Health and care workers have had enough

Workers from across Europe descended on Brussels today to demand adequate investment in health and social care.

As governments and employers bring back talk of tight budgets and spending cuts, health and care workers are taking to the streets. Across Europe, they have had enough—enough of being undervalued, enough of being underpaid and enough of not being able to provide quality care.

To highlight the crisis, the European Federation of Public Service Unions (EPSU) has organised a protest today in Brussels, coinciding with a meeting of Europe’s health ministers. Europe’s health and social-care workers are calling on ministers to recognise the essential roles they play. They are demanding adequate and sustainable public financing and needs-based staffing, and denouncing the commercialisation of health and care systems.

Strike wave

This year has seen a huge wave of strikes in health and social services across Europe, with grievances shared across the continent. Two years ago, millions of Europeans were applauding the ‘heroes’ working in hospitals, care homes and clinics. Today, these workers seem to have been forgotten.

Despite promises of pay rises in the early stages of Covid-19, health and care workers have experienced real pay cuts through rampant inflation. With many workers leaving the sector due to exhaustion and burnout after over two years on the pandemic frontline, those remaining are even more overburdened. One of the most challenging aspects of the job is now being unable to provide the level of care recipients deserve. This places an even greater emotional burden on the workers, which increases the psychosocial risks they face.

During a strike in Spain in March, Juani Peñafiel, a care worker in Madrid and a member of the CCOO confederation, explained:

They have us in much worse conditions than we had during the pandemic: they haven’t renewed temporary contracts; a single cleaner has to clean 40 rooms, common areas and serve breakfast and lunch; we have nurses who have to attend 180 residents during the afternoon shift; a geroculturist has 11 minutes for each dependent person … enough is enough.

In October, health workers in Italy demonstrated with many of the same concerns. Antonino Trino, a nurse in Messina and member of the public-services section of the CGIL confederation, said: ‘I am here today to ask ministers for more attention to the nursing profession, a vital profession for the national health service. Nurses are forgotten, underpaid and vilified heroes.’

The severity of the crisis in health and care was recognised at the recent session of the World Health Organization Regional Committee for Europe. Dr Hans Kluge, director of WHO-Europe, said: ‘Personnel shortages, insufficient recruitment and retention, migration of qualified workers, unattractive working conditions and poor access to continuing professional development opportunities are blighting health systems.’ The EPSU, supported by many other organisations, added that governments have ’the crucial responsibility of securing and delivering the required funding to increase investment in recruitment and retention of health and care professionals’.

European Care Strategy

The European Commission has realised the need for action across the European Union. In the new European Care Strategy, associated with two Council of the EU recommendations, the commission has set out several policy measures to tackle the crisis.

The strategy supports the implementation of the European Pillar of Social Rights, which include the right to affordable long-term care of good quality, work-life balance for individuals with care responsibilities and the rights of persons with disabilities. It recognises these rights cannot be delivered without an adequately staffed, adequately funded and adequately trained workforce.

The draft council recommendation on access to affordable, high-quality, long-term care proposed that national co-ordinators should be appointed to monitor and implement the strategy and act as contact points at EU level, and that member states should submit national action plans within 12 months. While a council recommendation falls short of a legally binding instrument, these proposals would have ensured measures would be taken at the national level.

Regrettably, the European health ministers who have gathered in Brussels today do not however seem to understand the urgency of the crisis. The version of the recommendation on long-term care approved yesterday refers to national co-ordinators or an ‘appropriate coordination mechanism’ and removes the requirement for national action plans. Instead, it asks member states to communicate a ‘set of measures’ to the commission within 18 months.

The language of the recommendation has also been watered down: instead of saying that member states ‘should’, it now says that they ‘are recommended to’. This suggests implementation is optional and undermines the imperative for concrete measures.

Pushing back

At today’s action, health and care workers from across Europe are pushing back. Among other things, they are calling for sufficient public funding and investment to allow workers to deliver high-quality care, increased protection for occupational health and safety, including against psychosocial risks, and reinvestment of any profit in the sector. They are also calling for the strengthening of collective bargaining and for sectoral collective agreements that uphold adequate, needs-based staffing, fair wages, good working conditions and trade union rights.

Joining the action with over 60 members, the Romanian health union SANITAS said:

The inflation rate in Romania increased to 15.9 per cent in September 2022, the highest level in the last 19 years. The cost of living is doubled compared with last year due to the increased prices of all consumer goods. However, most professions in the health and social assistance sector have seen insignificant salary increases of between €10 and €60 a month. In this context, it is necessary to draw the attention of European decision-makers to the fact that health workers in Romania are worried about their fate, as is everyone in the entire European Union.

Barbro Andersson, vice-president of Kommunal, the largest Swedish union, said: ‘Kommunal wants better conditions for everyone who works in health and social services. We’re convinced that with good wages and good working conditions, we can ensure the welfare not only of employees but also users, employers and society at large. That’s why Kommunal is participating in this protest.’

As Europe’s news cycle moves on and the attention of policy-makers and the public shifts, the action organised in Brussels today is a reminder that health and social services are the backbone of our societies. With the arrival of refugees from Ukraine and the energy crisis continuing to put pressure on key services, health and care workers will not wait for the sector to collapse. From workers across Europe, the message is loud and clear: enough is enough.