The Berlin Hospital Workers Movement was started during the height of the Covid pandemic in 2021. A group of hospital workers inspired by Jane McAllevey’s Organising for Power training course set out to radicalise their hospital unions and led a fight for higher pay, safe staffing and insourcing of outsourced workers.
The movement organised across twelve hospitals and led a strike that lasted over 30 days and won significant improvements in staffing including mandatory staffing ratios, extra pay for overtime shifts, and extra holidays for staff who have to work understaffed shifts.
The movement filmed a documentary which provides a good account of their organising work, and the strike:
How the movement built itself holds many lessons for trade union activists trying to organise and inspire NHS workers to resist the running down and collapse of NHS services.
The Berlin health workers organised with the support of their union ver.di, using the formula that the movement was “powered by ver.di”, but not run by it. They emphasised workers organising themselves and leading the movement themselves and set about developing innovative ways to organise.
To build the movement they formed campaign groups in hospitals and worked to recruit activists on as many wards and departments as possible. These activists were given the task of surveying and organising their ward or department to find out what staffing levels and improvements they wanted, and of electing a representative to represent that ward at the movements mass meetings.
The motivation for surveying the whole workplace was that if they managed to survey all the workers, then the specific demands that came out of their departments surveys would be incorporated in to the movements demands to management.
They worked for many months to recruit and build across the twelve hospitals in Berlin, until they had sufficient survey results and elected representatives to show the movement was well implanted.
Activists used many innovative methods to engage union members; one time they asked for photos from everyone who signed a petition, and used the images to make a banner showing how many people had signed it.
Once the movement had enough elected representatives, a mass meeting was held at an open air sports stadium. Over 500 representatives from across the 12 hospitals attended. They debated and discussed the list of demands that came out of their organising work, agreed a set of demands, and voted to strike to win them.
In the German system, rather than a national contract that all staff follow, contracts are made between employees and their specific employer and negotiated by the union. The union can open a dispute and ask for a new contract with new conditions, and that is what they did. Through Ver.di the movement went in to dispute with the employers demanding a new contract with specific staffing ratios, increased pay, and penalties for the employer if staff had to work in understaffed areas.
They staged a “protest strike”, followed by an indefinite strike which lasted over 30 days. Most of their demands were won including improved pay, specific staffing ratios and penalties such as staff receiing and extra days annual leave for every understaffed shift they work. They did not win all their demands; the outsourced workers remained outsourced after their strike, although pay and conditions were improved.
3rd Hospital Workers Conference
I was invited to attend the conference having met some of the movement activists when they visited London in February. The Rosa Luxembourg Foundation brought several activists over during the early days of the NHS strikes to talk about their experiences, and meet with striking NHS workers.
The conference was attended by over 200 hospital workers and took place over two days. The union Verdi had encouraged all union members to take the time off work as union training so they could attend. Union members are entitled to ten days a year of under their employment laws/collective agreements.
For union reps and member struggling to get time off work to organise, it was a simple example of successfully using existing laws/collective agreements to free up members to organise.
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| "More of us is better for everyone" |
The conference had a number of themes; Health Policy, Unions, Union Practice, Stronger Together and Youth. They covered issues like staff shortages, fighting for democratic hospital systems, organising against extra shifts and forced overtime, uniting health struggles with struggles over rent. It was inspiring seeing a union conference hosting such discussions, trying to build unity with other struggles and project a better future for the health service than the one at present under capitalism.
I attended "Outage Management - How do we protect us; overtime, on-call, extra shifts" The discussion looked at the ways hospitals organised overtime and extra shift work. There is a practice in hospitals of staff regularly being asked to work extra shifts to cover for understaffing. However it had the added layer that staff were having their rota’s changed and new shifts inputted after the rota had been planned and issued to staff. Hospital workers were being called by their managers and were told they had to come in to work the shifts, and they felt they could not disagree because the shifts were part of their rota.
The sessions aimed to educate union members on their rights to refuse extra shifts, and how the system could be turned around on management.
The issue came down to managers abusing the system which exist in many large companies in Germany. The workers council is made up of staff members elected by the employees, who represent the workers to management and have some powers or oversight function within the organisation. The workers council is separate from the trade unions. Trade union members do stand for election to some councils, but not all and many of the councils are not very active in using their powers to support staff.
In the hospitals the workers councils have the authority to approve or reject planned rota’s for staff, they are meant to check them to ensure staff are not being made to work too many shifts and have adequate rest days. However the reality in many hospitals is the councils are not checking the rota and the sign off is perfunctory. This sign off is all the management need to impose the shifts on staff, even if they have added more shifts to the rota and made the rota unsafe or unmanageable for that staff member. As well, managers would avoid paying the proper overtime rates to staff which they should get for extra shifts, instead just paying the normal rate.
A key message from the meeting was for staff to feel empowered to say no to their managers, and to ask for the rota to be checked by workers council representatives. This stopped the managers imposing the shifts, and forced the council representatives to review the rota’s.
The situation reminded me of the issues with claiming overtime pay within the NHS. Under Agenda For Change terms and conditions, any staff staff have the right to claim overtime pay, or Time Off In Lieu (TOIL) for any hours they work beyond 37.5 hours per week. Most hospitals avoid paying this by not giving managers the right to authorise overtime shifts, and not having any systems for recording overtime that is done.
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| "We are indispensible - now its your turn!" |
On the afternoon of the first day, Ina Cyzborra, the Health minister or the Social Democratic Party which runs the Berin Federal region attended the conference to speak with the staff. The minister was confronted by outsourced hospital workers who demanded that she keeps to the promises the SPD made to invest in the health system, and bring outsourced workers in house. The minister carefully avoided making any commitments during the talk, explaining and excusing their inaction as due to factors outside their control.
The movement had prepared a protest and during the ministers talk, outsourced hospital workers came out with banner a banner, chanting and making speeches about the SPDs failure to bring them back in-house.
There was then a back and forth with the minister as workers demanded to know when the SPD would act to support them, and the minister making excuses for the delay.
The fact that the health minister felt they should visit the conference, despite knowing the pressure and opposition they would face showed the power and influence the movement has.
Relaying the state of the NHS strike wave
I gave a talk on the state of the NHS after a decade of austerity, and how this was causing the deterioration of the health service, and driving the wave of strike action.
A copy of the slides can be downloaded here.
The talk was well received and was followed by many questions and lively discussion of the situation. Several of the Berlin health workers remarked that the NHS situation looked like their future, and pointed out the politicians in Germany were discussing centralising their health service in the name of greater efficiency, foreshadowing job cuts and workplace closures.
In contrast with the NHS which has over 200 hospitals across the U.K., the German health system has over 1000 hospitals across the country.
There were questions about the situation of activists in the health service, how much co-ordination there was and whether there were attempts by groups of workers to support each others strikes.
In the German health system, there are only two unions; ver.di for hospital workers, and the Marburger Bund for doctors. I contrasted this with the U.K where we have 14 unions in the NHS, a complex mix of general unions and smaller craft unions representing specific professions. This makes finding unity across the workforce much harder, and means there is greater effort needed to co-ordinate across a workforce divided in to many different union organisations.
