regulations are enforced at a minimum. Even the legally applicable minimum staffing levels, which are totally inadequate to guarantee quality patient care, are consistently not adhered to.
Instead of the required minimum ratio of one nurse for every intensive care patient, the ratio is sometimes one to four. As a result, important medications are not administered in a timely manner and treatments such as caring for wounds cannot be carried out correctly.
“Unfortunately, patients often have to lie in their own faeces for a considerable amount of time,” the nurses wrote with regard to the hygiene situation. This suggests that under these conditions, measures of basic hygiene, which are all the more important during the pandemic, often cannot be adequately observed.
“In order to ensure that the patient is cared for, many colleagues regularly forego their breaks outside of the ward,” write the nurses. Many suffer from “the feeling that they are doing more than is actually humanly possible.” Many colleagues cry during or after work and no longer have the strength for leisure activities after work.
These descriptions do not differ from the conditions in Berlin hospitals. In numerous interviews, nurses report on completely overworked employees and poorly cared for patients due to major staff shortages.
While the nursing staff at Charité and Vivantes are fighting for better working conditions and relief from unbearable workloads, Vivantes management interrupted the negotiations for several days until Monday this week.
The last offer from management was an outright provocation. The offer not only contained no improvements for nursing staff, but even called for further concessions in some areas. For example, a staff-to-patient ratio on a normal ward of 10 patients to every nurse during the day and 20 patients to one nurse at night. It is impossible to provide quality care under these conditions.
Instead of intensifying and expanding the strike in response to management’s provocations, Verdi is determined to reach an agreement as quickly as possible. At the Charité, the negotiations between Verdi and the management are well advanced and Verdi believes an agreement is possible in the next few days. While concrete terms for minimum staffing levels on wards are currently still being negotiated, the parties have agreed on what they refer to as burden compensation. The system awards a point to a staff member who works five shifts while understaffed. Each point can be converted into eight hours of free time. However, days off accruing from this scheme will be capped at five per year.
Such an arrangement would neither end the overworking of nurses nor improve patient care. If a nurse works two shifts lasting eight hours while understaffed, they are not even entitled to two hours of free time. With the Verdi proposal, the company would still make a hefty profit with every overworked nurse and health care worker who breaks down crying at the end of the shift.
In view of the real situation of constant overwork, the capping of time off at five days means that it would have little impact. Most nurses already work massive amounts of overtime that is almost impossible to reduce due to the lack of staff. Verdi’s proposal aims merely to legally codify this permanent state of overwork in a collective agreement.
Nursing staff cannot expect much from the minimum staffing rules under negotiation. As early as 2016, after the conclusion of the “historic collective bargaining agreement” with similar rules, Verdi announced with great fanfare that working conditions would improve massively. In fact, nothing has changed. On the contrary, the situation is so catastrophic today that nurses are prepared to strike for over three weeks.
At Vivantes, the management recently offered one day of leisure time compensation after 12 hours of understaffed work. Trainees would only receive the free day after working 48 shifts. Nonetheless, union representatives expressly stated that here, too, they were optimistic that an agreement could be found soon.
Verdi’s despicable role is also evident in the negotiations for the workers employed by Vivantes’ subsidiaries. The staff in the cleaning, catering, laboratory and security services departments have also been on strike for many weeks. These workers receive up to €900 less for the same work as employees in the parent company. According to the union, many do not even receive the minimum wage of €12.50.
Vivantes, whose supervisory board chairman is the Berlin Senator for Finance Matthias Kollatz (SPD), has refused to give any ground. Verdi and the employers have agreed to call on the former Brandenburg Minister-President Matthias Platzeck (SPD) to serve as a mediator. The worn-out Social Democrat was not chosen at random. Under Platzeck’s leadership, the strike by workers at Charité subsidiary CFM, which had been rumbling on for years, was only settled at the beginning of this year.
Verdi and Charité management sought to appease the approximately 2,500 employees with the prospect of an adjustment of wages to the TVÖD (public sector collective agreement) after they had previously earned several hundred euros less for years. Even today, wages are still well below the TVÖD. Verdi deliberately excluded the CFM from the current strike at the Charité. Platzeck is now supposed to enforce a similar fraud at Vivantes.
This shows how closely Verdi, management and the political establishment work together against the workers. This week, incoming mayor Franziska Giffey (SPD) met again in the Zionskirche with employees of the state-owned hospitals. Workers can only expect a further deterioration in their conditions under a new state government formed in the House of Representatives.
Giffey stated that “in the upcoming exploratory talks with all parties, hospital financing will be an important topic.” The main focus will be on how savings can be made at the state-owned hospitals. In the past few years, the municipal hospitals have received only a small amount of funds for investments, so that they had to finance them with their own funds that could actually have been diverted into patient care. The SPD has headed the Berlin government since 2001 and is therefore responsible for the current miserable conditions, together with the Left Party and the Greens.
It is becoming increasingly clear that the health care workers at Charité and Vivantes have to organize themselves in rank-and-file committees independently of Verdi in order to successfully lead the fight against the SPD/Left Party/Green Senate. The strike must be extended across the country and internationally. The whole working class must take action to come to the defence of health care workers.
The strike vote on an unlimited strike at the Brandenburger Asklepios hospitals in Brandenburg/Havel, Lübben and Teupitz concluded on October 5. Workers at these facilities recently organised a four-day warning strike. They are fighting for an increase in salaries, some of which are more than €10,000 per year below those of other Asklepios hospitals.
