Friends from France have written a detailed paper on the question – read it <a href="https://mouvement-communiste.com/documents/MC/Booklets/BR6_Sant%C3%A9%20_EN_vF%20Site.pdf">here</a>.
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Debate on the current character of hospitals and their restructuring

Struggles in and beyond the white factory – Organising within hospitals

Against the militarisation of the health sector – A Vital Signs position

Vital Signs Mag supports the day-to-day struggle to defend our working conditions and the conditions for our patients. Through the experience of self-organisation, struggle and solidarity we can gather forces and question a system that confines us in repetitive jobs, puts as in competition with each other, exploits our life time and energy, creates billionaires and mass starvation and drives us all towards wars and natural destruction. As Vital Signs we speak in favour of a working class revolution for a classless society.
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<li>THE CURRENT SYSTEM is based on classes. The producers don’t own their means of production and products, they don’t decide how and what is produced, and when. Production takes place to create profit and to maintain the resulting division into rich and poor, rulers and ruled.</li>
<li>The current system contains a contradiction that allows us to think about a better society. The achieved rate of productivity is high, meaning, only a minority of people actually work to produce essentials like food, homes, necessary items and services. This level of productivity and social knowledge would allow everyone to live a good life. It would allow us to minimise time spent on producing necessary goods and to decide about production and life on a wider social and non-hierarchical scale. BUT, due to its class nature, the system only employs people  if production is profitable and uses labour-saving technology to reduce the number of people employed. This creates unemployment. More unemployment means more competition amongst workers which in turn means lower wages. The result is an increase of relative poverty despite an increase of social productivity. The system has to waste time and energy on producing things only necessary in a class society (private security, prisons, arms, elite education etc.). It creates unnecessary labour as a result of bad coordination (companies or departments are only interested in their individual gains) and hierarchical, bureaucratic structures.</li>
<li>Due to its limited goal and internal conflict – the separation of the producers from the means and command of production – the system creates frequent situations of economic crisis. During these crises, production facilities are left unused despite social need. There is too much, rather than too little, but the overproduced items and facilities can’t be sold or used to make profit. An increase of national strife and wars have been historic outcomes of these crises and the only way that the system has to solve them. Another main crisis created by the system is lasting environmental damage. Without getting rid of the class structure of society, the above mentioned crises cannot be avoided or meaningfully confronted. This poses a structural limit to reformism.</li>
<li>The main power of the system lies in the fact that producers can only come together and produce under the system’s command, e.g. only big corporations bring together workers in a global supply chain. This means that although production depends on the work of millions of workers, it seems as if the corporations were the source of production. The production process is structured in a way which keeps individual workers or groups of workers separated and in a hierarchy, e.g. between manual and intellectual workers. The creative capacities of billions of people are wasted on repetitive, useless jobs. By maintaining the divisions between domestic work and social production, between developed and underdeveloped regions, the system reproduces the divisions between men and women, and divisions along ethnic lines.</li>
<li>The second power lies in the state. The state guarantees that the working class remains separated from the means of production and from the products by two main means: a) threatening those with violence who challenge the current property relations and b) using its legal and political arenas to integrate and/or individualise social disputes, e.g. through the courts or the parliament. Operating within the legal structure of the nation state, political parties and trade unions are prone to channel class disputes into legal or parliamentary alleys. This reinforces passivity and illusions amongst workers.</li>
<li>While the potential for a classless society ‘based on the free association of producers’ is objectively given, it depends on the global working class to emancipate itself and create the material basis for a new society. In order to challenge the main pillars of power of the current system mentioned above this process of emancipation will necessarily have to have certain features: a) workers will have to overcome the separations that the current social production process imposes on them; b) workers will have to appropriate the means of production, collectivise knowledge and develop new forms of collective decision making on a local and global scale; on this basis wage labour and money relations can be abolished c) workers will have to confront and overcome the state forces that maintain the current order and property relations.</li>
<li>Revolutionary process is therefore both a material struggle for power over day to day issues (about wages or housing, against harassment), and a learning process on a global scale. Workers have to learn to lead their own struggles and to overcome boundaries set by management and the state. Any forms of organisation that do not aim at self-organisation and activity of workers, but keep the command separate from them cannot be revolutionary. The same is true of organisations that reinforce divisions between workers, e.g. based on professions or nationalities.</li>
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Debate on the current character of hospitals and their restructuring

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Struggles in and beyond the white factory – Organising within hospitals

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