Operation? Streik!

Krankenschwester in Israel - nicht im Streik, aber auch nicht im Stress.cc CC BY-NC-ND 2.0 by ygurvitz
Krankenschwester in Israel – nicht im Streik, aber auch nicht im Stress.
cc BY-NC-ND 2.0 by ygurvitz

Tel Aviv. Seit dem 2. Dezember streiken in Israel die Krankenschwestern – insgesamt 28.000 Frauen. Obwohl bereits im Februar diesen Jahres ein Warnstreik auf die zunehmend unhaltbaren Zustände bezüglich der Arbeits- und Lohnsituation der in den Krankenhäusern Beschäftigten aufmerksam machen sollte, sind Verhandlungen mit dem Finanzministerium über höhere Löhne erst jetzt zustande gekommen. Die Vertröstungstaktik der Regierung Netanyahu hat unfreiwillig ihr vorläufiges Ende gefunden.

One Response to “Operation? Streik!”

  1. Rainer,

    —–Ursprüngliche Nachricht—–
    Von: Portside Moderator [mailto:moderator@PORTSIDE.ORG]
    Gesendet: Dienstag, 18. Dezember 2012 04:10
    Betreff: The defense of public healthcare in Madrid

    The defense of public healthcare in Madrid
    Interview with Dr. Marciano Sanchez Bayle

    by Andy Coates, MD

    December 15, 2012

    Published by Portside

    Madrid’s physicians, nurses and other health
    professionals have been marching in the streets with
    their patients for over a month, protesting the
    government’s plan to privatize and sharply reduce
    public health services.

    Spain’s National Health System (SNS), established in
    1986, fulfills a mandate included in Spain’s national
    constitution. Article 43 guarantees healthcare to all
    Spaniards, including the right to adequate public
    health services.

    The attack on the SNS is led by the government in
    Madrid. (Administration of the SNS is decentralized;
    each of Spain’s 17 semi-autonomous regions sets health
    budgets and priorities.) At the beginning of November
    Madrid moved to privatize ten percent of public health
    centers as well as the administration of six hospitals
    – half of the hospitals in the region. Of the hospitals
    to be privatized, all were recently built.

    The response: an unprecedented and massive mobilization
    of people in Madrid, now making mainstream news across
    the world. Caregivers and patients together have joined
    protests at every public health clinic and hospital in
    Madrid. Marches have involved hundreds of thousands.
    Caregivers have gone on strike and stopped traffic
    outside their workplaces.

    The Partido Popular, in power nationally as well as in
    Madrid, also proposed to convert La Princesa Hospital,
    a tertiary care center serving about 300,000 patients
    annually, into a specialty care center for patients
    over the age of 75. In addition to mass meetings and
    sit-ins at La Princesa Hospital, a petition in protest
    gained over 200,000 signatures. The Mayor of Madrid,
    herself a member of the Partido Popular, signed on. The
    government has retreated from its plans at La Princesa
    Hospital yet the struggle continues.

    Last week a group of patients, nurses and physicians
    disrupted a speech at the Madrid regional Assembly,
    where the government’s economic counselor was
    explaining the hospital privatization plans. In this
    short news video, Dr. Marciano Sanchez Bayle chants for
    public healthcare beside a woman who unfurls a banner,
    the first to be led out by police. Note the Assembly
    members who stood to applaud the protesters.


    Here is a short interview I conducted with Dr. Sanchez
    Bayle of the Federation of Associations for the Defense
    of Public Health (FADSP) this week. He practices and
    teaches pediatrics in Madrid. ==========

    Q: Many of us in the United States have difficultly
    imagining health care delivered by a public system.
    Would you please describe how patients in Madrid get
    their medical care?

    A: In Spain the health system is public and coverage is
    universal. This means that when a person thinks he or
    she has a health problem, they go their public health
    center. There they are attended by a doctor and/or a
    nurse who will make the appropriate decision whether to
    diagnose and treat, ask for diagnostic tests, refer the
    patient to a specialist or admit them to a hospital.

    Of course, if the situation is serious or occurs
    outside regular treatment hours, patients can go to a
    hospital emergency room. Hospitals are also mostly
    public. Thus far all of these services are free,
    including the tests. A patient does have to pay a share
    of the cost of their prescriptions, however. On a per
    capita basis, the Spanish system is four times less
    costly than in the U.S. Yet we achieve much better
    outcomes, according to basic health indicators.

    Q: How has the government proposed to change this in

    A: The proposal in Madrid is to privatize some of the
    hospitals and health centers, turning them over to
    private businesses.

    Q: How will this affect patients?

    A: There will be an immediate and significant
    downsizing of personnel, resulting in diminished access
    to care. It will undermine the quality of care. It will
    substantially lengthen waiting lists.

    In addition, these changes will result in what we call
    risk selection, whereby private entities will seek out
    the most profitable pathologies, i.e. those persons who
    are less sick. As a result, people will face more
    obstacles to getting the care they need, following the
    Tudor Hart law of inverse care – medical attention will
    be dispensed in inverse proportion to the needs of the

    These will be the short-term results, because it is
    clear to us that the Partido Popular, the conservative
    party, hopes to install a health care model based on
    private insurance. The disastrous results of such a
    model as the United States, are well known.

    Q: What will it mean to doctors and nurses?

    A: First of all, there will be fewer of them employed,
    with layoffs and fewer facilities to practice in. For
    those remaining, it will result in overwork and a
    worsening of professional working conditions.

    Q: Please describe the protests that have emerged in

    A: It would take a very long time to fully answer your
    question because there have been such a multitude of
    actions. Briefly, it has produced a strike by the staff
    of the centers — doctors, nurses, administrators,
    auxiliaries, etc. — which has been organized according
    to a rotating schedule, e.g. specific days a week.
    Health worker sit-ins, sometimes joined by patients,
    have also occurred. These started first in the
    hospitals, then in the health care centers. These
    protests have been going on for 30 days.

    In addition, massive demonstrations have been held in
    Madrid, some with more than 100,000 people,
    professionals and patients. Every day there are
    demonstrations blocking traffic in front of the health
    centers. Last week an action was carried out under the
    slogan “Hug your Hospital,” in which human chains
    circled all the public hospitals of Madrid.

    The most interesting thing is the supportive reaction
    of the citizenry. People are very committed to the
    defense of the public health care system. Of course, we
    Spanish continue to have a bit of the guerillero and
    anarchist spirit in us, so to speak, and many
    initiatives have been sprouting up like mushrooms.

    Q: What is the significance of the La Princesa Hospital
    in this struggle?

    La Princesa Hospital is located in the center of
    Madrid. It has 600 beds and a high level of
    specialization. It is the referral center for many of
    the peripheral centers of Madrid and beyond.

    The attempt to convert La Princesa into a geriatric
    center was the spark that lit the movement: the unions
    of the center started a sit-in which still continues.
    The sit-in has mobilized more that 90 percent of the
    facility’s workers. Citizens in the zone it serves have
    also joined in. The hospital’s governing council
    negotiated with some of the doctors, i.e. department
    heads, and the two sides arrived at an agreement which
    doesn’t seem bad. Yet the struggle to withdraw all the
    measures that affect health care in Madrid, including
    this issue, continues.

    We have been hearing about many protests against
    austerity in Europe, in Spain, in Madrid. What is the
    justification used by the government to move to
    privatize the public system?

    The government says that it’s the crisis and that there
    is no money, but it’s a lie. They have allocated
    215,695 million euros to bail out the banks, and with
    these measures they say that they will save 7,000
    million euros in health care. What they want to do is
    to use the excuse of the crisis to privatize health
    care, to put it in private hands in order to make a
    profit on the health of the people.

    A: What is your view of this demand for austerity?

    I have already said that they want to take away
    peoples’ rights in favor of the banks and private

    Q: Why did you disrupt the Madrid Assembly? Who was
    with you?

    A: What we did was to try to demonstrate within the
    Assembly professionals’ and citizens’ rejection of this
    blatant act of aggression against health care. The
    elected representatives should not have deaf ears to
    the opinion of the immense majority. Keep in mind that
    the Partido Popular, now in government, didn’t include
    these measures in its election program. They gained
    their votes through trickery and are now attacking our
    public health care system.

    Q: What else would you like to share with people in
    North America about this struggle? What can we do to

    A: The right to health care is a peoples’ right and
    should be defended as such. What is happening in Spain
    today may seem far-off to the people of the United
    States, but the world is globalized and interconnected.
    Every advance or retreat which happens in one part of
    the world has a repercussion for us all. Help can come
    in spreading word of the struggle so the problem is
    known, and also demonstrating solidarity through
    demonstrations in front of Spanish embassies and
    sending signed protest letters to entities and people
    in the government of Madrid.

    Solidarity is very important, not only for those who
    receive it but also for those who practice it, because
    it makes us better people and benefits our common,
    concrete struggles.


    [Dr. Marciano Sanchez Bayle, a spokesperson for Spain’s
    Federation of Associations in Defense of Public Health,
    is also president of the International Association of
    Health Policy. He practices and teaches pediatrics in
    Madrid. http://www.fadsp.org/

    Dr. Andrew Coates will be president of Physicians for a
    National Health Program in 2013. He practices and
    teaches internal medicine in upstate New York.

    [Many thanks to the author for submitting this to

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